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How To Prepare For Prostate Radiation Therapy

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Spaceoar For Prostate Radiation Therapy

Radiation therapy for prostate cancer: What to expect

Radiation therapy is a treatment option for prostate cancer. Radiation therapy can be very effective in treating prostate cancer. Some providers may suggest the use of SpaceOAR with treatment. The use of SpaceOAR can reduce radiation exposure to the rectum, and potentially reduce side effects from radiation therapy.

Who Can Undergo External Radiation Therapy

  • Radiation therapy is for men with prostate cancer of all stages and risks of progression. It can be used as the sole treatment or in conjunction with hormone therapy.
  • Men who are not good candidates for surgery because of other health problems or their age.
  • Men in whom the cancer has not been completely eliminated or in whom the cancer has reappeared after surgery.
  • Men whose cancer has spread beyond the prostate and into the surrounding tissues. The treatment is combined with hormone therapy before and after radiation therapy. This treatment can also be offered to men who have few metastases.
  • Men whose cancer cells have spread to the bones, to help reduce the size of the tumor or to ease the pain caused by bone metastases.

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Surgical procedures to remove the diseased prostate are usually necessary. Surgical procedures are not always necessary. If the disease is caused by bacterial infections, a doctor can treat the symptoms using alpha-blockers or surgery. Physical therapy, relaxation exercises, and warm baths are all recommended. A physician may also prescribe antibiotics to cure the infection. A bacterial infection can also cause a recurrence of the condition.

An enlarged prostate can be uncomfortable for both men and women. Some of the symptoms of an enlarged male reproductive organ include a weakened urine stream, urgent need to urinate, and urinary tract infections. BPH can also cause damage to the kidneys. A sudden inability to urinate can be life-threatening, as it can lead to bladder and kidney damage. Unfortunately, most men with enlarged prostrates put up with the symptoms for years before they seek treatment. However, many of the men with symptoms finally decide to go to a doctor for proper gynecological evaluation and to begin enlarged prostatic therapy.

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Who Is On My Radiation Therapy Team

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.

External Beam Radiation Therapy

The Advantages of Radiation Therapy for Prostate Cancer ...

In EBRT, beams of radiation are focused on the prostate gland from a machine outside the body. This type of radiation can be used to try to cure earlier stage cancers, or to help relieve symptoms such as bone pain if the cancer has spread to a specific area of bone.

You will usually go for treatment 5 days a week in an outpatient center for at least several weeks, depending on why the radiation is being given. Each treatment is much like getting an x-ray. The radiation is stronger than that used for an x-ray, but the procedure typically is painless. Each treatment lasts only a few minutes, although the setup time getting you into place for treatment takes longer.

Newer EBRT techniques focus the radiation more precisely on the tumor. This lets doctors give higher doses of radiation to the tumor while reducing the radiation exposure to nearby healthy tissues.

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What Happens To The Prostate After Radiation

The entire prostate gland is radiated when we treat the cancer. The prostate normally produces some of the fluid in the ejaculation. Radiation therapy has the side effect of damaging the glands in the prostate, so a lot less fluid is produced. The ejaculation may be dry or nearly dry. In addition, you will probably be sterile after radiation, but this is not 100% guaranteed and should not be relied upon as a form of birth control. You can still usually have erections because the nerves and blood vessels that go to the penis are not as damaged as the prostate gland.

The prostate gland will end up having a lot of scar tissue. It will shrink in size to about half its original weight within a couple years after finishing radiation. The urethra passes through the canter of the prostate gland like the hole of a doughnut. Sometimes this passage can widen, other times it can shrink after radiation. In summary, the prostate gland is heavily damaged from radiation and does not work normally afterwards.

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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Weekly Visits During Your Treatment

Your radiation oncologist and radiation nurse will see you each week to talk with you about any concerns, ask about any side effects you may be having, and answer your questions. This visit will be before or after your treatments each ________________. You should plan to be at your appointment for about 1 extra hour on those days.

If you need to speak with your radiation oncologist or radiation nurse any time between your weekly visits, call your radiation oncologists office or ask the support staff or your radiation therapists to contact them when you come in for treatment.

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How to prepare for your prostate CT planning appointment

The main purpose of the prostate is to produce semen, a milky fluid that sperm swims in. During puberty, the body produces semen in a large number of cases, including enlarged prostate. This fluid causes the prostate to swell and cause a number of bladder-related symptoms. This is why the prostate is important to the body. It can be caused by many factors, including infection and inflammation.

A enlarged prostate can also cause blockages in the urethra. A blocked urethra can also damage the kidneys. A patient suffering from an enlargement of the prostate may have pain in his lower abdomen and genitals. If pain is present, a digital rectal examination will reveal hard areas. A doctor may prescribe surgery or perform an endoscopic procedure. If the enlarged prostate is not completely removed, it will shrink.

