How Can I Reduce Skin Reactions
- Gently cleanse the treated area using lukewarm water and a mild soap such as Ivory, Dove, Neutrogena, Basis, Castile, or Aveeno Oatmeal Soap. Do not rub. Pat your skin dry with a soft towel or use a hair dryer on a cool setting.
- Try not to scratch or rub the treated area.
- Do not apply any ointment, cream, lotion, or powder to the treated area unless your radiation oncologist or nurse has prescribed it.
- Do not wear tight-fitting clothing or clothes made from harsh fabrics such as wool or corduroy. These fabrics can irritate the skin. Instead, choose clothes made from natural fibers such as cotton.
- Do not apply medical tape or bandages to the treated area.
- Do not expose the treated area to extreme heat or cold. Avoid using an electric heating pad, hot water bottle, or ice pack.
- Do not expose the treated area to direct sunlight, as sun exposure may intensify your skin reaction and lead to severe sunburn. Choose a sunscreen of SPF 30 or higher. Protect the treated area from direct sunlight even after your course of treatment is over.
Swelling Bruising Or Tenderness Of The Scrotum
Symptoms generally resolve on their own within three to five days. Oral anti-inflammatory medications such as ibuprofen are usually sufficient for pain relief, if necessary. You should avoid hot tubs and Jacuzzis for at least two to three days after the procedure. Postpone bike riding until the tenderness is gone.
Will My Diet Affect My Treatment
Yes. Good nutrition is an important part of recovering from the side effects of radiation therapy. When you are eating well, you have the energy to do the activities you want to do, and your body is able to heal and fight infection. Most important, good nutrition can give you a sense of well-being.
Since eating when you don’t feel well can be difficult, consider working with a dietitian. They can help make sure that you are getting adequate nutrition during your radiation therapy.
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Why And For Whom
Radiotherapy uses high-energy rays or particles to destroy cancer cells. Radiation can be used for prostate cancer:
- as the primary treatment to destroy cancer cells.
- after surgery to destroy cancer cells left behind and to reduce the risk of recurrence .
- after surgery if the cancer recurs in the area where the prostate gland was .
- to relieve pain or manage symptoms of advanced prostate cancer .
The amount of radiation given during treatment, as well as when and how it is given, is different for each person.
If I Choose Radiation Therapy Will Surgical Treatment Still Be An Option
If radiation therapy is used as the primary treatment, and the treatment is not successful, surgery or repeat radiation therapy are not considered to be desirable treatments due to the high risk of serious complications. It is important to note that the cure rates for surgery and radiation are similar. Therefore, you may have the same risk of cancer recurring if surgery is performed. If surgery is performed after radiation, or additional radiation is recommended, the physician performing the re-treatment should have a high level of experience. There are experimental clinical studies being evaluated for use of very localized re-irradiation for this group of patients. Some patients for which radiation is not effective are treated by systemic therapy or by close surveillance.
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What Types Of Radiotherapy Are There
There are two common types of external beam radiotherapy:
- intensity-modulated radiotherapy
- 3-dimensional conformal radiotherapy .
You may also hear about image guided radiotherapy . This is part of all radiotherapy treatments. Taking images of the prostate before each treatment allows your radiographer to make small changes to the area that is going to be treated, in case the prostate has moved slightly since your last treatment session. This makes sure the surrounding healthy tissue gets as little radiation as possible. It also makes sure the whole prostate is treated.
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, size and shape of your prostate. The radiotherapy machine gives beams of radiation that match the shape of the prostate as closely as possible. This helps to avoid damaging the healthy tissue around it, reducing the risk of side effects.
The strength of the radiation can be controlled so that different areas get a different dose. This means a higher dose of radiation can be given to the prostate without causing too much damage to surrounding tissue.
3D conformal radiotherapy
As with IMRT, the radiation beams are mapped to the size, shape and position of the prostate. But the strength of the radiation cant be controlled in 3D-CRT, so all areas are treated with the same dose.
