What Are The Side Effects Of Brachytherapy
- Frequent urination or urinary retention or burning with urination
- Erectile dysfunction
- Urethral stricture or narrowing of the urethra
- Diarrhea or blood in the stool
- Secondary cancers
For the short time that the seeds are giving off larger amounts of radiation, you should avoid close proximity to children or pregnant women. Make sure to talk with your radiation oncologist or oncology nurse for instruction about radiation safety and exposure for family members or pets.
If you are traveling through an airport following brachytherapy treatment, there is a chance that radiation detectors will be set off. Talk to your radiation oncologist and ask for a note to indicate youve just had radiation treatment.
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.
Physical Emotional And Social Effects Of Cancer
Cancer and its treatment cause physical symptoms and side effects, as well as emotional, social, and financial effects. Managing all of these effects is called palliative care or supportive care. It is an important part of your care that is included along with treatments intended to slow, stop, or eliminate the cancer.
Palliative care focuses on improving how you feel during treatment by managing symptoms and supporting patients and their families with other, non-medical needs. Any person, regardless of age or type and stage of cancer, may receive this type of care. And it often works best when it is started right after a cancer diagnosis. People who receive palliative care along with treatment for the cancer often have less severe symptoms, better quality of life, and report that they are more satisfied with treatment.
Palliative treatments vary widely and often include medication, nutritional changes, relaxation techniques, emotional and spiritual support, and other therapies. You may also receive palliative treatments similar to those meant to get rid of the cancer, such as chemotherapy, surgery, or radiation therapy.
Before treatment begins, talk with your doctor about the goals of each treatment in the treatment plan. You should also talk about the possible side effects of the specific treatment plan and palliative care options.
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How Does External Beam Radiation Therapy Work
External beam radiation therapy, or EBRT, uses a machine to direct high-energy X-rays at the cancer in daily doses. The radiation beam is generated by a machine called a linear accelerator or LINAC. Using treatment planning computers and software, your treatment team controls the size and shape of the beam as well as how it is directed at your body to most effectively treat your tumor and minimize damage to surrounding normal tissue.
To minimize side effects, the treatments are typically given five days a week over a six-to-nine week period. The break in days allows the doctors to get enough radiation into the body to kill the cancer while giving healthy cells time to recover.
Watch our expert medical oncologist, Dr. Alicia Morgans from Vanderbilt-Ingram Cancer Center, discuss external beam radiation therapy:
Patient And Radiotherapy Characteristics
Table 1 summarizes the clinical characteristics of the entire cohort and comparison between patients who received prostate radiotherapy and those who did not. The median age was 69 years, and 55% of the patients were 70 years. The Eastern Cooperative Oncology Group performance status was 01 in 79% of patients 74% had a Gleason score 8 and the initial PSA levels were 100 ng/mL in 61% of patients. The number of metastatic lesions on initial presentation was 1 in 13% of patients, 24 in 30%, and 5 in 40%, with 78% of the cases being bone metastases. Age was the only factor with significant distribution difference between PRT and non-PRT patients, whereas no significant differences in the distribution of performance status, Gleason score at diagnosis, initial PSA level, disease extent, metastatic site, and the use and duration of androgen deprivation therapy were observed between the two groups.
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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.
How Does Radiotherapy Work
Radiotherapy aims to destroy prostate cancer cells without causing too much damage to healthy cells. External beam radiotherapy is high-energy X-ray beams targeted at the prostate from outside the body. These X-ray beams damage the cancer cells and stop them from growing and spreading to other parts of the body . Radiotherapy permanently damages and kills the cancer cells, but healthy cells can repair themselves and recover more easily.
Radiotherapy treats the whole prostate. It aims to treat all the cancer cells, including any that have spread to the area just outside the prostate. The treatment itself is painless but it can cause side effects that may cause you problems.
You may have radiotherapy to a wider area, including the nearby lymph nodes, if there is a risk that the cancer has spread there. Lymph nodes are part of your immune system and are found throughout your body. The lymph nodes in your pelvic area are a common place for prostate cancer to spread to. If you do have radiotherapy to a wider area, you will be more likely to get side effects.
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What Is Radiation Recall
Radiation recall is a rash that looks like a severe sunburn. It is rare and happens when certain types of chemotherapy are given during or soon after external-beam radiation therapy.
The rash appears on the part of the body that received radiation. Symptoms may include redness, tenderness, swelling, wet sores, and peeling skin.
Typically, these side effects start within days or weeks of radiation therapy. But they can also appear months or years later. Doctors treat radiation recall with medications called corticosteroids. Rarely, it may be necessary to wait until the skin heals before continuing chemotherapy.
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Questions To Ask The Health Care Team
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Who is creating my radiation therapy treatment plan? How often will the plan be reviewed?
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Which health care professionals will I see at every treatment session?
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Can you describe what my first session, or simulation, will be like?
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Will I need any tests or scans before treatment begins?
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Will my skin be marked as part of treatment planning?
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Who can I talk with if Im feeling anxious or upset about having this treatment?
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How long will each treatment session take? How often will I have radiation therapy?
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Can I bring someone with me to each session?
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Are there special services for patients receiving radiation therapy, such as certain parking spaces or parking rates?
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Who should I talk with about any side effects I experience?
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Which lotions do you recommend for skin-related side effects? When should I apply it?
