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Prostate Cancer Radiation Treatment Options

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Need Of Radiation Therapy For Prostate Cancer

Siteman experts explain prostate cancer treatment options

Generally, radiation therapy or radiotherapy for prostate cancer is given to the cancer patient at different points during the treatment routine. This treatment can be provided

  • As the first treatment for men with low-grade cancer or when the cancer is in the early stage and is contained within the prostate gland.
  • As a part of the first treatment in combination with other treatments like hormone therapy to patients whose cancer has grown and spread into nearby tissues outside the prostate.
  • As a post-surgery to prevent cancer recurrence.
  • Symptomatic relief to the patient if prostate cancer has advanced and spread outside the prostate.
  • Will My Diet Affect My Treatment

    Yes. Good nutrition is an important part of recovering from the side effects of radiation therapy.

    When you eat well, you have the energy to do the activities you want to do, and your body is able to heal and fight infection. Most importantly, good nutrition can give you a sense of well-being.

    Since eating when you don’t feel well can be hard, let your treatment team know if youâre having trouble. You could also consider working with a dietitian. They can help make sure that youâre getting enough nutrition during your radiation therapy.

    These tips might help while youâre going through treatment:

    Try new foods. Things that you havenât liked in the past may taste better to you during treatment.

    Power up with plant-based foods. They can be healthy and tasty substitutes for meat. So for instance, swap out a burger or chicken for beans and peas at a few meals each week.

    Eat a rainbow of fruit and vegetables. Get your fill of these healthy powerhouses every day. Good options include spinach, raspberries, yellow peppers, carrots, and cauliflower.

    Limit or avoid unhealthy choices. That includes red or processed meats, sugary foods and drinks, and processed foods.

    Aim to stay at a healthy weight during treatment. You can ask your doctor what your ideal range on the scale should be. Itâs normal to have small weight changes while you go through treatment.

    Try to stay physically active. If youâre not active now, you can ask your doctor how to move more and exercise safely.

    Getting Help With Treatment Decisions

    Making such a complex decision is often hard to do by yourself. You might find it helps to talk with your family and friends before making a decision. You might also find it helpful to speak with other men who have faced or are currently facing the same issues. The American Cancer Society and other organizations offer support programs where you can meet and discuss these and other cancer-related issues. For more information about our programs, call us toll-free at 1-800-227-2345 or see Find Support Programs and Services.

    Itâs important to know that each manâs experience with prostate cancer is different. Just because someone you know had a good experience with a certain type of treatment doesnât mean the same will be true for you.

    You might also want to consider getting more than one medical opinion, perhaps even from different types of doctors. For early-stage cancers, it is natural for surgical specialists, such as urologists, to favor surgery and for radiation oncologists to lean more toward radiation therapy. Doctors specializing in newer types of treatment may be more likely to recommend their therapies. Talking to each of them might give you a better perspective on your options. Your primary care doctor may also be helpful in sorting out which treatment might be right for you.

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    What Types Of Radiotherapy Are There

    There are different types of external beam radiotherapy used to treat prostate cancer. Ask your doctor, nurse or therapeutic radiographer which type of radiotherapy you are being offered, and for how long.

    Intensity-modulated radiotherapy

    This is the most common type of external beam radiotherapy in the UK. A computer uses the scans from your radiotherapy planning session to map the location of your prostate and the organs near it to work out the precise radiation dose and create a plan for your radiotherapy treatment.

    The radiotherapy machine gives out beams of radiation that match the shape of the area to be treated as closely as possible. This helps to avoid damaging the healthy tissue around it, reducing the risk of side effects. It also allows the treatment area to get the right doses of radiotherapy to get rid of the cancer. Most radiotherapy centres use a type of IMRT technique called VMAT . It is also sometimes called RapidArc.

