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How Successful Is Radiation Treatment For Prostate Cancer

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How Has Radiation Therapy For Prostate Cancer Evolved In Recent Years

Radiation therapy for prostate cancer: What to expect

Radiation has evolved dramatically in the last 40 years, and during that time, our ability to plan and deliver treatment has changed at about the same rate as computers have progressed. Think of your computer 10 years ago and your iPad now, says Dr. Yu. You might have heard about your fathers or grandfathers perhaps difficult radiation experience in the 1970s or 80s, so you may be wary. But todays radiation therapy is so different we plan, deliver, and aid in recoveries that have better outcomes and fewer side effects than in the past.

Active Surveillance And Watchful Waiting

If prostate cancer is in an early stage, is growing slowly, and treating the cancer would cause more problems than the disease itself, a doctor may recommend active surveillance or watchful waiting.

Active surveillance. Prostate cancer treatments may seriously affect a person’s quality of life. These treatments can cause side effects, such as erectile dysfunction, which is when someone is unable to get and maintain an erection, and incontinence, which is when a person cannot control their urine flow or bowel function. In addition, many prostate cancers grow slowly and cause no symptoms or problems. For this reason, many people may consider delaying cancer treatment rather than starting treatment right away. This is called active surveillance. During active surveillance, the cancer is closely monitored for signs that it is worsening. If the cancer is found to be worsening, treatment will begin.

ASCO encourages the following testing schedule for active surveillance:

  • A PSA test every 3 to 6 months

  • A DRE at least once every year

  • Another prostate biopsy within 6 to 12 months, then a biopsy at least every 2 to 5 years

Treatment should begin if the results of the tests done during active surveillance show signs of the cancer becoming more aggressive or spreading, if the cancer causes pain, or if the cancer blocks the urinary tract.

What Is Stereotactic Body Radiation Therapy And What Advantages Does It Offer

Traditionally, we deliver external beam radiation in 45 to 48 sessions over a span of ten weeks, using very sophisticated computer-based planning and enhanced imaging techniques and tumor tracking during the treatment. This is called image-guided IMRT and it is the current standard of care.

But there is increasing interest in giving this radiation in shorter courses of treatment. Many of the people we care for have a type of radiation therapy called MSK PreciseTM. MSK Precise is a form of SBRT that can be given in five sessions instead of the usual 45 to 50. MSK has been doing this for the past nine years, and the results in the several hundred people whove been treated have been excellent so far. The treatment is very well tolerated, with outcomes that are at least equivalent to and possibly better than the standard ten weeks of treatment. Because of its superior precision, MSK Precise has less side effects than more conventional radiation techniques, with extremely low rates of incontinence and rectal problems. The sexual side effects are low and similar to what is experienced with conventional external radiation techniques. And of course, its much more convenient for patients.

For patients with more-advanced tumors, we are completing a phase II trial in which were combining sophisticated brachytherapy approaches with MSK Precise. This kind of combination of dose-intense or escalated radiation may end up being a very effective regimen.

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What Happens During Radiation Therapy

Radiation therapy uses high-energy x-rays or a stream of particles . High doses of radiation can destroy abnormal cancer cells. Each treatment destroys some of the cancer cells at a microscopic level. Patients do not feel the radiation during treatment. They will only hear some electrical noise and may see light from the machine.

Where You Get Treated Matters

Radiation Therapy for Prostate Cancer Treatment

Like all radiation therapies, brachytherapy is best administered by medical professionals who specialize in the treatment.

Fox Chase was the first to perform HDR prostate implants in the eastern United States and has one of the largest and most experienced brachytherapy programs in the region.

At Fox Chase, we have our own brachytherapy operating room in the radiation oncology department, Horwitz said. The physicians, the physicists, the nurses, the anesthesiologistsall of us do this all the time, so we’re very good at it.

Learn more about brachytherapy treatment at Fox Chase Cancer Center.

