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How Many Radiation Treatments Are Needed For Prostate Cancer

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Working During Radiation Therapy

Which is Better – Surgery vs. Radiation for Prostate Cancer?

Some people are able to work full-time during radiation therapy. Others can work only part-time or not at all. How much you are able to work depends on how you feel. Ask your doctor or nurse what you may expect from the treatment you will have.

You are likely to feel well enough to work when you first start your radiation treatments. As time goes on, do not be surprised if you are more tired, have less energy, or feel weak. Once you have finished treatment, it may take just a few weeks for you to feel betteror it could take months.

You may get to a point during your radiation therapy when you feel too sick to work. Talk with your employer to find out if you can go on medical leave. Check that your health insurance will pay for treatment while you are on medical leave.

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Ng Tohu Matua: Te Maimoatanga Matepukupuku Repe Ure

  • M te mhio ki te whanga o t matepukupuku repe ure, e whina i t rp maimoa ki te whakamahere i maimoatanga.
  • Ka whakaritea he whakamtau toto prostate specific antigen ki te ine i te taumata PSA kei roto i t toto. Mehemea
  • kua piki t PSA, he tohu tnei kua piki ake te mrea o t whai i te matepukupuku repe ure, e ai ki te tangata whai taumata PSA pai.
  • Ara an tahi atu take, atu i te matepukupuku, piki ai te PSA, n reira, kore e taea te whakamahi i te whakamtautau PSA anake ki te whakatau i te matepukupuku repe ure.
  • Ko te whakamtautau -mati tou, ko te porooro, ko te unuhanga tahi atu whakamtautau.Mehemea kei roto te matepukupuku i to tauira unuhanga, ka tauinetia m te whakamahi i te tauine ISUP .
  • He huarahi te mahi tauine ki te krero i te momo hua u ptau matepukupuku, te tere o t rtou tipu, me te hua o tna kaha ki te hrapa ki whi k o te tinana.Tr pea ka whakahaerehia tahi atu titiro whakatau pr ki te CT, ki te MRI rnei, , i tahi w, he titiro whakatau -kiwi.Ka whakamahia ng putanga o ng whakamtautau me ng titiro whakatau ki te krawarawa i te whanga taumata o t matepukupuku tna rahi, me tna kaha rauroha.

Which Approach Is Better: Active Surveillance Surgery Or Radiotherapy

The 10 year outcomes of the Prostate Testing for Cancer and Treatment trial from the United Kingdom has provided valuable insights into the management of localized PCa.4 The trial recruited 1643 men 50 to 69 years old. Of these 545 men underwent active surveillance, 553 surgery, and 545 radiotherapy. For the participants, the median follow-up was 10 years, the median age was 62 years, the median PSA was 4.6 , 77% were Gleason 6 and 21% were Gleason 7, and 76 % were T1c and the remaining T2. There were 17 prostate-cancerspecific deaths overall: 8 in the active surveillance group, 5 in the surgery group, and 4 in the radiotherapy group. The difference was not statistically significant among groups.

Metastases developed in more men in the active-monitoring group than in the surgery group or the radiotherapy group . Higher rates of disease progression were seen in the active-monitoring group than in the surgery group or the radiotherapy group . In summary, at a median of 10 years, prostate-cancerspecific mortality was low irrespective of the treatment assigned, with no significant difference among treatments. Surgery and radiotherapy were associated with lower incidences of disease progression and metastases than was active monitoring, while 44% of the patients who were assigned to active monitoring did not receive radical treatment and avoided side effects.5

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Are There Side Effects Of The Combination Approach To Prostate Cancer Radiation Therapy

When it comes to early stages of disease, patients very frequently do well with either brachytherapy or external beam radiation. Success rates of around 90% or higher can be achieved with either approach. When the disease is somewhat more advanced based on the PSA level, Gleason score, extent of visible disease on magnetic resonance imaging we have learned over the years that higher doses of radiation are critical to achieving better results. Some evidence, including a large trial, suggests that for patients with intermediate- or high-risk prostate cancer, a combined approach using brachytherapy along with external beam radiation may be best compared to standard dose external beam radiation therapy alone.