    Stereotactic radiotherapy

    Stereotactic radiotherapy, also known as stereotactic ablative radiotherapy , is another type of external beam radiotherapy that is offered in some hospitals. SABR gives a much higher dose of radiation to the treatment area at each treatment session compared to IMRT, but a lower dose overall. You will have fewer treatment sessions with this technique. It is a very precise treatment that can be delivered on a standard Linac machine.

    Proton beam therapy

    Faq: Radiation Therapy For Prostate Cancer


    Why would I choose radiation therapy?

    Radiation therapy, including external beam radiation therapy and brachytherapy, is an alternative form of treatment for prostate cancer. EBRT may be used after other treatments, such as surgery, to manage cancer that has recurred or is at high risk of recurrence. Radiation therapy has an excellent record of success, providing long-term disease control and survival rates equivalent to other treatments, including surgery.

    How should I expect to feel during radiation therapy?

    Undergoing external beam radiation therapy is similar to having a routine X-ray. Radiation cannot be seen, smelled or felt. Generally, side effects don’t appear until the second or third week of treatment. Because radiation therapy is a local treatment, only the areas of the body where it is directed will experience side effects. Most patients will experience some or all of the following:

    • Increase in the frequency of urination
    • Urinary urgency
    • Softer and smaller volume bowel movements
    • Increased frequency of bowel movements
    • Worsening of hemorrhoids or rectal irritation with occasional scant blood and fatigue

    Many questions may arise during radiation therapy treatment. Your doctors will be available to answer questions throughout your treatment.

    How should I expect to feel after radiation therapy?

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    If Treatment Does Not Work

    Recovery from cancer is not always possible. If the cancer cannot be cured or controlled, the disease may be called advanced or terminal.

    This diagnosis is stressful, and for some people, advanced cancer may be difficult to discuss. However, it is important to have open and honest conversations with your health care team to express your feelings, preferences, and concerns. The health care team has special skills, experience, and knowledge to support patients and their families and is there to help. Making sure a person is physically comfortable, free from pain, and emotionally supported is extremely important.

    People who have advanced cancer and who are expected to live less than 6 months may want to consider hospice care. Hospice care is designed to provide the best possible quality of life for people who are near the end of life. You and your family are encouraged to talk with the health care team about hospice care options, which include hospice care at home, a special hospice center, or other health care locations. Nursing care and special equipment, including a hospital bed, can make staying at home a workable option for many families. Learn more about advanced cancer care planning.

    After the death of a loved one, many people need support to help them cope with the loss. Learn more about grief and loss.

    Transurethral Resection Of The Prostate

    If cancer cannot be completely removed by a prostatectomy, a transurethral resection of the prostate may be recommended instead. The procedure is usually performed to ease urinary symptoms associated with prostate cancer.

    A 1- to 2-day hospital stay is usually necessary. A urinary catheter is placed in the bladder during the hospital stay. Symptom relief occurs quickly, sometimes after only a few days.

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    After Prostate Cancer Has Been Diagnosed Tests Are Done To Find Out If Cancer Cells Have Spread Within The Prostate Or To Other Parts Of The Body

    The process used to find out if cancer has spread within theprostate or to other parts of the body is called staging. The information gathered from the staging process determines the stage of the disease. It is important to know the stage in order to plan treatment. The results of the tests used to diagnoseprostate cancer are often also used to stage the disease. In prostate cancer, staging tests may not be done unless the patient has symptoms or signs that the cancer has spread, such as bone pain, a high PSA level, or a high Gleason score.

    The following tests and procedures also may be used in the staging process:

    Radiation Therapy For Advanced Prostate Cancer

    Prostate Cancer Treatment Options | Virtual Event

    When prostate cancer spreads, it tends to travel first to the bones. This may be diagnosed using imaging tests such as computed tomography scans. Cancer in the bones may cause pain and discomfort, so radiation is one tool that doctors may recommend to help manage the disease. Other commonly used treatments for advanced prostate cancer include chemotherapy, hormone therapy or immunotherapy.

    External radiation therapy may be used to help reduce bone pain by targeting specific tumors, especially on the spine.