While the size of an enlarged prostate will influence the extent of urinary symptoms, men may experience a range of urinary symptoms. Some men have minimal or no symptoms at all. Some men will have a very enlarged prostate, whereas others will have a mild enlargement. Generally, the symptoms can stabilize over time. Some men may have an enlarged prostate but not notice it. If they have an enlarged colon, their physician can perform a TURP procedure.

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Signs Of Prostate Cancer Include A Weak Flow Of Urine Or Frequent Urination

These and other signs and symptoms may be caused by prostate cancer or by other conditions. Check with your doctor if you have any of the following:

  • Weak or interrupted flow of urine.
  • Sudden urge to urinate.
  • Trouble starting the flow of urine.
  • Trouble emptying the bladder completely.
  • Pain or burning while urinating.
  • Blood in the urine or semen.
  • A pain in the back, hips, orpelvis that doesnât go away.
  • Shortness of breath, feeling very tired, fast heartbeat, dizziness, or pale skin caused by anemia.

Other conditions may cause the same symptoms. As men age, the prostate may get bigger and block the urethra or bladder. This may cause trouble urinating or sexual problems. The condition is called benign prostatic hyperplasia , and although it is not cancer, surgery may be needed. The symptoms of benign prostatic hyperplasia or of other problems in the prostate may be like symptoms of prostate cancer.

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Diarrhea And Rectal Discomfort

Many people develop diarrhea within the first few weeks after treatment begins. Its also common to have cramping, pressure, and discomfort in your rectal area. You may also strain to have a bowel movement with no results.

There are some ways to help you manage these issues. Start following these guidelines if and when you begin to have symptoms. Continue them until your bowel movements return to your usual pattern. This may take 2 to 4 weeks after your treatment is completed.

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Possible Side Effects Of Radiation Treatment

There are possible side effects associated with radiation therapy. Some people may not experience any side effects. Others may experience mild or bothersome side effects.

Some side effects may only last a short period of time, and others may last longer or forever. Side effects may occur at the time of treatment or could develop months after treatment.

Most side effects are manageable by your radiation team and last only a short time. Before starting treatment, your doctor will discuss possible side effects and their duration.

Because we use advanced targeting technology, the probability of side effects is lower.

Possible side effects include:

Bowel Issues Because radiation treatment is so close to the rectum, it could cause irritation. This irritation could cause soreness, blood in your stool, or rectal leakage. Most of the time these issues are temporary, but in rare cases, normal bowel function does not return. Because patients use a rectal balloon during each treatment, the likelihood of rectal issues is lower.

Urinary Issues Radiation can cause irritation to the bladder. This can cause urinary frequency, urgency and a burning sensation. If these problems occur, they generally go away after time.

Keeping your activity level up will result in less fatigue and feeling better.

Keeping your activity level up will result in less fatigue and you will feel better overall.

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Frequent Urination Burning With Urination And Difficulty Urinating

External beam radiation for prostate cancer

These are the most common complaints. Occasionally the urinary stream will weaken. Generally these symptoms are managed with medications to help the bladder function better or eliminate burning. Rarely, your doctor may order a urine test. Symptoms will resolve after the end of treatment. Contact your doctor if you see blood in your urine or if you are unable to urinate.

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Weekly Visits During Treatment

Your radiation oncologist and radiation nurse will see you each week to evaluate your response to treatment, ask about any side effects you may be having, and answer your questions. This visit will be before or after your treatments each _____________. You should plan on being in the department about 1 extra hour on those days.

If you need to speak with your radiation oncologist or radiation nurse any time between these weekly visits, call your radiation oncologists office or ask the support staff or your therapists to contact them when you come in for treatment.

What Are Male Sex Hormones

Hormones are substances that are made by glands in the body. Hormones circulate in the bloodstream and control the actions of certain cells or organs.

Androgens are a class of hormones that control the development and maintenance of male characteristics. The most abundant androgens in men are testosterone and dihydrotestosterone .

Androgens are required for normal growth and function of the prostate, a gland in the male reproductive system that helps make semen. Androgens are also necessary for prostate cancers to grow. Androgens promote the growth of both normal and cancerous prostate cells by binding to and activating the androgen receptor, a protein that is expressed in prostate cells . Once activated, the androgen receptor stimulates the expression of specific genes that cause prostate cells to grow .

Almost all testosterone is produced in the testicles a small amount is produced by the adrenal glands. Although prostate cells do not normally make testosterone, some prostate cancer cells acquire the ability to do so .