You can also request an appointment with a Fox Chase medical professional online. Or you can call .

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What Are The Side Effects Of Hormone Therapy For Prostate Cancer

Because androgens affect many other organs besides the prostate, ADT can have a wide range of side effects , including:

  • loss of interest in sex
  • Studer UE, Whelan P, Albrecht W, et al. Immediate or deferred androgen deprivation for patients with prostate cancer not suitable for local treatment with curative intent: European Organisation for Research and Treatment of Cancer Trial 30891. Journal of Clinical Oncology 2006 24:18681876.

  • Zelefsky MJ, Eastham JA, Sartor AO. Castration-Resistant Prostate Cancer. In: Vincent T. DeVita J, Lawrence TS, Rosenberg SA, eds. DeVita, Hellman, and Rosenberg’s Cancer: Principles & Practice of Oncology, 9e. Philadelphia, PA: Lippincott Williams & Wilkins 2011.

  • Smith MR, Saad F, Chowdhury S, et al. Apalutamide and overall survival in prostate cancer. European Urology 2021 79:150158.

  • How Does External Beam Radiation Therapy Work

    External beam radiation therapy, or EBRT, uses a machine to direct high-energy X-rays at the cancer in daily doses. The radiation beam is generated by a machine called a linear accelerator or LINAC. Using treatment planning computers and software, your treatment team controls the size and shape of the beam as well as how it is directed at your body to most effectively treat your tumor and minimize damage to surrounding normal tissue.

    To minimize side effects, the treatments are typically given five days a week over a six-to-nine week period. The break in days allows the doctors to get enough radiation into the body to kill the cancer while giving healthy cells time to recover.

    Watch our expert medical oncologist, Dr. Alicia Morgans from Vanderbilt-Ingram Cancer Center, discuss external beam radiation therapy:

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    Are There Any Long

    Long-term risks are slight, but do exist. Its rare but possible that a patient will suffer worsening urinary and rectal function, and there is always a risk of radiation causing cancer.

    “Because there are some risks, albeit small ones, we do not treat a patient unless we believe that we can have a real impact on his survival,” says Dr. Yu. For a patient with a very slow-growing cancer, we typically monitor instead of advising immediate treatment.”

    What Is The Success Rate Of Radiation Therapy For Prostate Cancer

    Trial finds most effective prostate cancer therapy

    Men with localised prostate cancer who are treated with external-beam radiation therapy have a cure rate of 95.5% for intermediate-risk prostate cancer and 91.3% for high-risk prostate cancer. The 5-year survival rate using this treatment is 98.8% overall.

    Accordingly, can prostate cancer be cured with radiation?

    Treatment for Prostate Cancer: External-Beam Radiation Therapy. If you have localized prostate cancer that needs curative treatment, you have two good options: Radiation and surgery. More than 60,000 American men opt for radiation every year, and the cure rates are excellent.

    How long do you need radiation therapy for prostate cancer?

    External beam radiation therapy is given to you five days a week for four to eight weeks. The total dose of radiation and the number of treatments you need depends on the size of your prostate cancer, your general health, and other medical treatments you have had or need to have.

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    What Are Potential Side Effects

    Typically, prostate-cancer patients tolerate radiation well.

    During the first several weeks, side effects are minimal.

    In the following weeks, you may begin to experience a few changes, including irritative urinary and bowel symptoms.

    “We manage those with changes to diet, or medication,” says Dr. Yu. “We have helpful clinical nutritionists who can help ease side effects related to treatment, and if a patient has severe side effects, its possible to suspend treatment for a week.”

    There is a small risk of a major medical problem, such as rectal bleeding, after radiation. In recent years, the precision of radiotherapy has helped to reduce such complications. Doctors track their patients regularly after treatment in order to catch any serious symptoms early.

    “Our urology group is also exploring focal salvage therapies that may be able to address residual cancer that returns after radiation treatment,” says Dr. Yu.

