When is radiation used to treat prostate cancer

For some patients, temporary high dose rate brachytherapy is used to administer higher doses of radiation through catheters placed in the prostate for a short time. Radium, a radioactive substance, is used to treat men with metastatic prostate cancer that no longer responds to hormone therapy. Because it mimics calcium, the radium is selectively absorbed into areas where prostate cancer is invading bone.

This revolutionary treatment has been shown to improve the survival of men with metastatic prostate cancer that has spread to the bones, and to delay problems in the bone such as pain or fracture. Compared to earlier radiation methods, these modern techniques reduce the chance of urinary and bowel problems. With several treatment options available, your doctor will work with you to develop and oversee a treatment plan that precisely addresses your prostate cancer while minimizing the risk to surrounding tissues.

This is why it is important to choose an experienced radiation oncologist who specializes in the management of prostate cancer. High volume centers where practitioners have significant experience and treat large numbers of patients with prostate cancer may be associated with good outcomes and fewer lasting problems related to treatment. However, it is possible to have a permanent reduction in the sperm count or sterility.

If you are considering fathering additional children, you may wish to seek medical advice regarding your fertility and need to bank sperm. Testosterone is secreted by the Leydig cells in the testicles.

Generally, the doses of internal scatter radiation that reach the testicles are not high enough to impair Leydig cell function. Following external beam radiation therapy EBRT , you will have an initial appointment to make sure that treatment-related side effects are diminishing or have gone away. The frequency of follow-up appointments will be based on the risk of cancer recurrence.

In general, serial PSA blood tests will start around the third month after treatment completion. Testing typically occurs every three to four months during the first two to three years after treatment completion and then every six months thereafter. Changes to this schedule may be made during the process of follow-up evaluation. Patients receiving brachytherapy will have an appointment for a CT scan of the prostate approximately three to four weeks after the procedure.

This CT scan will be used to evaluate the quality of the implant. Generally on the same day, an appointment in the Urology Department will also be scheduled. Serial PSA blood tests will be used to monitor your progress after definitive treatment of your prostate cancer. Following radiation therapy, your PSA will fall but will not reach its lowest value, or nadir, immediately after treatment.

Though infrequent, it may take up to two to three years for the PSA to reach its nadir. Keep in mind that the PSA may not decline steadily. Temporary increases in PSA, also called "spikes" or "bounces," may occur during the first 12 to 36 months after external beam radiation therapy EBRT or brachytherapy.

These bounces are not signs of treatment failure. If you received hormone therapy, the PSA decline and the period of decline may be prolonged. As your testosterone recovers, your PSA may rise.

This increase is not considered a "bounce or spike" and is not a sign of treatment failure. There is much debate over the most accurate means to detect treatment failure after radiation therapy.

A consensus definition was established in an effort to systematize the evaluation of treatment outcomes. This definition defines treatment failure as three consecutive increases in the PSA value after the nadir has been reached.

There are several problems with this definition. Also, the consensus definition was intended to be used after EBRT monotherapy, not after brachytherapy or combined treatment with hormone therapy, as it is sometimes used. A task force is working to define a more sensitive accurately detects increases in the PSA and specific the detected PSA rises truly represent treatment failure definition for post-EBRT therapy, as well as establish definitions for treatment failure following brachytherapy and combined radiation and hormone therapy.

This does not mean that PSA testing should be abandoned at this time. It remains an important monitoring tool and serial testing at regular intervals is critical to its effective use. Your doctor will evaluate additional data in conjunction with the PSA to monitor your treatment outcome. Usually, no additional treatment is needed after radiation therapy. The need for additional treatment is determined by the PSA, Gleason score and stage of the prostate cancer and having your daily treatments as scheduled, particularly for external beam radiation therapy EBRT.

Regular post-treatment PSA evaluation plays an important role in monitoring and evaluating the need, if any, for additional treatment in the future. Should the cancer recur, options for treatment will in part depend upon the initial treatment. Additional or alternative forms of radiation therapy, prostatectomy, cryotherapy, hormone therapy or any of a number of treatments under evaluation in clinical trials may be recommended.

Your team of doctors, including a radiation oncologist, urologist and medical oncologist, will discuss treatment options and recommendations with you. UCSF Health medical specialists have reviewed this information. It is for educational purposes only and is not intended to replace the advice of your doctor or other health care provider. We encourage you to discuss any questions or concerns you may have with your provider. Good nutrition may reduce the incidence of prostate cancer and help reduce the risk of prostate cancer progression.

