A Guide to Radiation Therapy for Prostate Cancer
- Radiation therapy is an important and non-invasive way to treat prostate cancer because it is both effective and precise.
- Two newer radiation options, SBRT and MRI-Linac, offer targeted radiation that can be completed in as few as 5 treatments.
- Radiation treatment involves painless sessions targeting cancer cells while minimizing damage to healthy tissue. Some patients do experience side effects.
- Advanced metastatic prostate cancer may require other treatments besides radiation. Be sure to discuss all of your options with your care team.
According to Zelefsky, radiation therapy can be more convenient and less invasive than many other available treatments for advanced prostate cancer. It can be used before, after, or with other treatments such as surgery or chemotherapy
Read More- Non invasive approach that does not require surgery
- Radiation directly to the tumor sparing other tissues
- Can spare nerves related to sexual function
- Extremely low risk of urinary leakage
What is radiation therapy for prostate cancer?
Radiation therapy is a targeted treatment for prostate cancer. It uses high-energy X-rays to destroy cancer cells. There are many approaches to deliver radiation therapy to treat prostate cancer including Intensity Modulated Radiation Therapy (IMRT) and brachytherapy, a few of the newer approaches include:- SBRT (Stereotactic Body Radiotherapy): A condensed form of targeted radiation therapy delivered in a much shorter time frame that can be as effective as several weeks of traditional radiation. With SBRT patients usually complete treatment in just 2 weeks. SBRT is not right for every patient so ask your treating team if you are a good candidate for this type of radiation therapy.
- MRI-Linac: Radiation therapy guided by an MRI that can make real-time adjustments for better accuracy.
Which type of radiation therapy is right for you?
To decide what type of radiation therapy to use, your doctor will assess the specific characteristics of your prostate cancer, most likely using these three tests:
- Gleason score, which is a grading system that helps predict how fast your cancer may grow and spread. The Gleason score looks at the aggressiveness of prostate cancer cells under a microscope and is assigned by a type of doctor called a pathologist.
- PSA test, which looks at the amount of prostate-specific antigen (PSA) in your blood. Higher PSA levels suggest prostate cancer, although other conditions like infection or inflammation can also raise PSA levels.
- Imaging, depending on the PSA level and Gleason Score your treatment team may also order additional imaging tests such as a bone scan, CT scan, MRI, or PSMA-PET scan.
Having this detailed analysis ensures that you get an effective and safe treatment plan. This personalized approach is important for getting the best outcome possible for each patient.
“Choosing treatments based on the disease characteristics is so critical,” Dr. Zelefsky, says. “It’s simply not a cookbook where one treatment fits all.”
Related: A prostate Cancer Overview
How does it work?
Radiation therapy for prostate cancer typically involves regular visits to a clinic for targeted treatments. During each session, you’ll lie still as advanced machines aim high-energy rays at the cancer cells.
The goal of the therapy is to destroy cancer cells while minimizing damage to the surrounding healthy tissue.
You may feel anxious or uncomfortable during these sessions, but the treatment itself is painless. You won’t see or feel the radiation. However, you may experience some side effects such as:
- Fatigue
- Skin irritation in the treated area
- Urinary problems
- Loose stools or diarrhea
Any side effects are usually temporary (although some may be longer lasting or permanent). Your care team can help you manage them, and they will watch you closely throughout the treatment to address any concerns or symptoms you have.
Options for advanced metastatic prostate cancer
For advanced metastatic prostate cancer that has spread to other parts of the body, Zelefsky says your doctor may consider other treatment options beyond traditional radiation.
“These methods can offer relief and control even in more advanced stages,” Dr. Zelefsky says. However, he adds that they typically don’t offer a cure.
Some treatment options for advanced disease your doctor may consider:
- Immunotherapy: Enhances the immune system with drugs like checkpoint inhibitors to target and combat cancer cells.
- Brachytherapy: Places radioactive “seeds” near tumors for precise radiation.
- Hormonal Therapy (ADT): Lowers testosterone with medication or orchiectomy, sometimes using anti-androgen drugs or secondary therapies.
- Radionuclide Therapy: Delivers focused radiation with radium-223 (Xofigo) for bone metastases treatment.
- Surgery: Considered for prostate removal or managing complications like spinal cord compression.
- Clinical Trials: Offers experimental treatments for metastatic prostate cancer patients to test out new and innovative therapies.
Related: Nobel Prize Winner Jim Allison And The Invention Saving Millions of Lives
Questions for your doctor
When considering radiation therapy for prostate cancer, here are five straightforward questions to ask your doctor:
- Can you explain the different types of radiation therapy available for prostate cancer, and which one is recommended for my specific case?
- What are the potential side effects of radiation therapy, and how can they be managed?
- How many radiation sessions will I need, and how long will each session take?
- What are the chances of the cancer returning after radiation therapy, and what follow-up tests will be necessary?
- Are there any other treatments besides radiation that might work for me?
Related: The Challenge of Deciding When to Treat Prostate Cancer
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