 RADIATION THERAPY
for
PROSTATE CANCER
Non-Surgical Options Facts to Help Patients
Make An Informed Decision
Facts About
Prostate Cancer
Prostate cancer is the most common malignancy
in American men. -
In 2003, more than 220,000
men were diagnosed as having prostate cancer, making it the number one type of
cancer in men. -
Nearly 29,000 men died from prostate
cancer in 2003. -
More than 75 percent of prostate cancer
is diagnosed in men over age 65. Risk
Factors For Prostate Cancer
Incidence of prostate cancer increases
with age. -
Median age at diagnosis in Caucasian
males is 71. -
African-American men have the highest incidence
of prostate cancer in the world. -
Heredity accounts for
5 to 10 percent of cases. Screening
For Prostate Cancer
According to the American Cancer Society, men
aged 50 or older should be offered a digital rectal exam (DRE) and a PSA blood
test. However, it is a good idea to visit your doctor earlier to establish a baseline
PSA level so you can monitor changes. -
Prostate
specific antigen (PSA) is a valuable marker for prostate cancer although BPH or
infection may also cause a rise in PSA. -
Normal range
is 0-4, however, a PSA above 3 in men younger than 60 may be considered abnormal. -
African-American men and men with a family history of prostate
cancer should be examined beginning at an earlier age.
Diagnosing Prostate Cancer
Prostate cancer is most often
diagnosed through a blood test measuring the amount of prostate specific antigens
(PSA) in the body. However, signs and symptoms of prostate cancer can include:
-
Changes in urinary flow: Frequency, urgency, hesitancy. -
Frequent night time urination. -
Painful
urination. -
Blood in urine. Other
conditions that may cause these symptoms include an enlarged prostate (benign
prostatic hypertrophy or BPH) or infection. Radiation
Therapy Options For Treating Prostate Cancer
After a diagnosis of
prostate cancer has been established with a biopsy, the patient should discuss
the treatment options with a radiation oncologist and a urologist. Radiation therapy
treatment options to cure prostate cancer include:
External Beam Radiotherapy
External beam radiotherapy involves
a series of daily outpatient treatments to accurately deliver radiation to the
prostate. There are two principal methods for delivering
external beam radiation. -
3-dimensional
conformal radiotherapy combines multiple radiation treatment fields to deliver
precise doses of radiation to the prostate. Tailoring each of the radiation beams
to accurately focus on the patient's tumor allows coverage of the prostate cancer
while at the same time keeping radiation away from nearby organs such as the bladder
or rectum. -
Intensity modulated radiation therapy or
IMRT is the most recent advance in the delivery of radiation. IMRT improves on
3-D conformal radiotherapy by modifying the intensity of the radiation within
each of the radiation beams. This technique allows more precise adjustment of
radiation doses to the tissues within the target area, potentially allowing an
increased radiation dose to the prostate and reduced doses to nearby normal tissues.
Higher doses to the prostate translate into a greater chance for cure, while lower
doses to surrounding organs mean fewer side effects.
Both types of external beam radiotherapy are acceptable treatment; IMRT offers
advantages for some but not all prostate cancer patients. With either type of
therapy, painless radiation treatments are delivered in a series of daily sessions,
each under half-hour in duration, Monday through Friday for seven to ten weeks
overall. Potential side effects, including fatigue, increased frequency
or discomfort of urination, and loose stools, typically resolve within a few weeks
after completing treatments. Impotence is also a potential side effect of any
treatment for prostate cancer. However, many patients who receive radiation therapy
for prostate cancer are able to maintain sexual function. Prostate
Brachytherapy
Prostate brachytherapy, better known as a seed implant,
is often done in the operating room. There are two methods
of delivering internal radiation for prostate cancer:
These treatments are designed to deliver a very high dose of radiation to the
tumor by inserting radioactive seeds directly into the prostate gland under ultrasound
guidance while the patient is under anesthesia. Isotopes of iodine or palladium
are most commonly used. The seeds are approximately four millimeters long and
less than a millimeter in diameter. In certain situations, both prostate brachytherapy
and external radiation may be recommended to combat the tumor. The side
effects from seed implants are similar to those experienced with external beam
radiotherapy. Patients usually experience urinary frequency and discomfort in
urination. These effects may be lessened with medication and usually dissipate
over the course of three to six months. Proton Beam Therapy
In
a few parts of the country, proton beam therapy is being used to treat prostate
cancer. Proton therapy is administered much the same way as external beam
therapy, but it uses protons rather than x-rays to irradiate cancer cells. Hormone
Therapy
Certain patients may benefit from hormone therapy in addition
to radiation. In some patients, hormone therapy works with radiation therapy to
improve cure rates. Where Can I Get More Information?
Your
primary care physician and prostate cancer specialists (urologists and radiation
oncologists) can provide you with information on prostate cancer, as well as information
on how to contact support groups in your area and throughout the country. Helpful
Web Sites on Prostate Cancer
National Prostate Cancer Coalition -
http://www.4npcc.org/
Prostate
Cancer Foundation - http://www.prostatecancerfoundation.org/
Us
Too! International Prostate Cancer Education and Support Network - http://www.ustoo.org/ Learning
About Clinical Trials
The radiation oncology team is constantly exploring
new ways to treat cancer patients through studies called clinical trials. Today’s
standard radiation therapy treatments are a result of clinical trials completed
many years ago. For more information, please contact the following organizations: National
Cancer Institute
www.cancer.gov/clinicaltrials
National
Institutes of Health
http://www.clinicaltrials.gov/
Radiation
Therapy Oncology Group
http://www.rtog.org/
Southwest
Oncology Group
http://www.swog.org/ About
the Radiation Oncology Team
Radiation oncologists are the doctors
who oversee the care of each patient undergoing radiation treatment. Other members
of the radiation oncology team include radiation therapists, radiation oncology
nurses, medical physicists, dosimetrists, social workers and nutritionists. About
ASTRO
The American Society for Therapeutic Radiology and Oncology
is the largest radiation oncology society in the world. The Society’s mission
is to advance the practice of radiation oncology by promoting excellence in patient
care, promoting research and disseminating research results. If
you would like to receive a free printed copy of our booklet, Radiation Therapy
for Prostate Cancer, please contact Jessica Brown at jessicab@astro.org
or download by clicking
here.
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