Tuesday, January 31, 2023

Side Effects After Radiation Treatment For Prostate Cancer

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Help For Bowel Dysfunction

Radiation Therapy Side Effects for Prostate Cancer Patients

To help with symptoms of bowel dysfunction, your healthcare team may recommend:

  • Avoiding foods that can irritate your bowels

  • Taking antidiarrheal medications

  • Increasing fiber intake from fruits and vegetables

If you have persistent rectal bleeding, your team may recommend laser therapy. Laser therapy will scar the blood vessels in your rectum so they stop bleeding.

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Side Effects From Radiation Therapy

Radiation for prostate cancer may cause short- or long-term side effects. Even though radiation targets the cancer cells, normal body tissues near the tumor can be affected. Specifically, we are talking about the rectum, small intestine, bladder, urethra, bone marrow, and sexual organs. If these organs repair incompletely, the radiation effects may devolve into scar tissue. Most side effects from radiation resolve within 1-2 months after treatment. However, a minority of men encounter long-term problems.

Fatigue

There is one radiation-related side effect that has nothing to do with the surrounding organsfatigue, which may begin to be noticeable after two weeks or so. The maximum level of fatigue usually occurs after about four weeks of treatment and persists until the end of the treatment. After the radiation is complete, normal energy levels typically recover in four to eight weeks. Moderate-intensity exercisewalking 30 minutes at least three days each weeksubstantially reduced fatigue.

Sexual Function

Genitourinary System

Rectum

Small Intestine

The Importance of Skillful Treatment

Short Term Side Effects

Patients who receive any type of radiation therapy to treat their prostate cancer can have side effects. Short term side effects are ones that start during or shortly after your radiation treatment. Below is a list of possible short term side effects. Treatments can affect each patient differently, and you may not have these particular side effects. Talk with your care team about what you can expect from your treatment

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What To Expect After Radiation Therapy For Prostate Cancer

Patients who receive radiation therapy for prostate cancer may experience a wide range of short-term and long-term side effects. And side effects may vary widely from patient to patient depending on a variety of factors, including the extent of the disease and the patients overall health. For instance, some patients may need a urinary catheter to help empty the bladder. Other patients may experience sexual side effects.

At CTCA, our trained supportive care providers work closely with you and your doctors to determine how best to address radiation therapy side effects. Services may include:

  • Pelvic floor therapy

Having Your Planning Scan

External Beam Radiation Therapy for Prostate Cancer

The scan will help your doctor work out the exact dose and area of your treatment.

Before your scan, you may need to have a special diet or take medicine to empty your bowel. You may also need to drink water to fill your bladder. This is to get very clear CT pictures to help plan your treatment.

You may also have a very small amount of liquid passed into your rectum to empty your bowel. You may need to do this before each session of radiotherapy.

During the scan, you need to lie still in the same position you will be in for your radiotherapy.

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What Are The Side Effects Of External Beam Radiation Therapy

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.

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.

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Hormone Therapy Side Effects

Testosterone is the primary male hormone, and plays an important role in establishing and maintaining typical male characteristics, such as body hair growth, muscle mass, sexual desire, and erectile function, and contributes to a host of other normal physiologic processes in the body. The primary systemic …

Be Careful With Injections Or Blood Draws

Side Effects of Surgery Vs Radiation for Prostate Cancer

If the lymph nodes under your arm were treated as part of the treatment for cancer, some doctors recommend having blood drawn, IVs, and shots done in the unaffected arm if possible. Some also recommend getting flu shots and other vaccinations in the unaffected arm or somewhere else, like the hip. But not all experts agree with this restriction. And if the lymph nodes under both arms were treated, it’s not possible to have an unaffected arm. For this reason, it’s important to ask your doctor about whether this restriction is right for your situation.

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How Do I Know Which Breast Cancer Treatment To Choose

Your doctor will think about a few things before they recommend a treatment for you:

  • The type of breast cancer you have
  • The size of your tumor and how far the cancer has spread in your body, called the stage of your disease
  • Whether your tumor has things called receptors for HER2 protein, estrogen, and progesterone, or other specific features.

Your age, whether youâve gone through menopause, other health conditions you have, and your personal preferences also play a role in this decision-making process.

Advantages And Disadvantages Of External Beam Radiotherapy

Advantages

  • You dont need a general anaesthetic and you dont need to stay overnight in hospital.
  • You may be able to work and carry on normal activities during the treatment.
  • You are not radioactive during or after the treatment so you can be in close contact with others.
  • Each treatment is relatively short. It usually takes about 15 minutes, although you may be in the radiotherapy department for up to an hour.

Disadvantages

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The ‘look Good Feel Better’ Program

The American Cancer Society has teamed up with the Personal Care Products Council and the National Cosmetology Association to create “Look Good Feel Better.” This program teaches beauty techniques that can boost your appearance and how you feel about yourself after your cancer treatment.

For more information, call 800-395-LOOK, or go to the website.

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Proton Beam Radiati On Therapy

Radiation Therapy For Prostate Cancer And Erectile Dysfunction

Proton beam radiation therapy capitalizes on a unique physical property of high energy protons generated from a cyclotron. The accelerated charged particles travel through tissue until reaching a depth determined by their energy. Once they reach that depth, the remainder of the radiation dose is deposited in a sharp Bragg peak with no dose going beyond that point. When multiple proton beams are used, a very sharp and tight radiation dose distribution is created. This modality is especially attractive when tumors are in close proximity to sensitive organs. PCa is one of the more common indications in which proton therapy is utilized.

