Lesson 3: Prostate Cancer Treatment Options
External Beam Radiation
External beam radiation is used to kill cancer cells by hitting them with high-energy rays or particles. Only very few centers in the world use particles to treat prostate cancer. Particles have not been shown to be superior to x-ray radiotherapy, so the following will focus on x-ray therapy. In modern clinics, the x-rays are targeted through the skin to the affected areas that have been located by conventional (conventional radiotherapy) or computer imaging (3-dimensional conformal radiotherapy). Radiation has proven to be a very effective way to kill cancer cells, but it also damages some of your healthy cells. Radiation affects the cells that are growing or dividing the fastest, such as cancer cells, but also skin cells, and the cells that line your bladder and bowel. Virtually all-normal cells will heal, but there may be permanent changes in the areas around the prostate that received a lot of radiation. This scarring can make future surgery difficult. However, the chances of needing surgery on the prostate after modern radiation are very low. The damaging effects of radiation may not be evident until many years after the treatment, and most frequently include: a small risk of bleeding from the rectum, changes in urinary or bowel function, and/or erectile dysfunction. The risk of anything serious occurring (for instance, something that would require surgery to fix) is rare.
Generally, External Beam Radiation is carried out over a 6 to 8 week period. The treatment requires a trip to a treatment center for 30 to 60 minutes each day, 5 times a week, for the duration of the treatment. The treatment itself only lasts about 10 minutes. Your body will need to heal itself from the radiation as well as clean up the dead cancer cells so while undergoing treatment you may experience mild fatigue. Your bladder and bowels will likely be irritated to a certain degree, which will persist for about a month or two after treatment stops.
External Beam Radiation is offered at specialized treatment centers and because the treatment is carried out over 6 to 8 weeks, this may mean you would have to relocate to get treated. However, more and more clinics and hospitals are offering this form of treatment. If you need assistance in locating a clinic or hospital near you that offers this type of service, please don’t hesitate to ask. The American Cancer Society has a facility locator at: http://www.cancer.org/docroot/home/index...
Conformal Radiation http://www.phoenix5.org/Infolink/Michals... is a newer technique that makes use of a template that the radiation is shot though. The template is customized to you, given the shape of your body and organs, as well as the most likely locations of any prostate cancer cells. This technique allows the technician to deliver the radiation more accurately than possible with conventional radiation. Again, more and more clinics and hospitals are starting to offer this type of treatment. Please, let me know if you need assistance in finding a facility close to your home.
The success of any treatment will depend on 3 tumor factors: the size of your tumor (T stage), your Gleason Score, and your last PSA test before treatment, as well as the technical skills of your Urologist/Radiation Oncologist.