    Some patients with advanced cancer may qualify to be part of a clinical trial involving radiation. In clinical trials, researchers study the effect of new treatments to see whether these are as safe and comprehensive as current treatments, or better.

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    Will Radiation Therapy Make Me Tired

    Everyone has their own energy level, so radiation treatment will affect each person differently.

    People often feel fatigue after several weeks of treatment. For most, this fatigue is mild. But some people lose a lot of energy and need to change their daily routine.

    If your doctor thinks you should limit how active you are, theyâll discuss it with you.

    To minimize fatigue while youâre receiving radiation treatment:

    • Get enough rest.
    • Pace yourself, and plan rest breaks throughout your day.

    Proton Beam Radiation Therapy

    Proton beam therapy focuses beams of protons instead of x-rays on the cancer. Unlike x-rays, which release energy both before and after they hit their target, protons cause little damage to tissues they pass through and release their energy only after traveling a certain distance. This means that proton beam radiation can, in theory, deliver more radiation to the prostate while doing less damage to nearby normal tissues. Proton beam radiation can be aimed with techniques similar to 3D-CRT and IMRT.

    Although in theory proton beam therapy might be more effective than using x-rays, so far studies have not shown if this is true. Right now, proton beam therapy is not widely available. The machines needed to make protons are very expensive, and they arent available in many centers in the United States. Proton beam radiation might not be covered by all insurance companies at this time.

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    What Is Proton Beam Radiation Therapy

    This type of therapy treats tumors with protons instead of X-ray radiation. It may be able to deliver more radiation specifically to a prostate cancer tumor with less damage to normal tissue.

    Proton beam therapy might be a safe treatment option when a doctor decides that using X-rays could be risky for a patient. But so far, research hasnât shown that it works better than traditional radiation therapy against solid cancers in adults.

    The side effects of proton beam therapy are similar to the ones that other types of radiation treatment bring on. But since proton therapy may be less damaging to normal tissue, the side effects might be milder.

    After treatment, you may gradually have ones like:

    • Fatigue or low energy
    • Sore, reddened skin around the area where you got treated
    • Hair loss around the treatment spot

    One of the disadvantages of proton therapy is that it might not be covered by all insurance companies. Youâd need to check with your health plan to find out.

    Proton therapy also isnât widely available. You can get it only at certain centers in the U.S.

    An Inclusive Clinical Trial

    Treatment Available For Prostate Cancer: What Are Your Options?

    The team designed the phase 3 trial to be as inclusive as possible to capture a population that looks like people commonly treated in the community, Dr. Buyyounouski explained. The participants included both people getting radiation immediately after surgery and those who waited until they had rising PSA levels.

    Participants who had some invasion of their cancer into nearby tissue were eligible, although those whose cancer had spread to their lymph nodes were excluded. They could also receive up to 6 months of androgen deprivation therapy, a type of hormone therapy, if recommended by their doctor.

    Participants were randomly assigned to treatment with HYPORT, consisting of a higher dose of radiation every weekday for 5 weeks or the commonly used, lower dose every weekday for 7 weeks. They were asked about urinary and bowel symptoms before radiation and 6, 12, and 24 months after treatment, using the Expanded Prostate Cancer Index Composite questionnaire.

    After prostate cancer treatments, common urinary symptoms can include urine leakage or pain or burning when urinating. Common bowel symptoms can include bowel leakage or urgency. The trial did not measure sexual side effects, such as erectile dysfunction, since these can also be affected by hormone therapy.

    About three-quarters of the participants completed all questionnaires. At the end of treatment, people who received HYPORT reported more bowel side effects, although urinary side effects were equivalent between groups.

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    Side Effects Of Hormone Therapy

    Hormone therapy may cause side effects associated with low testosterone, such as hot flashes, sweating, weight gain, reduced sexual desire and depression. Some men also may experience swollen breasts, depression, memory loss and heart problems. Eventually, the cancer may become resistant to hormone therapy. If hormone therapy stops working, doctors may switch treatments.

