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Tomotherapy Side Effects Prostate Cancer

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TomoTherapy at Hoag Family Cancer Institute

Another type of prostate issue is chronic prostatitis, or chronic pelvic pain syndrome. This condition causes pain in the lower back and groin area, and may cause urinary retention. Symptoms include leaking and discomfort. In severe cases, a catheter may be required to relieve the symptoms. If the problem is unresponsive to other treatments, your doctor may suggest a surgical procedure. If these do not work, your symptoms could progress and become chronic.

An acute bacterial infection can cause a burning sensation. Inflammation of the prostate can affect the bladder and result in discomfort and other symptoms. This is the most common urinary tract problem in men under 50, and the third most common in men over 65. The symptoms of acute bacterial prostatitis are similar to those of CPPS. Patients may experience a fever or chills as a result of the infection.

A bacterial infection can also lead to prostate issues. Acute bacterial infections can be hard to treat. Some men with a bacterial infection may need to take antibiotics to prevent or treat symptoms. Symptoms of the disease include fever and chills, pain in the lower back and the tip of the penis. Some men may have blood in the urine, frequent urination, and blood in the urine. If you suffer from acute bacterial prostatitis, a medical professional should be able to prescribe you the appropriate treatments to prevent the disease.

How Sex Might Be Affected

With some types of radiation therapy involving the pelvis and/or sex organs, men and women may notice changes in their ability to enjoy sex or a decrease in their level of desire.

For women: During radiation treatment to the pelvis, some women are told not to have sex. Some women may find sex painful. Treatment can also cause vaginal itching, burning, and dryness. You most likely will be able to have sex within a few weeks after treatment ends, but check with your doctor first. Some types of treatment can have long-term effects, such as scar tissue that could affect the ability of the vagina to stretch during sex. Again, your cancer care team can offer ways to help if this happens to you. You can also get more information in Sex and Women With Cancer.

For men: Radiation may affect the nerves that allow a man to have erections. If erection problems do occur, they are usually gradual, over the course of many months or years. Talk with your doctor about treatment options if this is a concern for you. You can get more information in Sex and Men With Cancer.

If you get internal radiation therapy with seed implants, check with your cancer care team about safety precautions during sex

How Many Sessions Will I Need

The number of sessions you may need will vary depending on your circumstances. Often patients will need somewhere around 5 sessions per week for a period of five to eight weeks. Your oncologist should discuss with you how many sessions you will require.

The sessions itself will only take around 10-30 minutes . As minimal pain is associated with this type of treatment and no anaesthetic is required, you can continue with daily activities as normal around your sessions.

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If Youre Getting Radiation Therapy To The Brain

People with brain tumors often get stereotactic radiosurgery if the cancer is in only one or a few sites in the brain. Side effects depend on where the radiation is aimed. Some side effects might show up quickly, but others might not show up until 1 to 2 years after treatment. Talk with your radiation oncologist about what to watch for and when to call your doctor.

If the cancer is in many areas, sometimes the whole brain is treated with radiation. The side effects of whole brain radiation therapy may not be noticeable until a few weeks after treatment begins.

Radiation to the brain can cause these short-term side effects:

  • Headaches
  • Trouble with memory and speech
  • Seizures

Some of these side effects can happen because radiation has caused the brain to swell. Medicines are usually given to prevent brain swelling, but its important to let your cancer care team know about headaches or any other symptoms. Treatment can affect each person differently, and you may not have these particular side effects.

Radiation to the brain can also have side effects that show up later usually from 6 months to many years after treatment ends. These delayed effects can include serious problems such as memory loss, stroke-like symptoms, and poor brain function. You may also have an increased risk of having another tumor in the area, although this is not common.

Talk with your cancer care team about what to expect from your specific treatment plan.

Stereotactic Body Radiation Therapy Or Stereotactic Ablative Radiotherapy

Comparing Proton Therapy, IMRT, &  the CyberKnife System

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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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.

How Does Tomotherapy Treatment Work

Undergoing TomoTherapy treatment may seem similar to having a CT scan or an X-ray.

When its time for the treatment, a radiation therapist helps the patient into position on the table. In most cases, the patient will be face up. The patients position may change from session to session, depending on the shape and location of the tumor. The therapist typically places a device or devices to keep the patient still during the procedure.