Urologist suggests brachytherapy. I requested a Prolaris test. My inclination is to wait on treatment and biopsy next year. What is standard policy for this situation?

Thank you. I'm told my prostate is to small for brachytherapy at 18cc volume. Was told 20cc is the smallest size to perform the procedure Question - Can't fewer seeds be implanted for a smaller prostate? Please advise Thank you in advance.

Just had a Radical Prostatectomy, gleason score of Possibly a leak in one area of capsule Standard EBRT. Thanks, very concerned about side effects of standard EBRT. Looks like I have a node in pelvic bed around prostate involved, started on Casodex and will begin Lupron in 2 weeks, then radiation Also not sure if I need to be on hormones for 2 years. Also, Axumin PT is negative. Was Gleason 9 however. I recently underwent a prostatectomy.

The pathology report showed there was patchy neuroendocrine differentiation and focal transformation to small cell carcinoma. From my understanding small cell carcinoma is a very rare, aggressive cancer.

We have a number of experts in treating neuroendocrine tumors. I have gleason score and doctors inform me that I am a great candidate for either surgery or radiation. The possible deciding factor is my prostate is very large. Would radiation shrink it to allevieate my urinary issues? Dear Robert, we are not able to answer individual medical questions on our blog. What are the comparative results of these two options? MSK prides itself on performing the difficult procedure of salvage radical prostatectomy.

Dear Suku, we are not able to answer individual medical questions on our blog. I had a prostatectomy and now have a biochemical recurrence, as shown by my rising PSA. I was diagnosed with PSA of 5. Also Decipher of low risk 0. I am feeling great!

Side effects manageable. So for those who are going through this, or thinking about what to do, anxiety will pass once you engage. Talk to people in the waiting area before treatment. It is encouraging. Good Luck! Is this the radiation showing a high read or, does he need a radical prostatectomy? Dear Carol, we are not able to answer individual medical questions on our blog. If he would like to have a consultation with someone at MSK to discuss this, you can make an appointment online or call Thank you for your comment and best wishes to both of you.

What are the different types of radiation therapy for prostate cancer? Back to top Do we know which treatment is better for prostate cancer, brachytherapy or external beam radiation?

Learn why brachytherapy is the best form of treatment for some cancers. Learn more. Learn what it means to receive hypofractionated radiation therapy in this short animation. Dear William, sending you our deepest sympathies for the loss of your loved ones to cancer. Thank you for reaching out to us. I do both weight bearing exercises, as well as plenty of aerobic For example, when I am on the treadmill, I start out putting it up to 15 percent while walking 2.

I keep my weight on the lighter side and try to get enough sleep. Thanks - Roland. Best Regards Ed Ford. Hi, new. These high-energy waves break down the DNA inside cancer cells and prevent them from replicating. Radiation therapy can also damage healthy cells, but treatment seeks to minimize damage to healthy tissue. Normal cells can often recover from damage once treatment stops. According to the American Cancer Society , radiation therapy may be used to treat prostate cancer :.

Two types of radiation therapy are used to treat prostate cancer. These are external beam radiation therapy and brachytherapy. During external beam radiation therapy, a machine aims beams of concentrated radiation at cancer cells in the prostate.

It may be used to treat cancer in the early stages or to help relieve symptoms if cancer spreads to bone. The procedure is generally painless. According to the American Cancer Society, people typically undergo radiation therapy 5 days per week for at least several weeks. Brachytherapy uses small radioactive pellets about the size of rice grains to kill prostate cancer cells. Your doctor will position the pellets in your prostate with help from imaging techniques such as an ultrasound, computerized tomography CT scan, or magnetic resonance imaging MRI.

Brachytherapy may be combined with external radiation if your cancer is at a high risk of growing outside your prostate. External beam radiation therapy and brachytherapy both have the potential to cause side effects. Generally, most side effects go away within 2 months of finishing treatment.

Radiation can irritate the lining of your rectum. This can lead to diarrhea , blood in your stool , or rectal leakage. In the majority of cases, these symptoms go away after treatment, but in rare cases, they may be permanent. Bladder irritation caused by radiation is called radiation cystitis.