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How else can I take care of myself during the treatment period?
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Will special precautions be needed to protect my family and others from radiation exposure during my treatment period?
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What will my follow-up care schedule be?
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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.
Proton Beam Radiati On Therapy
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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What The Results Showed
After five years, there were no significant differences in survival associated with any of the selected treatments. Just one man in the favorable risk category died from prostate cancer during the study, and there were eight deaths from the disease in the unfavorable risk group.
Many men in the study had initial problems with sexual, bowel, urinary, and hormonal functioning. Brachytherapy caused more irritative urinary problems during the initial six months than the other treatments, but then those symptoms steadily improved. Brachytherapy and EBRT were associated with minor bowel symptoms such as urgency, bleeding, frequency, and pain that resolved within a year in men from both risk groups.
Dr. Marc Garnick, Gorman Brothers Professor of Medicine at Harvard Medical School and Beth Israel Deaconess Medical Center, and editor in chief of HarvardProstateKnowledge.org, agreed the study provides a valuable resource that adds to existing information. Yet he cautioned against brachytherapy, warning that this particular treatment in some cases has long-term urinary side effects that can significantly alter a patients quality of life. I do not routinely recommend brachytherapy, Garnick said. This is especially true in patients with a pre-existing history of urinary tract infections or prostatitis.
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Focal Therapy For Prostate Cancer
With recent advances in MRI and targeted biopsy, we are better able to locate the exact area of prostate cancer. Men who do not have an enlarged prostate, who have prostate cancer that is detected only in a single region of the prostate and have intermediate grade cancer can be a candidate for focal therapy. This type of therapy treats only the cancerous tissue and spares the normal prostate, thereby preserving urinary and sexual function
Here at UCLA we commonly use cryotherapy or HIFU to focally treat prostate cancer. Given that this is a relatively new form of treatment, we have established rigorous post-treatment protocols using MRI and biopsies to ensure that the cancer has been adequately treated.
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How Does Radiotherapy Treat Advanced Prostate Cancer
Radiotherapy can be used in different ways to treat advanced prostate cancer:
- As part of your first treatment for advanced prostate cancer If youre offered radiotherapy as part of your first treatment, youll have a type called external beam radiotherapy.
- To improve symptoms in areas where the cancer has spread You may have external beam radiotherapy to the part of the body where the cancer is causing problems.
- To help some men with bone pain live longer If your cancer is causing bone pain, you may be offered a type of internal radiotherapy called radium-223 to help you live longer and to treat the bone pain.
A clinical oncologist or radiographer will plan your radiotherapy with you. They will explain which type of radiotherapy you will have, how long the treatment could take and the possible side effects. This could depend on where your cancer has spread to, any symptoms youre having, and your general health and fitness.
A team of treatment radiographers will give you the treatment. They’ll also give you support and information during your treatment.
The information on this page is for men with advanced prostate cancer. If your cancer hasn’t spread to other parts of the body, read our information on external beam radiotherapy for localised or locally advanced prostate cancer instead.
Why Choose Radiation Therapy For Prostate Cancer
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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Image Guided Radiation Therapy
In this type of radiation therapy, CT scans are taken both during the planning process and just before treatment begins. Comparing the two images allows doctors to adjust treatment as needed, since tumors can move between treatments. This allows precision targeting of the cancer while avoiding nearby healthy tissue.
In some cases, doctors will implant a tiny marker in or near the tumor to pinpoint it for IGRT to account for organ/tumor motion even if the body is immobilized.
Calypso is another form of IGRT where the prostate can be tracked during the treatment.
The Risk Of Your Cancer Coming Back
For many men with localised or locally advanced prostate cancer, treatment is successful and gets rid of the cancer. But sometimes not all the cancer is successfully treated, or the cancer may have been more advanced than first thought. If this happens, your cancer may come back this is known as recurrent prostate cancer.
One of the aims of your follow-up appointments is to check for any signs that your cancer has come back. If your cancer does come back, there are treatments available that aim to control or get rid of the cancer.
Your doctor cant say for certain whether your cancer will come back. They can only tell you how likely this is.
When your prostate cancer was first diagnosed, your doctor may have talked about the risk of your cancer coming back after treatment. To work out your risk, your doctor will have looked at your PSA level, your Gleason score and the stage of your cancer. If your prostate has been removed, it will have been sent to a laboratory for further tests. This can give a better idea of how aggressive the cancer was and whether it is likely to spread. If you dont know these details, ask your doctor or nurse.
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Does Radiotherapy For The Primary Tumor Benefit Prostate Cancer Patients With Distant Metastasis At Initial Diagnosis
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Affiliation Departments of Radiation Oncology, Yonsei University College of Medicine, Seoul, Korea
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Affiliation Departments of Radiation Oncology, Yonsei University College of Medicine, Seoul, Korea
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Affiliation Department of Urology, Yonsei University College of Medicine, Seoul, Korea
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Affiliation Department of Urology, Yonsei University College of Medicine, Seoul, Korea
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Affiliation Department of Urology, Yonsei University College of Medicine, Seoul, Korea
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Affiliation Department of Urology, Yonsei University College of Medicine, Seoul, Korea
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Affiliation Departments of Radiation Oncology, Yonsei University College of Medicine, Seoul, Korea
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Affiliation Departments of Radiation Oncology, Yonsei University College of Medicine, Seoul, Korea