Before the radiation treatment begins, the patient moves through the machine while a clinician uses scanning technology to capture a 3D image of the treatment area. This allows the radiation oncologist and radiation therapist to shape the beams according to the size, shape and location of the tumor on that specific day.

During treatment, the patient moves through the machine slowly as radiation is applied from 360 degrees. The patient may hear clicking, humming or other noises from the machine.

The procedure may take as little as 15 minutes and is painless.

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What To Expect From Tomotherapy Treatment

Your Mercy care team provides an outpatient treatment schedule, which typically includes daily treatments over one to eight weeks. Each TomoTherapy session lasts about 10-20 minutes. It’s noninvasive and as painless as a CT scan or x-ray.

Before & During Treatment

When you arrive for treatment, youll be taken to the TomoTherapy treatment room, where a Mercy radiation therapist will help you get positioned. Youll most likely lie on your back, and the therapist may fit you with a device to help you remain still during treatment. Tiny markings may be made on your skin to line up equipment with the treatment area. Youll move through the TomoTherapy machine once for pre-treatment imaging. Based on these images, your radiation plan or position may be adjusted. Then, youll move through the machine again slowly as customized treatment is delivered.

Possible Side Effects Of Radiation Treatment

Tomotherapy for Prostate Cancer 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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What Are The Benefits

Tomotherapy treatment does have short-term side effects, including fatigue and irritability, peeling and redness of the skin, but for prostate cancer patients with localised or locally advanced stage cancer, Tomotherapy is an effective treatment. Success rates have been similar amongst patients both young or old including men aged eighty or over.

Tomotherapy is so safe and exact, treatments can be repeated in previously irradiated areas, and using fewer doses to do so. Prostate cancer patients receiving Tomotherapy are also treated faster. Each eight week course of treatment where high dose radiation is delivered to the prostate involves just five weekly sessions that typically last around twenty five minutes each.

¹Mayo Clinic, Intensity-modulated radiation therapy , 16th April 2020

What Is 3d Conformal Radiation Therapy

Itâs a procedure that uses a computer to make a three-dimensional picture of your tumor. It helps your treatment team deliver the highest possible dose of radiation to the tumor while minimizing the damage to normal tissue.

3D conformal radiation therapy uses CT-based treatment combined with three-dimensional images of a prostate tumor. CT is short for computed tomography, which uses X-rays to produce detailed pictures inside the body.

So far, this technique has worked well for localized tumors such as prostate cancer limited to the prostate gland.

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Tomotherapy And Hypofractionated Radiotherapy

The radiotherapeutic approach to carcinoma has been relatively consistent for more than 3 decades. Although refinements in existing treatment technique have allowed higher doses of radiation treatment to be offered to patients with limited disease, there are 2 unique forms of external beam radiotherapy that have garnered increasing interest over the past few years.

The first of these is helical radiotherapy using a computed tomography -like gantry and a rotating radiation beam that passes through the target area of interest. This modality, termed tomotherapy, has been used in the management of primary central nervous system tumors and viscera-based malignancies. Although the CT-like gantry generates megavoltage radiation, its design allows ready acquisition of CT-like images, which have been successfully used in optimizing patient positioning on a daily basis.

The second distinct modality is hypofractionated radiotherapy. In this form of therapy, radiation is delivered from an accelerator however, the equipment is mounted to a computer-guided robotic arm. Because the machine is capable of treating the target at angles that are not possible with conventional rotation-based equipment, it yields the theoretical advantage of conforming the dose more closely to the target organs shape.

Does Msk Offer Proton Therapy For Prostate Cancer

TomoTherapy

Some men with prostate cancer may choose to receive another form of external-beam radiation therapy called proton therapy. Proton therapy can deliver a high radiation dose to the prostate while lowering the radiation dose to normal surrounding tissue. It is unclear if there is any advantage to proton therapy compared with IMRT. We are now studying how these approaches compare in terms of side effects and outcomes at the New York Proton Center. These efforts are being led by radiation oncologist Daniel Gorovets.