    How Can I Choose From Among The Options

    In addition to talking with family and friends, you will need a team of physicians to help advise you. You should meet with everyone involved in your treatment planning before choosing a treatment, including:

    • your primary care doctor
    • a urologist to discuss surgery
    • a radiation oncologist to discuss radiation therapy
    • a medical oncologist to discuss hormone suppression, if your cancer is more advanced

    After you meet with these doctors, you can make an informed decision regarding your treatment options. You may have an early-stage or moderately advanced cancer with no evidence of spread to other organs . If so, your two major treatment options are active surveillance , surgery or radiation therapy .

    You may have advanced cancer and require hormonal suppression therapy or chemotherapy. If so, you will need a medical oncologist to administer these drugs. Doctors use hormone-ablation therapy to treat advanced prostate cancer. It suppresses androgen because these hormones stimulate most prostate cancer growth. Your internist, urologist, radiation oncologist or medical oncologist may administer the treatment. Depending on the stage of the cancer, your doctor may use hormone suppression therapy and radiation therapy to help control your disease. You may receive hormone suppression therapy for as little as four to six months, or for as long as two to three years.

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    Are There Side Effects Of The Combination Approach

    There is a slightly higher chance that patients who receive the combined therapy will have rectal irritation or urinary side effects, both of which are common with any radiation treatment given to the prostate. But at MSK, we routinely use sophisticated planning techniques that help us reduce the dose given to normal tissues such as the rectum, bladder, and urethra, lessening the chances of side effects and complications.

    In addition, at MSK, we routinely use a rectal spacer gel, which we inject between the prostate and the rectum while the patient is under mild anesthesia, to create a buffer between these two tissues. By creating this space, we can further reduce the dose of radiation that the rectum is exposed to. This leads to fewer side effects for the patient. The rectal spacer gel is biodegradable and after a few months dissolves on its own within the body, causing no harm or long-term effects.

    Can Prostate Cancer Be Cured With Radiation

    South West Voice

    Treatment for Prostate Cancer: External-Beam Radiation Therapy. If you have localized prostate cancer that needs curative treatment, you have two good options: Radiation and surgery. More than 60,000 American men opt for radiation every year, and the cure rates are excellent.

    People also ask, what is the success rate of radiation therapy for prostate cancer?

    Men with localised prostate cancer who are treated with external-beam radiation therapy have a cure rate of 95.5% for intermediate-risk prostate cancer and 91.3% for high-risk prostate cancer. The 5-year survival rate using this treatment is 98.8% overall.

    How long do you need radiation therapy for prostate cancer?

    External beam radiation therapy is given to you five days a week for four to eight weeks. The total dose of radiation and the number of treatments you need depends on the size of your prostate cancer, your general health, and other medical treatments you have had or need to have.

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    Q: What Can Be Expected During Prostate Cancer Radiation Therapy

    EBRT is similar to having a routine X-ray. Radiation is not seen, smelled or felt and side effects dont occur until 2 or 3 weeks into treatment. Prostate cancer radiation therapy is a local treatment so only the areas of the body where it is administered will experience side effects.

    Most patients experience some or all of the following prostate cancer radiation therapy side effects:

    • Burning or tingling with urination
    • Difficulty starting urination or weak urinary stream
    • Hemorrhoids or rectal irritation with some blood
    • Increase in urination frequency and urgency
    • Infrequent, softer and smaller volume bowel movements
    • Occasional diarrhea

    Depending on the severity of these side effects, patients will be given anti-diarrheal medications or a medication to decrease the frequency of urination. Most symptoms are short-lived and diminish after the prostate cancer radiation therapy ends. Otherwise, patients typically continue with their normal daily activities during treatment.

    Patients are given detailed written instructions about the following:

    Sperm production Prostate cancer radiation therapy affecting the testicles may lead to a temporary reduction in sperm count and, in some cases, lead to a permanent reduction in sperm count or sterility. Patients who are considering conceiving should seek medical advice regarding fertility and sperm banking.

