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Radiotherapy For Prostate Cancer


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Treating prostate cancer

Radiotherapy, or radiation treatment, delivers radiation to the prostate, killing cancer cells. Both localised prostate cancer, where the cancer is retained within the prostate, and locally-advanced prostate cancer, where the cancer has not spread beyond the area surrounding the prostate, can be treated using radiation treatment1. For these types of prostate cancer, radiation treatment has the potential to kill all of the cancer cells, offering a potential cure for prostate cancer1.

For more advanced prostate cancers, where the cancer has spread to other parts of the body, the targeted nature of radiation treatment is not able to kill all of the cancer cells1. However it is still offered to patients with advanced prostate cancer as a method of slowing the progression of the disease and relieving the symptoms1.

How does radiation treatment work in treating prostate cancer?

Unlike surgical treatments for prostate cancer, radiation treatment treats the cancer without removing the prostate. There are two forms of treatment for prostate cancer:
1. External radiation treatment – radiation delivered from outside of the body by an external radio beam
2. Internal radiation treatment (brachytherapy) – implanting small radioactive seeds into the prostate

External radiation treatment is usually offered as an outpatient procedure and can be given at many local hospitals. The radiation is delivered in short sessions for five days, normally for a period of four to eight weeks1.

Brachytherapy to treat prostate cancer

Brachytherapy is one of the newer therapies for treating prostate cancer and involves implanting radioactive seeds into the prostate, via a small surgical procedure.

The advantage of brachytherapy over external radiation is that it delivers a more concentrated dose of radiation to the area affected by the cancer, and reduces the risk of damage to healthy cells in the body.

Not all patients with prostate cancer are eligible for brachytherapy, as this form of internal radiotherapy requires a particular size of prostate.

Disadvantages of radiation treatment to treat prostate cancer

Radiation treatment requires more follow-up than surgery in treating prostate cancer. With surgery the removal of the prostate means that a patient’s prostate-specific antigen (PSA) level will be non-existent. However with radiotherapy, the prostate remains inside the body; this means that PSA levels need to be closely monitored in order to judge the effectiveness of the radiotherapy in killing the cancer cells.

Side-effects of radiation treatment to treat prostate cancer

Radiation treatment has similar side effects to surgery; this is because both treatments impact on the urinary system. Both surgery and radiation therapy carry a risk of sexual dysfunction and urinary problems.

However, radiation treatment also has short term side effects caused by the radiation1. These include:
• discomfort surrounding the area of the anus1
• diarrhea1
• Pubic hair loss1
• exhaustion1
• Inflammation of the lining of the bladder (cystitis), causing increased frequency of, and pain during, urination1

Brachytherapy carries the additional risk that the prostate may swell after the radioactive seeds have been implanted. In a minority of patients this causes problems with urination and means that the patient will need to self-catheterise to empty their bladder.

With radiation treatment, as with surgery, there is a one-in-three chance of the prostate cancer returning1.

Mr Christopher Eden
Consultant Urologist

Reference:
1. NHS Choices – Prostate cancer treatment. Date last updated: 14.02.11. Website:
www.nhs.uk/Conditions/Cancer-of-the-prostate/Pages/Treatment.aspx

 

10518 Revised November 2012

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