Radiation

Radiation Treatment for Prostate Cancer?

Radiation treatment is a common and effective therapy for prostate cancer. It involves the use of high-energy rays or particles to destroy cancer cells. Here’s an overview of what patients can expect before, during, and after radiation treatment, along with an explanation of hormonal therapy for prostate cancer.

Before Radiation Treatment

Before starting radiation therapy, patients typically undergo a thorough evaluation, which includes a physical examination, imaging tests (like MRI or CT scans), and possibly a biopsy to confirm the diagnosis and stage of the cancer. The medical team, often comprising a radiation oncologist, urologist, and other specialists, will discuss the treatment options, potential side effects, and the expected outcomes with the patient.

Patients may undergo a planning session called simulation. During simulation, the patient lies on a table in the treatment position, and the medical team uses imaging studies to map out the precise area to be treated. This ensures that the radiation targets the cancer while sparing as much healthy tissue as possible. Tiny marks may be placed on the skin to guide the radiation.

During Radiation Treatment

Radiation treatment for prostate cancer can be delivered externally (external beam radiation therapy, EBRT) or internally (brachytherapy).

• External Beam Radiation Therapy (EBRT): This involves directing radiation at the prostate from outside the body using a linear accelerator. Treatments are usually given five days a week over several weeks. Each session lasts only a few minutes, but the setup time can take longer.
• Brachytherapy: This involves placing radioactive seeds directly into the prostate. These seeds emit radiation over a period, effectively targeting the cancer cells.

During the treatment, patients are positioned carefully, and the machine may move around to deliver radiation from different angles. The procedure is painless, but some patients might feel discomfort from staying still for a prolonged period.

After Radiation Treatment

After completing radiation therapy, patients will have follow-up appointments to monitor their recovery and response to treatment. These visits typically include physical exams, PSA (prostate-specific antigen) blood tests, and possibly imaging studies.

Common side effects of radiation therapy for prostate cancer include:

• Short-term effects: Fatigue, urinary issues (such as increased frequency, urgency, or discomfort), bowel problems (like diarrhea or rectal bleeding), and skin irritation in the treated area.
• Long-term effects: Some men might experience persistent urinary or bowel symptoms, erectile dysfunction, and a slight risk of developing secondary cancers in the treated area.

Patients are encouraged to maintain a healthy lifestyle, including proper nutrition and regular exercise, to aid their recovery.

Hormonal Therapy for Prostate Cancer

Hormonal therapy, also known as androgen deprivation therapy (ADT), is often used in conjunction with radiation therapy for prostate cancer. It aims to reduce or block the production and action of androgens (male hormones like testosterone) that can promote the growth of prostate cancer cells.

How Hormonal Therapy Works

Hormonal therapy can be administered in various forms:

• LHRH agonists or antagonists: These drugs, given by injection, stop the testicles from producing testosterone.
• Anti-androgens: These oral medications block the action of testosterone on prostate cancer cells.
• Orchiectomy: A surgical procedure to remove the testicles, which are the primary source of testosterone.

When Hormonal Therapy is Used

Hormonal therapy is often used:

• In combination with radiation therapy to improve outcomes, especially in high-risk or advanced cases.
• As a neoadjuvant treatment to shrink the prostate before radiation.
• As an adjuvant treatment after radiation to help prevent recurrence.
• As the primary treatment for advanced or metastatic prostate cancer.

Side Effects of Hormonal Therapy

Common side effects of hormonal therapy include:

• Hot flashes
• Reduced libido and erectile dysfunction
• Weight gain
• Loss of muscle mass and bone density
• Fatigue
• Emotional changes, such as depression or mood swings

Patients receiving hormonal therapy are monitored regularly to manage these side effects and adjust treatment as necessary.

In conclusion, radiation therapy and hormonal therapy are integral parts of prostate cancer treatment, tailored to each patient’s needs and circumstances. Understanding what to expect before, during, and after these treatments can help patients and their families prepare and manage the journey more effectively.