Radiation for Prostate Cancer

Radiation treatment is a medical procedure for killing or disabling cancer cells in the prostate gland by using high-energy X-ray or proton beams. The radiation is delivered by one of two methods: a machine outside the body that directs a beam to the target area or by small nylon catheters or pellets with radioisotopes that are placed inside the body. Because radiation can damage healthy cells in addition to killing cancerous ones, precautions are taken to focus the radioactive effects on the cancer.

Radiation therapy has proven to be very effective in treating localized prostate cancers. More than 60,000 American men opt for this method of addressing their disease every year. External-beam procedures are typically handled on an outpatient basis and don’t require an anesthetic.

When Is Radiation Treatment Used for Prostate Cancer?

There are a number of circumstances in which radiation therapy is an appropriate method for treating prostate cancer:

• In early or localized stages of the disease. 
• In combination with other treatment methods for cases that have spread. 
• As a method of preventing cancer’s return after surgery. 
• As a method for treating a recurrent cancer following remission. 
• As pain alleviation when the disease reaches an advanced state.

Preparing for Radiation Treatment

Radiation treatment requires preparation on the part of you and your medical team. That’s because radiation dosages must be precisely targeted to maximize their curative effect while minimizing damage to surrounding tissues. This is particularly critical with external-beam radiation. Planning may involve:

• Radiation simulation: During a simulation procedure, your physician will insert marker pellets into your prostate to help him or her locate it more precisely. Members of the medical team may also mark your body to improve positioning for the radiation session./
• Planning scans: Your physician will take CT scans of your lower abdomen and pelvic region.

This preparatory work enables your physician to select the type and dosage of radiation best suited to treating your cancer.

What Types of Radiation Treatment for Prostate Cancer Are There?

As noted above, there are two primary forms of radiation treatment for prostate cancer: external beam radiation therapy, or EBRT, and prostate brachytherapy or internal radiation. There are variations on each of these technologies described below:

External Beam Radiation Therapy (EBRT)

• Three-dimensional Conformal Radiation Therapy (3D-CRT): 3D-CRT utilizes advanced computer software to precisely target radiation beams. Cancer cells are irradiated and healthy tissues spared.
• Intensity Modulated Radiation Therapy (IMRT): IMRT combines 3D targeting technology with an ability to control the intensity or dosage strength of the radiation beams. This creates an additional safeguard for protecting healthy cells from misdirected radiation.
• Stereotactic Body Radiation Therapy (SBRT): SBRT combines beam-control features with imaging technology to more precisely target high-dosage radiation. This has the advantage of speeding up the treatment process, by reducing the number of radiation sessions for the patient.
• Proton Beam Radiation Therapy: Proton-beam therapy replaces X-rays with protons as the radiation agent. Proton beams release energy in narrower intervals, which means that, in theory, they can be focused more completely on cancer cells than X-rays. Proton-beam radiation works with 3D-CRT and IMRT technologies.

Prostate Brachytherapy

• Permanent Brachytherapy: In permanent brachytherapy, roughly 100 tiny pellets with low-dosage radioisotopes are placed inside the prostate. These pellets irradiate the cancer cells in their immediate vicinity. These insertions are permanent; they are never removed from the body.
• Temporary Brachytherapy: In temporary brachytherapy, tiny nylon catheters are inserted in the prostate. The catheters allow the temporary seating of sealed pellets that contain radioactive materials.

What Are the Side Effects of Radiation Treatment for Prostate Cancer?

Radiation therapy comes with risks, based on the dosage size and the degree to which healthy cells are exposed to treatment. Some potential side effects are:

• Frequent or difficult urination
• Leaking or bloody urine
• Skin reactions
• Abdominal cramping and diarrhea
• Rectal bleeding or leaking
• Constipation and painful bowel movements
• Fatigue
• Impotence and other forms of sexual dysfunction
• Secondary cancers

Many of these conditions are temporary or can be medically treated. Serious, long-term side effects from radiation therapy for prostate cancer are relatively unusual.

What Should I Expect from Radiation Treatment for Prostate Cancer?

External-beam radiation is delivered to the body from a large machine known as a linear accelerator. You will lie down to receive treatment. The machine will pass over you several times. The process is painless and should last less than an hour. You will undergo treatment five days a week for a period of seven to nine weeks.

Prostate brachytherapy requires surgery. You will be given an anesthetic so you sleep during the operation. Your surgeon will implant either low-dosage radioactive pellets or tubes for high-dosage wires inside your prostate. In the latter case, you may receive several treatments before going home. Expect to spend time recuperating in the hospital. You may experience some pain in the days following the procedure.

You’ll see your physician regularly after completing radiation therapy for prostate cancer. He or she will evaluate the effectiveness of your treatment. This process will continue indefinitely, to ensure that you remain cancer-free. If the treatment is unsuccessful or your cancer returns, your physician will devise a new plan for addressing it.