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What Should I Expect During My Ebrt

Every patients experience during EBRT varies depending on the type of cancer, the size and location of the tumor and the type of therapy being used. But there are some general rules and expectations most patients should consider. For instance:

  • You may be asked to change into a hospital gown for your therapy, so wear clothes that are easy to remove. If a hospital gown is not necessary, you still may be asked to expose the area being treated, so you should wear clothes that are loose-fitting and comfortable. Do not wear jewelry.
  • A mold of the part of the body that is being treated may be required to help keep you still during treatment. If you are undergoing radiation therapy to the head and neck area, you may be fitted for a mesh mask designed to keep your head from moving during treatment.
  • Your skin may be marked with dots to identify the treatment area. These dots should remain on your skin for the duration of your treatment. If a mold or mask is required, it will also be marked.
  • You will need to remain still during your treatment, which will only take a few minutes.
  • EBRT is painless.
  • Patients do not become radioactive during or after EBRT treatments.

Is Tomotherapy The Right Treatment For Me

The main benefit of TomoTherapy is for patients whose cancer is difficult to treat. This may be for a variety of reasons:

  • If you have had a hip replacement , this makes it difficult to plan and deliver radiotherapy because your prosthesis lies so close to the prostate and can interfere with the radiotherapy beams. For these patients TomoTherapy has a particular benefit because of its accuracy and ability to deliver beams from all angles.
  • If there are particular concerns about the radiotherapy harming nearby organs, such as the bowel, either due to the location of your prostate cancer or other medical factors, for example, weakness in adjacent organs.

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Radiation Therapies Offered For Prostate Cancer

Research is currently underway to determine the best course of action for a man diagnosed with low risk, intermediate risk or high risk prostate cancer.

The longest follow-up and data on prostate cancer comes from both external beam radiation and brachytherapy. Here at City of Hope we have both external beam radiation and brachytherapy and are able to give suggestions and recommendations on either treatment taking into account all the patient characteristics.

External beam radiation we can treat either on TomoTherapy or TrueBeam machines. We use image guided radiation treatment daily so that we can minimize toxicity to the bowel, bladder, rectum By having both machines in our department we can compare/contrast the two machines to determine what is best for the patient in terms of giving maximum radiation to the prostate cancer and minimizing radiation to the nearby bladder, bowel, rectum. The picture below illustrates the benefit of tomotherapy in sparing dose to the rectum and bladder versus 3DCRT .

If we determine that the patient is a good candidate for brachytherapy, we are able to offer this course of treatment as well. We perform all brachytherapy in collaboration with our urologists, and have been performing brachytherapy for over 15 years. With a MRI scan of the prostate, we can better determine who is/is not a good candidate for brachytherapy.

Sore Skin In The Treatment Area

Tomotherapy for cancer treatment – Especially effective for prostate cancer treatment

Your skin in the treatment area might get sore, or redden or darken. Following these tips can help with this:

  • Wear loose fitting underwear and clothes. Natural fibres can be more comfortable than man-made fibres.
  • Gently wash the area each day. Use mild, unperfumed soap and warm or cool water. Try baby soap or liquid baby wash but check with the radiotherapy staff first.
  • Gently pat the skin dry with a soft towel. Rubbing the skin can make it sore.
  • Don’t use perfumed lotions on the area. Use only creams or dressings recommended by your specialist or radiographer.
  • Don’t use talcum powder because it can contain tiny metal particles. The particles can make the soreness worse.

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Specific Foods To Eat During Ebr Prostate Therapy

Foods During EBR Prostate Therapy

QUESTION: Very little info on specific foods/recipes to eat during the 44 sessions of EBR. After 9 sessions, my husband is having stomach issues and urinary problems.

ANSWER

  • As you probably know, the radiation is killing the cancer cells in the prostate. At the same time, this radiation is affecting the normal cells of the prostate, bladder and other organs situated nearby the prostate. The radiation of the EBRT is not killing them, but is destroying their metabolism, by damaging specific enzymes. For that reason, the organism needs a lot of energy provided by the carbs.
  • Besides this, for the synthesis of new enzymes and other important molecules, the organism needs a lot of amino acids provided by the proteins.
  • Furthermore, the radiation is also causing the formation of free radicals, which are able to damage the molecules in the normal cells. Vitamins from group B, vitamin C and vitamin A are acting as antioxidants, i.e., they have the ability to neutralize the free radicals and to prevent the destruction of those enzymes. Just boost your husband with vitamins pills, but not the effervescent one, because they are containing only the water-soluble vitamin C and vitamins from group B.
  • Besides this, it is good for your husband to cook him chicken meat. For example, chicken with potatoes or with rice. The chicken does contain a lot of proteins and the potatoes a lot of carbs.
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