Prostate cancer treatment radiation

Radiation Therapy for Prostate Cancer

What is Radiation Therapy for Prostate Cancer?

Radiation therapy is one treatment your doctor may recommend for prostate cancer. The treatment uses concentrated waves of intense energy to destroy cancer cells. The radiation may be in the form of X-rays, gamma rays, electron beams, or protons. These high-energy waves break down the DNA inside cancer cells and prevent them from replicating.

Radiation therapy may be used either by itself or in combination with other treatment options, such as hormone therapy, active surveillance, and prostatectomy (surgery).

Before Radiation Therapy for Prostate Cancer

When is radiation therapy used for prostate cancer?

Radiation therapy can be used:

. As the first treatment for low-grade cancer contained to the prostate gland.

. As the first treatment in combination with hormone therapy for cancer that’s growing outside the prostate and into nearby tissue.

. After surgery if the surgery doesn’t completely get rid of the cancer or if the cancer grows back.

. To keep advanced cancer under control and to help prevent symptoms.

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How you prepare

Before you undergo external beam radiation therapy, your health care team guides you through a planning process to ensure that radiation reaches the precise spot in your body where it's needed. Planning typically includes:

. Radiation simulation. During simulation, your radiation therapy team works with you to find a comfortable position for you during treatment. It's imperative that you lie still during treatment, so finding a comfortable position is vital. To do this, you'll lie on the same type of table that's used during radiation therapy. Cushions and restraints are used to position you in the right way and to help you hold still. Your radiation therapy team will mark the area of your body that will receive the radiation. Depending on your situation, you may receive temporary marking with a marker or you may receive small permanent tattoos.

. Planning scans. Your radiation therapy team will have you undergo computerized tomography (CT) scans to determine the area of your body to be treated.

After the planning process, your radiation therapy team decides what type of radiation and what dose you'll receive based on your type and stage of cancer, your general health, and the goals for your treatment.

The precise dose and focus of radiation beams used in your treatment is carefully planned to maximize the radiation to your cancer cells and minimize the harm to surrounding healthy tissue.

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What are the side effects of radiation therapy for prostate cancer?

External beam radiation therapy and brachytherapy both have the potential to cause side effects. Generally, most side effects go away within 2 months of finishing treatment.

External beam therapy

Potential side effects of external beam therapy include:

. Radiation proctitis

Radiation can irritate the lining of your rectum. This can lead to diarrhea, blood in your stool, or rectal leakage. In the majority of cases, these symptoms go away after treatment, but in rare cases, they may be permanent.

. Radiation cystitis

Bladder irritation caused by radiation is called radiation cystitis. Symptoms can potentially include:

. Frequent need to urinate

. Burning during urination

. Blood in your urine

. Dribbling or leaking after urinating

. Narrowing of urethra

Symptoms generally improve shortly after treatment, although they can sometimes be permanent. Developing leaking or dribbling when urinating more commonly occurs after prostate surgery than radiation therapy.

. Erection problems

After receiving radiation therapy for an extended period, you may develop erectile dysfunction. Your chance of developing erectile dysfunction increases the longer you’re on radiation.

. Fatigue

Radiation therapy commonly causes fatigue that remains for weeks or months after treatment is finished. Most people begin to feel tired within weeks of starting radiation therapy.

. Lymph node damage

Lymph nodes help circulate fluid around your body and contain immune cells. Radiation therapy can damage lymph nodes around your prostate and may lead to swelling or pain.

Brachytherapy

Internal beam therapy can cause similar symptoms as external beam radiation therapy such as radiation proctitis, trouble urinating, and erection problems.

Radioactive pellets used during brachytherapy can give off radiation for up to months. The amount of radiation is mostly contained to your prostate, but your doctor may recommend that you stay away from pregnant people or small children.

The pellets may also be picked up by detection systems at some airports, so you may want to bring a doctor’s note with you when you’re traveling.

Pellets can move, and in rare cases, they can move through your bloodstream and end up in other parts of your body such as your lungs or heart. Generally, this movement is harmless.

Talk with your doctor about side effects and what to expect

Your doctor can help you determine whether radiation therapy is right for you.

In addition, an oncologist — a doctor specializing in cancer treatment — can help you learn how to minimize your chance of developing side effects.

They can also refer you to local support groups where you can get in touch with other people who have undergone or are undergoing the same treatment.

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During Radiation Therapy for Prostate Cancer

What are the types of radiation therapy used for prostate cancer?

