Radiation To Treat Prostate Cancer
A Common Therapy For The 2nd Deadliest Cancer, After Lung Cancer
Sep 13, 2008
Radiation therapy or radiotherapy, in which high-energy x-rays are used to destroy cancer cells, is a common way to treat prostate cancer. Early-stage prostate cancer patients can opt for radiation over surgery, or they may use radiation to kill cancer cells in the prostate area after surgery. Men with advanced stages of prostate cancer may turn to radiation to relieve pain or other problems.
Today the most common ways to deliver radiation therapy is through various forms of external beam radiation therapy (EBRT) as well as brachytherapy. EBRT involves the delivery of radiation via a machine that aims x-rays at the body. During brachytherapy, a physician places small pellets or seeds of radioactive material directly into the prostate gland.
External Beam Radiation Therapy
External beam radiation therapy for prostate cancer usually requires approximately 6 to 8 weeks of treatment, which is delivered on an outpatient basis. Before treatment begins, a patient is measured and marked to ensure the radiation beams are accurately lined up with the prostate gland for each therapy session. Patients lie on a table and receive radiation from multiple directions to the pelvis.
Newer radiation therapy techniques use a special CT scan and computer to more precisely aim the radiation in the pevic area. Called three-dimensional conformal radiation therapy, it reduces the exposure of radiation to the bladder, rectum and other internal body parts.
High-Dose Delivery via IMRT and IGRT
Among the most popular and precise high-dose radiation therapies today are intensity-modulated radiation therapy (IMRT) and image-guided radiation therapy (IGRT). Both techniques allow physicians to deliver higher doses of radiation in concentrated areas for better outcomes, or cure rates. Reducing radiation exposure to healthy normal tissue and other vital organs also helps prevent once common side effects such as urinary frequency, diarrhea and even erectile dysfunction.
Brachytherapy, the "Seeding" Treatment
Brachytherapy is a treatment in which many radioactive “seeds” are implanted through the perineum, between the scrotum and anus, into the prostate gland. After the procedure, radiation from the seeds begins to destroy cancer cells over a number of weeks, but is generally not dangerous to other people. However, physicians often recommend staying away from children and pregnant women for 3-6 weeks.
Patients may require an overnight stay in the hospital for the implantation of the seeds. Following the procedure, some patients may experience some pain or aching in the perineum. Some patients may also experience burning or discomfort during urination. Occasionally, a patient will be unable to urinate, and may require a bladder catheter for several days or weeks to allow passage of urine.
Because implant radiation focuses the radiation closely around the prostate, this form of radiation works best in patients with early stage prostate cancer.
Side Effects from Radiation Therapies
Men often want to know if they will feel anyting during radiation treatments, and the answer is no. Some side effects build up over time, such as fatigue, loose stools, diarrhea, hemorroids, and burning during ejaculation and urination.
Studies show that men tend to maintain potency with brachytherapy better than with external beam radiation. About 25% of men who undergo brachytherapy will experience erectile dysfunction versus nearly 50% men who have standard external beam radiation, according to the Prostate Cancer Foundation. After two years, few men will see much of an improvement.
While the risk of impotence is significant for most men, many radiologists claim that percentages drop significantly with the newer, high-dose and targeted radiation therapies like IGRT and IMRT.
More Cutting-Edge Radiation Methods
Many radiation oncology centers now use different types of machines to deliver various forms of radiation, such as protons or neutrons. These appear to kill more cancer cells with the same dose. One of the latest methods of radiation therapy is to combine protons or neutrons with conventional x-rays. This therapy is being evaluated in clinical trials.
Cure Rates Rising
After skin cancer, prostate cancer is the second most common cancer in American men and is second only to lung cancer as a cause of cancer deaths, according to John Hopkins Medicine. In 2007, about 219,000 men were diagnosed with prostate cancer, and about 27,000 died of the disease. The good news is that reliable diagnostic tests and new radiation options are available, and cure rates are increasing.
Other articles on facing prostate cancer by Steve Vogel.
