Prostate Cancer Radiation Therapy

There are two types of radiation therapy used to treat prostate cancer, brachytherapy and external radiation therapy (XRT).

Brachytherapy

This form of treatment involves inserting radioactive seeds that are no larger than a grain of rice into the cancerous prostate gland. The seeds discharge radiation that kills the malignant tumor. The amount of seeds necessary for this procedure is by using a transrectal ultrasound (TRUS) which creates a three-dimensional grid map of the prostate, a computer calculates the volume of the gland, the number of seeds needed and determines where they will be placed.

This procedure takes 45 to 60 minutes. It is performed on an outpatient basis with a local anesthesia. Fifty to 100 rice-sized seeds are implanted by a needle, which is inserted through the perineum and into the predetermined location. The seeds contain a radioactive isotope (palladium 103 or iodine 125) that releases radiation for about 3 months and then becomes unmoving. With this therapy, higher doses of radiation are put right on the cancer. Discomfort is a common side effect from this treatment

Brachytherapy recovery patients are discharged the same day. The patient resumes routine activity within a day or so. A study has shown that most brachytherapy patients remain free of prostate cancer five years after treatment.

Recovery patients over the age of 70, experience incontinence or impotence.

External Radiation Therapy (XRT) procedure is used when the tumor has spread through the prostate gland to surrounding tissues. XRT is an outpatient procedure for seven or eight weeks without any anesthesia. From outside the body, a machine launches high-energy x-rays for five days per week onto the prostate tissue. The radiation destroys cancer cells and shrinks tumors. However, if healthy cells are continuously exposed, they will be unable to repair the extensive damage. This is why it is very important that precise aiming of the beam is crucial to the success of the treatment and avoidance of healthy cells.

According to urologychannel.com, a study of 999 patients found 79% of stage T1, 66% of stage T2, 55% of stage R3 and 22% of stage T4 prostate cancer patients survived 10 years after XRT treatment.

Side effects are milder than the side effects from the seed therapyCommonly experience complications with XRT include impotence, particularly in older men, discomfort with urination, urinary urgency and diarrhea, especially during the late stages of treatment.

CyberKnife has recently tested another treatment in some treatment centers. Stereotactic radiosurgery is used in treating prostate cancer. This procedure entails the use of a computer program to determine the precise shape, size and location of the tumor, then, a robotic arm helps deliver highly concentrated beams of radiation from many different angles and positions. These beams intersect at the tumor, and should not damage healthy tissue.

Since 1915, prostate cancer radiation treatment has been used in the United States. The first radiotherapy used radium applicator positioned adjacent to the prostate gland. Unfortunately, this procedure resulted in exceptional morbidity.

Electron beam x-rays was the next technique in radiotherapy. Unfortunately, these x-rays could not penetrate deeply enough to irradiate the affected tissue. The x-rays caused skin cancer, so they were used mainly for analgesic care.

Doctors were able to use megavoltage in prostate cancer treatment after World Ward II. They used radioactive isotopes from Cobalt 60. By the 1980’s, radiation oncologists began using the linear accelerator which increased the speed of particles and allowed for the most process aiming of the beam.

Through the years, researchers have made progress with improving techniques to treat prostate cancer with little discomfort for patients.

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