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Day Of Your Simulation

You may need to drink 1 glass of water 1 hour before your simulation and on each day of your treatment. This will make your bladder full and will move your small intestine away from the area receiving radiation. Your radiation oncologist or nurse will tell you if you need to do this.

Once you arrive

A member of your radiation therapy team will check you in. You will be asked to state and spell your full name and birth date many times. This is for your safety. People with the same or similar name may be having care on the same day as you.

You will be greeted by your radiation therapist. They will take a photograph of your face. This picture will be used to identify you throughout your treatment.

Your radiation therapist will then explain the simulation to you. If you havent already signed a consent form, your radiation oncologist will review everything with you, and ask for your signature.

Getting contrast

You may get contrast before your procedure. Contrast makes your small intestine easier to see on the scan. It can also be used to locate the bladder, rectum, and vagina . If you need contrast, you will get it in 1 or more of the following ways:

You may also have a catheter inserted into your rectum to remove air. This will help your radiation therapist see your rectum on the scan.

A temporary marker may also be placed near your anus. This will be removed at the end of your simulation and will not be used again until your treatment begins. This will take about 30 minutes.

How Is Hormone Therapy Used To Treat Hormone

Preparing for prostate radiotherapy treatment

Hormone therapy may be used in several ways to treat hormone-sensitive prostate cancer, including:

Early-stage prostate cancer with an intermediate or high risk of recurrence. Men with early-stage prostate cancer that has an intermediate or high risk of recurrence often receive hormone therapy before, during, and/or after radiation therapy, or after prostatectomy . Factors that are used to determine the risk of prostate cancer recurrence include the grade of the tumor , the extent to which the tumor has spread into surrounding tissue, and whether tumor cells are found in nearby lymph nodes during surgery.

The use of hormone therapy before prostatectomy has not been shown to be of benefit and is not a standard treatment. More intensive androgen blockade prior to prostatectomy is being studied in clinical trials.

Relapsed/recurrent prostate cancer. Hormone therapy used alone is the standard treatment for men who have a prostate cancer recurrence as documented by CT, MRI, or bone scan after treatment with radiation therapy or prostatectomy.

Hormone therapy is sometimes recommended for men who have a âbiochemicalâ recurrencea rise in prostate-specific antigen level following primary local treatment with surgery or radiationespecially if the PSA level doubles in fewer than 3 months.

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New Radiation Therapy Guidelines For Prostate Cancer Lowers Treatment Burden And Cost

Targeted Therapies in Oncology Staff WriterTargeted Therapies in Oncology

For clinicians who treat men with early-stage prostate cancer in their clinical practice, a new clinical guideline on the use of external beam radiation therapy has been developed by a panel of experts representing the American Society of Clinical Oncology, American Society for Radiation Oncology, and American Urological Association.

For clinicians who treat men with early-stage prostate cancer in their clinical practice, a new clinical guideline on the use of external beam radiation therapy has been developed by a panel of experts representing the American Society of Clinical Oncology , American Society for Radiation Oncology, and American Urological Association.1Incorporating these guidelines into practice may make treatment shorter and more convenient for patients with localized disease.

Scott Morgan, MD, an assistant professor of radiation oncology at the University of Ottawa and cochair of the guideline panel, said in an ASCO press release, Men who opt to receive hypofractionated radiation therapy will be able to receive a shorter course of treatment, which is a welcome benefit to many men. When clinicians can reduce overall treatment time while maintaining outcomes, its to our patients benefit, as they can spend less time away from family and less time traveling to and from treatment.

Motivation for Hypofractionation Guidelines

Hypofractionation Determinations for Localized Prostate Cancer

What Happens After Radiotherapy

After youve finished your radiotherapy, you will have regular check-ups to monitor your progress. This is often called follow-up. The aim is to:

  • check how your cancer has responded to treatment
  • help you deal with any side effects of treatment
  • give you a chance to raise any concerns or ask any questions.

Your follow-up appointments will usually start two or three months after treatment. You will then have appointments every three to six months. After three years, you may have

follow-up appointments less often. Each hospital will do things slightly differently, so ask your doctor or nurse for more details about how often you will have follow-up appointments.

PSA test

The PSA test is a blood test that measures the amount of a protein called prostate specific antigen in your blood. You will usually have a PSA test a week or two before each follow-up appointment, so the results are available at your check-up. This can often be done at your GP surgery. PSA tests are a very effective way of checking how well your treatment has worked.

After treatment, your PSA level should start to drop. Your PSA level wont fall to zero as your healthy prostate cells will continue to produce some PSA. But it could fall to about 1 ng/ml, although every man is different and your medical team will monitor your PSA level closely.

Treatment options after radiotherapy

Looking after yourself after radiotherapy

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