What Are The Advantages And Disadvantages Of External Beam Radiotherapy

Radiation Therapy Cost For Prostate Cancer

What may be important for one person might not be so important for someone else. If youre offered external beam radiotherapy, speak to your doctor, nurse or radiographer before deciding whether to have it. They can tell you about any other treatment options and help you decide if radiotherapy is right for you.

Advantages of external beam radiotherapy

  • If your cancer is localised or locally advanced, radiotherapy will aim to get rid of the cancer completely.
  • Many men can carry on with many of their normal activities while having treatment, including going to work and driving.
  • Radiotherapy can be an option even if youre not fit or well enough for surgery.
  • Radiotherapy is painless .
  • The treatment itself only lasts around 10 minutes, including the time it takes to get you into position. But youll probably need to be at the hospital for up to an hour each day to prepare for your treatment. You dont need to stay in hospital overnight.

Disadvantages of external beam radiotherapy

I was able to continue working throughout my treatment, although I got tired quickly. I had some side effects but nothing I couldnt cope with. A personal experience

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Bowel And Bladder Problems

Radiation therapy for prostate cancer can irritate the bowel, the bladder, or both.

A person can develop:

Radiation proctitis: Symptoms include diarrhea and blood in the stool.

Radiation cystitis: Symptoms include a need to urinate more often, a burning sensation when urinating, and blood in the urine.

Bladder problems may improve after treatment, but they may not go away completely.

Who Can I Contact If I Have Personal Concerns About My Treatment

Many hospitals and clinics have a staff social worker who can help you during your treatment. Check with your doctor to see if this is available to you.

The social worker can discuss any emotional issues or other concerns about your treatment or your personal situation and provide information about resources. The social worker can also discuss housing or transportation needs if necessary.

People dealing with certain medical issues find it helpful to share experiences with others in the same situation. Your doctor can provide a list of support groups if you are interested. Your social worker can provide additional information, and you can look online for support group resources.

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Radiation Therapy For Prostate Cancer

Radiation therapy uses high-energy rays or particles to kill cancer cells. Depending on the stage of the prostate cancer and other factors, radiation therapy might be used:

  • As the first treatment for cancer that is still just in the prostate gland and is low grade. Cure rates for men with these types of cancers are about the same as those for men treated with radical prostatectomy.
  • As part of the first treatment for cancers that have grown outside the prostate gland and into nearby tissues.
  • If the cancer is not removed completely or comes back in the area of the prostate after surgery.
  • If the cancer is advanced, to help keep the cancer under control for as long as possible and to help prevent or relieve symptoms.

Who Is On My Radiation Therapy Team

Precision Radiation Therapy: Low- to Intermediate-Risk Prostate Cancer

A highly trained medical team will work together to provide you with the best possible care. This team may include the following health care professionals:

Radiation oncologist. This type of doctor specializes in giving radiation therapy to treat cancer. A radiation oncologist oversees radiation therapy treatments. They work closely with other team members to develop the treatment plan.

Radiation oncology nurse. This nurse specializes in caring for people receiving radiation therapy. A radiation oncology nurse plays many roles, including:

  • Answering questions about treatments

  • Monitoring your health during treatment

  • Helping you manage side effects of treatment

Medical radiation physicist. This professional helps design treatment plans. They are experts at using radiation equipment.

Dosimetrist. The dosimetrist helps your radiation oncologist calculate the right dose of radiation.

Radiation therapist or radiation therapy technologist. This professional operates the treatment machines and gives people their scheduled treatments.

Other health care professionals. Additional team members may help care for physical, emotional, and social needs during radiation therapy. These professionals include:

  • Social workers

Learn more about the oncology team.

