Monday, May 23, 2022

What To Expect From Radiation Therapy For Prostate Cancer

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Proton Beam Radiati On Therapy

Radiation therapy for prostate cancer: What to expect

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.

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?

Remove Devices From Your Skin

If you wear any of the following devices on your skin, the manufacturer recommends you remove it before your simulation or treatment:

  • Continuous glucose monitor
  • Insulin pump

Talk with your radiation oncologist about whether you may need to remove your device before your simulation or treatment.;Make sure you have an extra device with you to put on after your simulation or treatment.

If youre not sure how to manage your glucose while your device is off, talk with the healthcare provider who manages your diabetes care before your appointment.

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Questions To Ask The Health Care Team

  • Who is creating my radiation therapy treatment plan? How often will the plan be reviewed?

  • Which health care professionals will I see at every treatment session?

  • Can you describe what my first session, or simulation, will be like?

  • Will I need any tests or scans before treatment begins?

  • Will my skin be marked as part of treatment planning?

  • Who can I talk with if I’m feeling anxious or upset about having this treatment?

  • How long will each treatment session take? How often will I have radiation therapy?

  • Can I bring someone with me to each session?

  • Are there special services for patients receiving radiation therapy, such as certain parking spaces or parking rates?

  • Who should I talk with about any side effects I experience?

  • Which lotions do you recommend for skin-related side effects? When should I apply it?

  • How else can I take care of myself during the treatment period?

  • Will special precautions be needed to protect my family and others from radiation exposure during my treatment period?

  • What will my follow-up care schedule be?

Why Choose Radiation Therapy For Prostate Cancer

Radiation Therapy Near Me

Radiation therapy is highly effective in treating prostate cancer, and every year, more than 60,000 men in America choose this treatment. Radiation treatment causes minimal side effects, such that you can continue to work and maintain your regular schedule during treatment. Additionally, for older men, its a good option if you have other health issues, or heart problems which rule out surgery. At MRO, youll be treated with some of the most advanced cancer-fighting technology available.

As a radiation oncologist, I enjoy the opportunity to connect with patients on a personal level to provide the best possible care, and to use my knowledge of both physics and medicine to treat their prostate cancer with the most effective technologies.Jenna Borkenhagen, MDMRO | St. Francis

Localized prostate cancer

For localized prostate cancer disease that hasnt spread outside the prostate radiation is often the primary treatment.

After surgery

Radiation treatment coupled with surgery, known as adjuvant therapy, helps decrease the risk of recurrence. Post-operative radiation is used to eliminate any cancer cells that may remain after a radical prostatectomy.

Along with hormone therapy

For men with a high risk of prostate cancer recurrence, hormone therapy is combined with radiation and has been shown to make a significant improvement in survival rates. Testosterone-suppressing drugs are prescribed to slow or stop the growth of the cancer.

Advanced/Metastatic cancer

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Radiation Therapy: What It Is

This therapy, also known as radiotherapy, is a cancer treatment procedure that uses high doses of radiation to kill cancerous cells and shrink the tumor as well. At low doses, this procedure is used as an x-ray.

This therapy can be internal or external or both form. For external beam, a machine that is outside your body aims at the cancerous cells. For internal therapy, the radiations are placed inside your body inside or near the cancer.

For radiotherapy for prostate cancer, high-energy rays are used to kill the cancer cells. This treatment procedure does not cause pain. However, it may result in various side effects that might cause pain and make you feel uncomfortable. The good thing is that there are numerous ways to manage radiotherapy side effects with the help of your radiation oncologist.

Ontogenesis Of Postural And Sphincter Anticipatory Adjustments

The control of body position in space develops with different intensity during life span . As an example, Zaino and McCoy showed that young healthy children exhibit much higher variability of posture control than older healthy children . It is also reported that the age 79 years is an important period of their life in which children master postural control . Moreover, Schmitz et al. showed that children 34 years old develop APA, although they show coexistence of both adult-like and immature patterns, concluding that this anticipatory activities are being set up and that children are progressively mastering them.

Changes in brain structure are continuous throughout life . By the age 2, the brain has reached 75% of its adult weight and the processes of synaptic pruning and cell death are most active during these early years . During the school-age years, strong signs of brain maturation are appreciable, especially in its connectivity . MRI measures of the structure in fibers tracts correlate with behavioral indices that also change in this period . Later changes involve the associative neocortex, which continues to develop well into the third decade , and the corpus callosum, which connects all major subdivisions of the cerebrum .

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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.

Stereotactic Body Radiation Therapy Or Stereotactic Ablative Radiation Therapy

What to Expect after Radiation Therapy for Prostate Cancer

Guided by advanced imaging techniques, SBRT delivers large doses of radiation over a short period of time to a precise area. SBRT is commonly referred to by the names of the machines used to deliver the radiation. SBRT can offer some patients with localized prostate cancer the convenience of fewer treatments while maintaining treatment effectiveness and safety. SBRT may also be used to treat metastases for some patients to reduce tumor mass and potentially enhance survival.

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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.