    A Biopsy Is Done To Diagnose Prostate Cancer And Find Out The Grade Of The Cancer

    A transrectal biopsy is used to diagnose prostate cancer. A transrectal biopsy is the removal of tissue from the prostate by inserting a thin needle through the rectum and into the prostate. This procedure may be done using transrectal ultrasound or transrectal MRI to help guide where samples of tissue are taken from. A pathologist views the tissue under a microscope to look for cancer cells.

    Sometimes a biopsy is done using a sample of tissue that was removed during a transurethral resection of the prostate to treat benign prostatic hyperplasia.

    If cancer is found, the pathologist will give the cancer a grade. The grade of the cancer describes how abnormal the cancer cells look under a microscope and how quickly the cancer is likely to grow and spread. The grade of the cancer is called the Gleason score.

    To give the cancer a grade, the pathologist checks the prostate tissue samples to see how much the tumor tissue is like the normal prostate tissue and to find the two main cell patterns. The primary pattern describes the most common tissue pattern, and the secondary pattern describes the next most common pattern. Each pattern is given a grade from 3 to 5, with grade 3 looking the most like normal prostate tissue and grade 5 looking the most abnormal. The two grades are then added to get a Gleason score.

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    Side Effects Of Chemotherapy

    • Digestive issues such as nausea, vomiting and diarrhea

    While on chemotherapy, patients are also susceptible to infections because their white blood cell counts are lower. Other common side effects include bruising or bleeding due to fewer blood platelets and fatigue due to the lowered red blood cell count.

    Its also possible to experience a severe allergic reaction to some of the drugs used to treat prostate cancer, especially Taxotere® and Jevtana® . The patients care team may recommend medicines before each session to help prevent a reaction.

    The prostate chemotherapy drug mitoxantrone may cause leukemia later in life, but this is rare. The prostate chemotherapy drug Emcyt® may increase the risk for blood clots.

    During chemotherapy, doctors may also offer supportive care services to help ease side effects. For example, naturopathic providers may suggest supplements to reduce nausea. Also, a mind-body therapist may recommend techniques to help the patient relax and feel less anxious during prostate cancer chemotherapy treatments.

    Treatment Options For Prostate Cancer

    Treatment options for early (localised) prostate cancer

    After a diagnosis of prostate cancer has been established with a biopsy, the patient should be evaluated and discuss the different treatment options with a radiation oncologist and a urologist. Established treatment options to cure prostate cancer include:

    • External beam radiotherapy
    • Prostate brachytherapy
    • Radical prostatectomy

    Whether one or all of these treatments are appropriate for you should be discussed with your doctors, as each approach has different advantages in terms of convenience, the need for a hospital stay, and the side effects that may come with each treatment.

    Some men diagnosed with prostate cancer may also choose to pursue watchful waiting , active surveillance or hormone therapy alone.

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

    Stereotactic body radiation therapy, or SBRT, involves the use of sophisticated image guidance that pinpoints the exact three-dimensional location of a tumor so the radiation can be more precisely delivered to cancer cells. Traditionally, external beam radiation has been delivered in anywhere from 45-48 sessions over multiple weeks. But large, randomized studies have shown that shorter courses of radiation are just as safe and effective. Therefore, at MSK, we have shortened all our radiation courses.

    There is increasing interest in giving this radiation in very short courses of treatment using intense radiation doses, called hypofractionated radiation therapy. Many of the people we care for have a type of radiation therapy called MSK PreciseTM. This is a hypofractionated form of SBRT that can be given in five sessions. MSK has been doing this for the past 20 years, and the results in the several hundred people whove been treated have been excellent so far. The treatment is very well tolerated and quite effective

    Because of its superior precision, MSK Precise can have fewer side effects than more conventional radiation techniques, with extremely low rates of incontinence and rectal problems. The sexual side effects are low, similar to what is experienced with more extended external radiation techniques. And of course, its much more convenient for patients.

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