Read Also: Which Laboratory Test Is Done To Screen For Prostate Cancer

When Is Radiation Therapy Given

Radiation therapy may be used:

  • for localised or locally advanced prostate cancer it has similar rates of success to surgery in controlling prostate cancer that has spread to the lymph nodes
  • if you are not well enough for surgery or are older
  • after a prostatectomy for locally advanced disease, if there are signs of cancer left behind or the cancer has returned where the prostate used to be
  • for prostate cancer that has spread to other parts of the body.

There are two main ways of delivering radiation therapy: from outside the body or inside the body . You may have one of these or a combination of both.

In intermediate and high-risk prostate cancer, radiation therapy is often combined with androgen deprivation therapy .

What Is Radiation Therapy

Radiation is the strategic use of ionizing radiation or photons to kill cancer cells. It works by damaging the cancer cells DNA .The targeted cells die without growing or replicating themselves. Radiation therapy, like surgery, is very effective at killing localized or locally advanced prostate cancer and has the same cure rate as surgery.

Just as surgical skill can play an important role in determining outcomes from prostatectomy, the technical skill of your radiation oncologist can play an important role in radiation outcomes. When choosing a radiation oncologist, look for a physicians who has broad experience with an assortment of approaches and can objectively help you decide on the best course of treatment.

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External Beam Radiation For Prostate Cancer

When most patients think of radiation therapy, they think of external beam radiation therapy , in which a beam of radiation is directed at cancerous tissue from outside the body. Technological advances, such as intensity-modulated radiation therapy and image-guided radiation therapy , allow radiation oncologists to use computer-controlled devices and image-guidance technology to see and target a three-dimensional image of the tumor, making the treatment more precise than ever before.

EBRT used to require 40-45 daily treatments. Now, 25-28 treatments are the norm. This type of protracted, fractionated radiation therapy, however, is now generally considered to be less appropriate for low-risk and favorable intermediate-risk patients. Instead, hypofractionated techniques and brachytherapy techniques are generally more advisable for many patients.

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Treatments For Prostate Cancer

Upfront Radiation May Be a Cost

If you have prostate cancer, your healthcare team will create a treatment plan just for you. It will be based on your health and specific information about the cancer. When deciding which treatments to offer for prostate cancer, your healthcare team will consider:

  • the type and stage of the cancer
  • the grade or Gleason score
  • prostate-specific antigen levels
  • the risk group
  • possible side effects of treatments
  • your personal preferences
  • your overall health and any existing medical conditions
  • your age and life expectancy
  • whether you have symptoms

Prostate cancer treatments can seriously affect your quality of life and cause side effects such as erectile dysfunction and incontinence . Many prostate cancers grow slowly and cause no symptoms or problems.

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Special Diet Needs While On Radiation Therapy

Radiation can cause side effects that make it hard to eat, such as nausea, mouth sores, and throat problems called esophagitis. Since your body uses a lot of energy to heal during radiation therapy, it is important that you eat enough calories and protein to maintain your weight during treatment.

If you are having trouble eating and maintaining your weight, talk to your doctor or nurse. You might also find it helpful to speak with a dietitian. For more information about coping with eating problems see the booklet Eating Hints or read more about side effects.

How Much Radiation Therapy Costs

Radiation therapy can be expensive. It uses complex machines and involves the services of many health care providers. The exact cost of your radiation therapy depends on the cost of health care where you live, what type of radiation therapy you get, and how many treatments you need.

Talk with your health insurance company about what services it will pay for. Most insurance plans pay for radiation therapy. To learn more, talk with the business office at the clinic or hospital where you go for treatment. If you need financial assistance, there are organizations that may be able to help. To find such organizations, go to the National Cancer Institute database, Organizations that Offer Support Services and search for “financial assistance.” Or call toll-free 1-800-4-CANCER to ask for information on organizations that may help.