Talking With Your Doctor

Different kinds of doctors and other health care professionals manage prostate health. They can help you find the best care, answer your questions, and address your concerns. These health care professionals include:

  • Family doctors and internists
  • Physician assistants and nurse practitioners
  • Urologists, who are experts in diseases of the urinary tract system and the male reproductive system
  • Urologic oncologists, who are experts in treating cancers of the urinary system and the male reproductive system
  • Radiation oncologists, who use radiation therapy to treat cancer
  • Medical oncologists, who treat cancer with medications such as hormone treatments and chemotherapy
  • Pathologists, who identify diseases by studying cells and tissues under a microscope

View these professionals as your partnersâexpert advisors and helpers in your health care. Talking openly with your doctors can help you learn more about your prostate changes and the tests to expect.

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What Happens During Radiation Therapy Treatment

What happens during your radiation therapy treatment depends on the kind of radiation therapy you receive.

External-beam radiation therapy

External-beam radiation therapy delivers radiation from a machine outside the body. It is the most common radiation therapy treatment for cancer.

Each session is quick, lasting about 15 minutes. Radiation does not hurt, sting, or burn when it enters the body. You will hear clicking or buzzing throughout the treatment and there may be a smell from the machine. Typically, people have treatment sessions 5 times per week, Monday through Friday. This schedule usually continues for 3 to 9 weeks, depending on your personal treatment plan.

This type of radiation therapy targets only the tumor. But it will affect some healthy tissue surrounding the tumor. While most people feel no pain when each treatment is being delivered, effects of treatment slowly build up over time and may include discomfort, skin changes, or other side effects, depending on where in the body treatment is being delivered. The 2-day break in treatment each week allows your body some time to repair this damage. Some of the effects may not go away until the treatment period is completed. Let the health care professionals if you are experiencing side effects. Read more about the side effects of radiation therapy.

Internal radiation therapy

  • The permanent implant loses it radioactivity

  • The temporary implant is removed

Weekly reports

Personal care

Sexual And Reproductive Health

What to Expect When Having Radiation Therapy

You can be sexually active during your radiation therapy, unless your radiation oncologist gives you other instructions. You wont be radioactive or pass radiation to anyone else.

If youre sexually active with someone whos able to get pregnant, its important to use birth control during and for 1 year after your radiation therapy. During your radiation therapy, your sperm may be damaged by the radiation. If you conceive a baby with this sperm, the baby might have birth defects. Using birth control helps prevent this.

For more information about your sexual health during cancer treatment, read the resource Sex and Your Cancer Treatment. The American Cancer Society also has resources about sexual health issues during cancer treatment. The one for men is called Sex and the Adult Male with Cancer. You can search for it at www.cancer.org or call for a copy.

Male Sexual and Reproductive Medicine Program

MSKs Male Sexual and Reproductive Medicine Program helps people address the impact of their disease and treatment on sexual health. You can meet with a specialist before, during, or after your treatment. We can give you a referral, or you can call for an appointment.

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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?

Who Should Consider External Beam Radiation Therapy

In most cases, external beam radiation therapy is used for men with localized prostate cancer . The intent of EBRT in this case is to kill the tumor while sparing as much healthy tissue as possible. Sometimes it is used in more advanced cases. For example, it can be used along with hormone therapy, or used to relieve pain from bone metastases.

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What Happens Before Radiation Therapy Treatment

Each treatment plan is created to meet a patient’s individual needs, but there are some general steps. You can expect these steps before beginning treatment:

Meeting with your radiation oncologist. The doctor will review your medical records, perform a physical exam, and recommend tests. You will also learn about the potential risks and benefits of radiation therapy. This is a great time to ask any questions or share concerns you may have.

Giving permission for radiation therapy. If you choose to receive radiation therapy, your health care team will ask you to sign an “informed consent” form. Signing the document means:

  • Your team gave you information about your treatment options.

  • You choose to have radiation therapy.

  • You give permission for the health care professionals to deliver the treatment.

  • You understand the treatment is not guaranteed to give the intended results.

Simulating and planning treatment. Your first radiation therapy session is a simulation. This means it is a practice run without giving radiation therapy. Your team will use imaging scans to identify the tumor location. These may include:

  • An x-ray

Depending on the area being treated, you may receive a small mark on your skin. This will help your team aim the radiation beam at the tumor.

You may also be fitted for an immobilization device. This could include using:

  • Tape

  • Plaster casts

These items help you stay in the same position throughout treatment.

Are There Side Effects Of The Combination Approach

Radiotherapy for Prostate Cancer – What to expect

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.

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What Are The Types Of Radiation Therapy Used For Prostate Cancer

Radiationtherapy for prostate cancer can be divided into two main categories.

Externalbeam radiation :Using a machine outside the body, beams of radiation are focused on theprostate gland. This can help relieve symptoms such as pain while limiting thedamage to the tissues surrounding the prostate.

The 4methods of external beam radiation are:

  • Three-dimensional conformal radiation therapy
  • Intensity modulated radiation therapy
  • Stereotactic body radiation therapy
  • Proton beam radiation therapy

Brachytherapy:Small radioactive pellets are inserted into the prostate, each one about thesize of a grain of rice. About 100 pellets are used to limit the damage tosurrounding tissues and organs. Brachytherapy is most often used forearly-stage cases and is sometimes combined with EBRT. The pellets can eitherbe inserted for a couple of days for high dosages or a few months for lowdosage depending on the patients overall status.

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