Other types of radiotherapy
External Beam Radiation Therapy
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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Types Of Radiation Therapy
External beam radiation therapy
X-rays are emitted by a particle accelerator, whose beam, directed at the patients prostate, passes through the skin to destroy tumor cells. Depending on the case, radiotherapy can also be used to treat the affected lymph nodes. This treatment is painless.
Brachytherapy is internal radiation therapy. For this treatment, a radioactive material is implanted directly into the prostate. The radiation destroys cancer cells over time. Brachytherapy is administered in two ways:
- High dose rate brachytherapy: Involves temporarily inserting a radioactive substance directly into the prostate using catheters connected to a radiation source. For cancers at a high risk of progression, this type of brachytherapy can be used in conjunction with external radiotherapy.
- Low dose rate brachytherapy: Radioative grains are permanently implanted in the prostate. This is generally a treatment option for relatively early stage cancers that are slow-growing and thus at a low risk of progression. It can also be an option for intermediate-risk cancers that meet a specific criteria.
Systemic radiation therapy
Systemic radiation therapy is a type of radiation therapy in which radioactive material travels through the bloodstream to reach cells all over the body.
Radium RA 223 dichloride is a systemic radiation therapy drug, which may be used for castrate-resistant prostate cancer that causes pain and has spread only to the bone.
Verification And First Treatment
You will first meet with the radiation oncology technologists to discuss your treatment steps. Do not hesitate to ask them YOUR questions.
This final visit will be to check if the treatment area is consistent with the treatment plan. You will need to get into the same position that you will be in for all your treatmentsyou will have the required accessories to keep you in position.
Then you will receive your first treatment immediately.
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Q: What Should Men With Prostate Cancer Look For In A Treatment Center
A: There are several things to look for in a cancer treatment center, but four critical components are:
What Happens Between Appointments
Contact your doctor or nurse if you have any concerns or get any new symptoms or side effects between your follow-up appointments.
Its important to speak to them if youre concerned about anything dont worry about them being too busy.
You can get support or advice over the telephone, or they might bring forward the date of your nextfollow-up appointment.
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Before Starting Your Treatment
First visit: Meeting with radiation oncologist
Before starting radiation therapy, you will first meet with the radio-oncologist who will explain the principle, objectives, and techniques to be used. You will also be informed of possible adverse reactions and the solutions that exist to prevent or limit them. Feel free to ask any questions you may have about this treatment.
Second visit: Implanting gold or platinum pellets
In some treatment centres, 34 gold or platinum pellets are implanted during the radiotherapy treatment to increase the precision of the localization. The pellets allow the radio-oncologist to see the prostate, which can slightly shift between sessions, more clearly and aim the beam with precision.
During your first visit, the medical team will implant 34 pellets into your prostate with the help of an ultrasound machine inserted into your rectum. This procedure is very similar to that used during your biopsy.
These pellets are reference markers that will permanently stay in your prostate but will have no side effects.
- Antibiotics will be prescribed to prevent infection. You will need to take them the night before your visit, the day of your visit, and the day after your visit.
- In preparation, you should also perform a Fleet enema the morning of the visit.
Third visit: Simulating a radiation therapy session
For this visit, and in all future treatments, your bladder shoul be full. You will be given instructions to guide you.
Possible Side Effects Of Radiation Treatment For Prostate Cancer
The radiation used to destroy cancer cells can also hurt normal cells in the nearby area. Side effects from radiation treatment are related to the area of the body being treated. Patients start to have side effects a few weeks into their treatment. While side effects may be unpleasant, there are treatments to help deal with them. Most side effects are temporary and slowly start to go away once treatment is done.
You will be seen by your radiation oncology providers often during treatment. These visits are a chance to ask questions and to talk about any side effects and how to best manage them. You can also call your providers to speak about any side effects.