    Reduce Radiation Side Effects During Prostate Cancer Treatment

    R. Alex Hsi, M.D. describes a simple but effective process to reduce side effects of radiation during prostate cancer treatment.

    Transcript: Reduce Radiation Side Effects

    The procedure we performed today was the placement of SpaceOar Hydrogel. Is a brand new product, recently approved by the FDA, just a few months ago.

    The idea is to actually place a water based gel in between the prostate and the rectum to push the two organs away from each other. Because as we give radiation to the prostate, it can give some radiation to the rectum, create some what we call collateral damage. This is a very simple concept, putting the SpaceOar gel in between the two we are pushing the rectum away and reducing the radiation dose.

    At PCC, we were one of the principal investigators in this trial.

    We place a needle between the prostate and rectum and take a double barreled syringe with a wide connector, connected to the backend of the needle. As you push the two syringes together the two liquids start to mix in the needle. By the time they get into the space between the prostate and rectum, they turn into a solid gel.

    It creates a space of about a centimeter or ten to twelve millimeters. That increases the space from about two millimeters, which is normal to about twelve.

    While the reduction in dose is about seventy five percent and that translates to about seventy percent reduction in rectal side effects.

    Prostate Cancer FreeVideo by Peninsula Cancer Center, Poulsbo, WA.

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    Next Steps & Resources:

    • Learn more about our featured clinical experts:
    • Glen Gejerman, M.D., co-director of urologic oncology at Hackensack Meridian Healths John Theurer Cancer Center and associate professor of Oncology at the Hackensack Meridian School of Medicine.
    • Prashant Desai, M.D., medical director of radiation oncology at Hackensack Meridian Ocean Medical Center.
    • Priti Patel, M.D., medical director of radiation oncology at Hackensack Meridian Riverview Medical Center.

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    Questions To Ask Your Doctor Nurse Or Radiographer

    Radiation therapy for prostate cancer: one patient’s story

    You may find it helpful to keep a note of any questions you have to take to your next appointment.

    • What type of radiotherapy will I have?
    • How many sessions will I need?
    • What other treatment options do I have?
    • What are the possible side effects and how long will they last?
    • What treatments are available to manage the possible side effects from radiotherapy?
    • Will I have hormone therapy and will this carry on after radiotherapy?
    • How and when will I know if radiotherapy has worked?
    • If the radiotherapy doesnt work, which other treatments can I have?
    • Who should I contact if I have any questions?
    • What support is there to help manage long-term side effects?

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    Who Remained Prostate Cancer Free

    You want your prostate cancer treatment to be successful. But how does one measure prostate cancer treatment success. Often, a successful prostate cancer treatment is measured by survival. If the patient does not die during treatment, was the treatment successful? Even if the cancer returns? Prostate Cancer Free Foundation, aims for a much higher standard. We want the cancer to go away, and never come back. That is what we call success anything else is failure.

    You want your prostate cancer treatment to be successful. But how does one measure prostate cancer treatment success. Often, a successful prostate cancer treatment is measured by survival. If the patient does not die during treatment, was the treatment successful? Even if the cancer returns? Prostate Cancer Free Foundation, aims for a much higher standard. We want the cancer to go away, and never come back. That is what we call success anything else is failure.

    Possible Side Effects Of Radiation Treatment For Prostate Cancer

    The radiation used to destroy cancer cells can also hurt normal cells in the nearby area. Side effects from radiation treatment are related to the area of the body being treated. Patients start to have side effects a few weeks into their treatment. While side effects may be unpleasant, there are treatments to help deal with them. Most side effects are temporary and slowly start to go away once treatment is done.

    You will be seen by your radiation oncology providers often during treatment. These visits are a chance to ask questions and to talk about any side effects and how to best manage them. You can also call your providers to speak about any side effects.

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