At Washington University in St. Louis we are collaborating with investigators from Massachusetts General Hospital and the Harvard Medical School conducting a randomized clinical trial of IG-IMRT versus proton beam radiation in men with low and intermediate risk PCa. The PARTIQoL trial is seeking to measure and compare relative the impact of the two modalities on patient quality of life after treatment. provides a comparison of these two treatment modalities.

Axial CT slice showing conformality of intensity modulated radiation therapy. Radio-opaque markers are apparent in the anterior aspect of the prostate gland. Axial CT slice showing conformality of proton beam radiation therapy in the same patient as panel a. More sparing of the anterior-lateral rectal wall and less dose to peripheral tissues is apparent.

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Radiopharmaceuticals That Target Psma

Prostate-specific membrane antigen is a protein that is often found in large amounts on prostate cancer cells.

Lutetium Lu 177 vipivotide tetraxetan is a radiopharmaceutical that attaches to PSMA, bringing radiation directly to the prostate cancer cells.

This drug can be used to treat prostate cancer that has spread and that has already been treated with hormone therapy and chemotherapy. The cancer cells must also have the PSMA protein. Your doctor will order a PSMA PET scan before you get this drug to make sure the cancer cells have PSMA.

This drug is given as an injection or infusion into a vein , typically once every 6 weeks for up to 6 doses.

Possible side effects

Some of the more common side effects of this drug include:

This drug can lower blood cell counts:

  • A low red blood cell count can cause tiredness, weakness, pale skin, or shortness of breath.
  • A low blood platelet count can lead to bleeding or bruising more easily than normal, or bleeding that is hard to stop.
  • A low white blood cell count can lead to an increased risk of infections, which might show as a fever, chills, sore throat, or mouth sores.

This drug might damage the kidneys. Your doctor or nurse will likely advise you to drink plenty of fluids and to urinate often before and after getting this drug, to help protect the kidneys. Tell your doctor or nurse if you start to pass less urine than is normal for you.

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.

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Side Effects Of Ebrt For Prostate Cancer

Many of the possible side effects of radiation therapy for prostate cancer involve the bladder and bowelthe prostate is very close to both. Although the goal is to target only the prostate with radiation, sometimes small amounts may cause problems to nearby areas of the body.

Some of the potential side effects from EBRT include:

  • Bowel problems, including diarrhea, leakage or rectal bleeding
  • Urinary symptoms, such as a need to urinate more frequently, incontinence or a burning sensation during urination

Watch For Signs Of Cellulitis

How Radiation Affects The Prostate | Mark Scholz, MD

Cellulitis is an infection in the tissues just under your skin. It can lead to lymphedema. Cellulitis is an urgent medical problem that you need to tell your doctor about right away.

Signs and symptoms of this problem include redness, warmth, pain, and possibly cracking or peeling on the skin in the area that’s infected. Fever and flu-like symptoms may also be present. If it becomes a repeated problem, antibiotics may be needed to keep it under control.

Lymphedema can also put you at risk of getting cellulitis.

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Stereotactic Body Radiation Therapy Or Stereotactic Ablative Radiotherapy

This type of therapy is used to deliver high doses of radiation to a precise area in the prostate using specialized techniques not achievable by standard conventional radiation therapy. This allows the total dose of radiation to be given in a shorter amount of time, usually 4 -5 treatments over 1 2 weeks rather than the several weeks used for other types of external radiation therapy.

The radiation beam needs to be extremely accurate in order to limit the side effects on healthy tissue. During treatment, the body immobilization used is often more restrictive than with IMRT due to the high doses of radiation. Fiducials, or internal prostate markers, are often used in this type of treatment.

Cyberknife and Truebeam are two types of LINACs used for SBRT treatment of prostate cancer.

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Who Might Benefit From Radiation Therapy

Your doctor might recommend radiation therapy in several situations.

It can be the first treatment for cancer that hasnât spread outside your prostate gland and is âlow grade.â The grade is a number that tells you how abnormal your cancer cells look under a microscope. The lower the grade, the more normal-looking your cancer cells are â and, in general, the more likely your cancer is slow-growing.

Radiation, along with hormone therapy, might also be part of your first cancer treatment if the disease has spread beyond your prostate into nearby tissues.

If you get surgery for prostate cancer, your doctor might recommend you get radiation therapy afterward, too. It can be helpful if the surgeon couldnât remove all of the cancer or if the cancer comes back in the area of your prostate.

If you have advanced prostate cancer, radiation could help keep the disease under control for as long as possible. It can also help prevent or ease symptoms that the cancer might cause.

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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?

When Is Brachytherapy Alone The Right Choice

6 Side Effects of Radiation Therapy and How to Manage Them

For a patient with disease that is confined to the prostate and not too aggressive, brachytherapy alone is a good option. With the use of sophisticated real-time computer-based planning, we can use brachytherapy to deliver radiation in an extraordinarily precise way, with minimal exposure to the surrounding normal tissues. It is also convenient for the patient as it is done in an outpatient setting and most people are able to get back to work the next day.

But brachytherapy is not right for everyone. For some patients with less-aggressive disease, a watch-and-wait approach would also be very reasonable. At MSK, our philosophy is that when the disease is caught very early meaning a low PSA level, or nonaggressive disease as reflected by a Gleason score of 6 with evidence of cancer in only a few of the biopsy samples and no evidence from the MRI of a significant amount of disease then it would be very appropriate to do active surveillance and hold off on treatment.

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Questions To Ask Your Doctor Nurse Or Radiographer

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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