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How Long Will My Follow
You will have follow-up appointments for some time after your treatment. Exactly how long will depend on your cancer, any side effects of treatment and the services in your area. You will usually have appointments for several years.
After your follow-up appointments finish, you may continue to have PSA tests. Speak to your GP if you have any problems or concerns they can refer you back to the hospital. Make sure you remind them about your prostate cancer, especially if its been a while since you had treatment or a PSA test.
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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What Symptoms Should I Look Out For
If your cancer does come back, the first sign is likely to be a rise in your PSA level, rather than any symptoms. And problems will often be side effects of treatment rather than a sign that your cancer has come back.
However, its important to let your doctor or nurse know if you do get any new symptoms or side effects, or are worried that your cancer might have come back. If your cancer has come back and has spread from the prostate to other parts of the body, it can cause symptoms, such as extreme tiredness ” rel=”nofollow”> fatigue), bone pain and problems urinating.
Your doctor or nurse can help find out what might be causing your symptoms and help you manage any side effects. They can also look at your PSA level and do other tests to see whether or not your cancer might have come back.
What other tests might I have?
If your doctor or nurse is concerned about your PSA level or if you have new symptoms that suggest your cancer might have come back, they may recommend that you have some other tests, such as a prostate biopsy, MRI scan, CT scan, bone scan or PET scan.
Your doctor or nurse will explain these tests to you if you need them, or you can get in touch with our Specialist Nurses for more information.
Do We Know Which Treatment Is Better For Prostate Cancer Brachytherapy Or External Beam Radiation
Its not a question of which therapy is better but rather which therapy is the most tailored, pinpointed radiation for the patients specific disease.
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 or the Gleason score or visible evidence of disease on an MRI we have learned over the years that higher doses of radiation are critical to achieving better results. Some evidence suggests that for patients with intermediate- or high-risk prostate cancer, a combined approach using brachytherapy along with external beam radiation may be best.
Data that we have published recently show that for patients with intermediate-risk disease, the combination of external beam radiation with brachytherapy not only provides better biochemical control, in terms of PSA level, but also reduces the risk of distant metastases, or spread of the disease. Another recent study from Canada, which compared outcomes in patients who were treated with external beam radiation or a combination approach, found superior results when the combined approach was used. These studies provide strong evidence that higher doses of radiation provide an important benefit to patients with intermediate-risk and high-risk prostate cancers.
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Who Will Help Me During My Imrt Treatments
Many people will help you with your IMRT treatment and care. This group of health care providers is often called your âradiation therapy team.â They work together to give you care that is just right for you. Your radiation therapy team includes a:
- Radiation oncologist. This is a doctor who uses radiation therapy to treat patients with cancer. Your radiation oncologist:
- Will decide how much radiation you will get for your prostate cancer treatment
- Plans how your prostate cancer treatment will be given
- Closely follows you during your prostate cancer treatment
- And, directs any care you need to help with any side effects you may have during and after your prostate cancer treatment
The radiation oncologist will work with the other doctors, nurses, and health care providers on your team. After your treatment is over, your radiation oncologist will see you for follow-up visits. At these visits, your radiation oncologist will find out how well the radiation worked to treat your prostate cancer and will help you with any side effects that you may have.
Keeping Up With Appointments And Screenings
Attending your doctors appointments after youve entered remission is very important. If you need to skip an appointment, you should make another appointment as soon as possible.
Use these appointments as a time to discuss any concerns you may have with your doctor. Your doctor can also conduct tests to check for the cancers return during these appointments.
Two tests to detect recurrent prostate cancer include a digital rectal exam and a PSA blood test. During a DRE, your doctor will insert a finger into your rectum. If your doctor detects something unusual, theyll likely ask for additional follow-up tests. These tests may include bone scans and imaging studies, such as an ultrasound or MRI.
Men often experience side effects from their prostate cancer treatments. Some of these side effects may be immediate and temporary. Others may take several weeks or months to show up and never fully disappear.
Common side effects from prostate cancer treatment include:
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