Also Check: Where Does Prostate Cancer Spread To Bones

Side Effects Of Brachytherapy

Brachytherapy causes the same types of side effects that external beam radiation therapy does, such as erectile dysfunction.

In some instances, side effects to the bowels may be less severe than those caused by EBRT. Side effects that impact the bladder, however, may be more severe.

High-dose brachytherapy may cause temporary pain and swelling. It may also cause your urine to look red or brown for a short period of time.

Brachytherapy presents with some risks that external beam radiation therapy does not. If you have permanent brachytherapy, you may emit radiation to others for several weeks or months. Your doctor may advise you to stay away from pregnant people and small children during this time.

Occasionally, the seeds may migrate away from their original placement. For this reason, you may also be instructed to wear condoms during sexual activity, to protect your partner.

What Are The Side Effects Of External Beam Radiation Therapy

Radiation therapy for prostate cancer: What to expect

As with most prostate cancer treatments, external beam radiation therapy can also cause side effects. The severity can depend on the type of radiation, dose size, length of treatment and area of treatments. These frequently include:

  • Skin irritation
  • Erectile dysfunction
  • Secondary malignancy

If you are considering prostate cancer treatment with a form of EBRT, talk with your radiation oncologist to discuss options, potential side effects, and how those side effects will be managed.

Recently, the FDA approved the use of Space OAR, a hydrogel product for men choosing radiation therapy that can reduce the radiation received by the rectum during treatment. This can help decrease the chances of developing rectal complications such as the inability to control your bowels. The hydrogel is injected between the prostate and rectum where the gel solidifies and creates a space before radiation begins. To learn more about this product, visit the manufacturers site here.

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Heres What You Should Know About This Treatment Option

Men who get diagnosed with prostate cancer have several options to choose from for their next step. Many men with slow-growing, low-risk cancer follow active surveillance, a wait-and-see approach that monitors the cancer for changes.

But if the cancer shows higher risk or has already begun to spread, other treatments are recommended. There are two options: surgery to remove the prostate or radiation to destroy the cancer cells.

Studies comparing these two approaches demonstrate no advantage of one over the other with respect to cancer control. Your path will depend on factors like your current health, the specifics of your cancer, and personal preference. Yet for many men, radiation can be the better option.

“Its much more precise than the traditional radiation used for other kinds of cancer, and research also has found that long-term quality of life is often better, with fewer adverse health effects compared to surgery,” says Dr. Anthony DAmico, a radiation oncologist with Harvard-affiliated Dana-Farber Cancer Institute and Brigham and Womens Hospital.

There are two main ways to deliver radiation to the prostate: external beam radiation and brachytherapy.

If This Uncertainty Would Bother You So Much That It Would Affect Your Quality Of Life Surgery May Be A Better Option For You Phuoc Tran Md Phd

However, if youre okay with waiting for the PSA nadir, and if you dont mind getting treatment over the course of a few weeks instead of in one operation, then radiation may be ideal for you.

What are my options?

Conventional external-beam radiation therapy is given in little doses, a few minutes a day, five days a week, for seven or eight weeks. These small doses minimize the injury risk for the healthy tissue near the tumor. Scientists measure radiation in units called Gy . Most men get a minimum total dose of 75.6 Gy, but could get as much as 81 Gy this works out to 2 Gy or less per day.

The treatment itself is painless just like getting an x-ray at the dentists office. But one big challenge with getting repeated treatments is making sure youre always in the exact same position, so the radiation can hit the target the way its supposed to. Thus, you will be custom-fitted with your own pelvic immobilization device, which will not only keep you from fidgeting, but will make sure youre not slightly higher and to the right on the table one day, and slightly lower and to the left the next.

When you get fitted for your device, you will have a CT scan, so doctors can get a 3D look at your prostate. Then, when you get the radiation, you wont just get it from one side, but from multiple directions, and each beam of radiation will be individually shaped to target the cancer and a 5- to 10-millimeter margin of healthy tissue around the prostate.

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