Two types of radiation therapy are used to treat prostate cancer. These are external beam radiation therapy and brachytherapy.

External beam radiation therapy

During external beam radiation therapy, a machine aims beams of concentrated radiation at cancer cells in the prostate. It may be used to treat cancer in the early stages or to help relieve symptoms if cancer spreads to bone. The procedure is generally painless.

People typically undergo radiation therapy 5 days per week for at least several weeks.

External beam radiation therapy can be broken into several subcategories:

. Intensity-modulated radiation therapy. A machine connected to a computer adjusts your position as the machine delivers radiation. The intensity and angle of the beams of radiation can be adjusted.

. Three-dimensional conformal radiation therapy. A computer maps cancer cells before radiation beams are aimed at your prostate from several directions.

. Stereotactic body radiation therapy. Large doses of radiation are administered in a short period. Treatment is usually given over a few days.

. Proton beam radiation therapy. Concentrated beams of protons are used to target cancer. In theory, proton beam radiation can deliver more radiation while doing less damage to healthy tissues.

Brachytherapy (internal radiation therapy)

Brachytherapy uses small radioactive pellets about the size of rice grains to kill prostate cancer cells. It’s generally only used for people with early stage prostate cancer.

Your doctor will position the pellets in your prostate with help from imaging techniques such as an ultrasound, computerized tomography (CT) scan, or magnetic resonance imaging (MRI).

Brachytherapy may be combined with external radiation if your cancer is at a high risk of growing outside your prostate.

There are two types of internal radiation therapy used to treat prostate cancer:

. Permanent brachytherapy. Radioactive material is inserted into your skin between your scrotum and anus using a needle. The pellets give off radiation for weeks to months.

. Temporary brachytherapy. A large dose of radioactive material is left in your prostate for about 5 to 15 minutes before being removed.

How radiation therapy is performed

Radiation therapy typically takes treatment sessions five days a week for 1 to 10 weeks. The total number of treatments depends on the size and type of cancer. Each session usually takes about 10 to 30 minutes. Often, the individual is given each weekend off from therapy, which helps with the restoration of normal cells.

At each session, you’ll lie on the treatment table, and your team will position you and apply the same types of cushions and restraints used during your initial radiation simulation. Protective covering or shields may also be positioned on or around you to protect other body parts from unnecessary radiation.

Radiation therapy involves the use of a linear accelerator machine, which directs radiation at the appropriate spot. The machine may move around the table in order to direct the radiation at the appropriate angles. The machine may also make a buzzing sound, which is perfectly normal.

You should feel no pain during this test. You’ll also be able to communicate with your team via the room’s intercom, if necessary. Your doctors will be nearby in an adjacent room, monitoring the test.

After Radiation Therapy for Prostate Cancer

Following up after radiation therapy

During the weeks of treatment, your healthcare provider will closely monitor your treatment schedule and dosing, and your general health.

You’ll undergo several imaging scans and tests during radiation so your doctors can observe how well you’re responding to treatment. These scans and tests can also tell them if any changes need to be made to your treatment.

If you experience side effects from radiation — even if they’re expected — tell your healthcare provider at your next appointment. Sometimes, even small changes can make a big difference in lessening side effects. At the very least, you may be given advice or a medication to help ease the discomfort.

Does radiation therapy cause cancer?

It has long been known that radiation therapy can slightly raise the risk of getting another cancer. It’s one of the possible side effects of treatment that doctors have to think about when they weigh the benefits and risks of each treatment. For the most part, the risk of a second cancer from these treatments is small and is outweighed by the benefit of treating the cancer, but the risk is not zero. This is one of the many reasons each case is different and each person must be part of deciding which kind of treatment is right for them. The risk is different depending on where the radiation treatment will be in the body.

If your cancer care team recommends radiation treatment, it’s because they believe that the benefits you’ll get from it will outweigh the possible side effects. Still, this is your decision to make. Knowing as much as you can about the possible benefits and risks can help you be sure that radiation therapy is best for you.

Will radiation therapy make me tired?

Everyone have their own energy level, so radiation treatment will affect each person differently. Patients often feel fatigue after several weeks of treatment. For most patients, this fatigue is mild. However, a loss of energy may require some patients to change their daily routine.

If your doctor thinks you should limit your activity, they will discuss it with you.

To minimize fatigue while you are receiving radiation treatment:

. Be sure to get enough rest.

. Eat well-balanced, nutritious meals.

. Pace your activities and plan frequent rest periods.