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PROSTATE CANCER TREATMENT

A number of options are available to treat patients with prostate cancer. The first step is a consultation with your urologist, who in most cases is a surgeon that specializes I disorders of the urinary tract disorders.  Then depending on the stage of your prostate cancer the urologist will discuss treatment options, which may include one or a combination of treatments. Radiation therapy is a common treatment for prostate cancer. The urologist will suggest that you speak with a radiation oncologist who specializes in the treatment of cancer using radiation therapy.

At the Carol G. Simon Cancer Center, prostate cancer is treated with two types of radiation:

  1. External Beam Radiation Therapy (EBRT):

External beam radiation therapy treats the prostate gland from the outside of the body. This treatment is done as an outpatient procedure that is delivered on week days over a period of 7 to 8 weeks.  The prostate patient is positioned on a special table for his treatment, while the radiation machine (linear accelerator) sends radiation beams to the prostate gland from different angles.  The linear accelerator does not touch the body, and there is no discomfort.  At our center, we use the most advanced form of radiation called Image Guided Radiation Therapy (IGRT) that pinpoints the exact position of the prostate gland each day that external beam radiation is delivered.

Side effects of external beam radiation therapy may include:

  1. fatigue
  2. bladder irritation or increased frequency of urination
  3. loose bowel movements

These side effects usually improve over time after radiation is completed.

  1. High Dose Rate (HDR) Brachytherapy:

High Dose Rate Brachytherapy is a technique that places radioactive sources inside the body in close proximity to the cancer cells.  The radioactive source is delivered through hollow tubes (catheters) that have been positioned inside the prostate gland during a brief operative procedure.  The radiation source is a solid radioactive material permanently attached to the end of a flexible wire, which is stored in a machine called an afterloader.  The afterloader delivers the wire tip to each positioned catheter one at a time for several minutes, until each prostate area has received the desired dose.  This procedure is carried out four times spaced over a 24 hour period.  The patient stays in the hospital bed for 1-2 days during this treatment time.  Patients remain comfortable by using available pain relief medications.  After the fourth HDR treatment, the Brach therapy applicators are removed and the patient is discharged to go home to recover.

Side effects of HDR Brachytherapy are similar to external beam therapy.  Medications are ordered if side effects are present.  Improvement occurs over several months.

  1. Some prostate patients may receive a combination of external beam radiation therapy and HDR Brachytherapy. 
  1. Prostate cancer patients often receive hormone therapy in combination with their radiation therapy.  The hormones can help by making the prostate gland smaller, as well as suppressing male hormones (testosterone), which encourage tumor growth.  Your urologist will advise you as to how long hormone therapy is needed before beginning radiation therapy.  Some men may experience fatigue and hot flashes when receiving hormone therapy.