Radiation Therapy for Prostate Cancer: Procedure, Success Rate

Radiation therapy, otherwise known as radiotherapy, is a treatment method that uses high-energy rays/ particles of radiation (X-rays or protons) to destroy cancer cells. There are two types of radiation therapy for prostate cancer. These are:

1. External Beam Radiation therapy 
2. Internal Beam Radiation therapy. 

Generally, radiation therapy or radiotherapy for prostate cancer is given to the cancer patient at different points during the treatment routine. This treatment can be provided 

1. As the first treatment for men with low-grade cancer or when the cancer is in the early stage and is contained within the prostate gland.
2. As a part of the first treatment in combination with other treatments like hormone therapy to patients whose cancer has grown and spread into nearby tissues outside the prostate.
3. As a post-surgery to prevent cancer recurrence.
4. Symptomatic relief to the patient (palliative care) if prostate cancer has advanced and spread outside the prostate.

Different types of radiation therapy are used for prostate cancer treatment. These include

External Beam Radiation Therapy (EBRT)

External Beam Radiation Therapy (EBRT) is a common type of radiotherapy used for cancer treatment. It is a painless procedure. In this type of radiation therapy, a machine (linear accelerator) present outside the body is used to focus high-energy rays/ particles of radiation (X-rays or protons) on the region of the prostate with cancer. 

New techniques of external beam radiation therapy techniques can also be used to treat prostate cancer. These new external beam radiation therapy techniques include

1. Intensity-Modulated Radiation Therapy (IMRT) 
   1. Intensity-modulated radiation therapy (IMRT) is a common type of EBRT used in prostate cancer treatment. 
   2. This method uses a computer-driven machine that circles the patient to provide radiation therapy for prostate cancer.
   3. The intensity of the beam and its shape can be adjusted such that high doses of radiation can be delivered to the prostate. This way, the radiation to the normal tissues surrounding the prostate gland can be limited. 
   4. Due to limited doses of radiation to the surrounding tissue, side effects can be reduced. 
   5. For providing better treatment, a new technique called Image-Guided Intensity Modulated Radiation Therapy (IG-IMRT) is also widely used these days. IG-MRT is an advanced type of intensity-modulated radiation therapy. Here, inbuilt imaging scanners are used to get prostate images before the patient receives radiation therapy.
2. Three-Dimensional Conformal Radiation Therapy (3D-CRT) 
   1. Three-dimensional conformal radiation therapy (3D-CRT) uses imaging techniques to produce three-dimensional images of the prostate and the surrounding tissues. 
   2. It also focuses high doses of radiation onto the tumour while leaving the surrounding healthy tissues as much as possible. 
3. Proton Beam Radiation Therapy 
   1. In proton beam radiation therapy, protons are used in cancer treatment instead of X-rays. This is because X-rays release excessive energy before and after it reaches its fixed point, which causes more damage to the normal tissues surrounding the prostate. 
   2. Protons, on the other hand, produce energy only after moving a certain distance. Due to this, protons induce less damage to the normal tissues present around the prostate. 
4. Stereotactic Body Radiation Therapy (SBRT)
   1. Stereotactic body radiation therapy (SBRT) uses advanced imaging techniques to treat prostate cancer. 
   2. In SBRT, high doses of radiation are given to a specific area of cancer for a short span of time. 
   3. This technique can be used to treat patients with both local and advanced prostate cancer. 
   4. SBRT technique is often addressed by the names of the radiation machines, for example, X-knife or Gamma knife. 

Internal Radiation Therapy

Internal radiation therapy is also known as brachytherapy, interstitial radiation therapy, or seed implantation. In this treatment approach, a radioactive source, i.e., seeds or pellets, is kept inside the prostate to provide cancer treatment. 

After the radioactive source is inserted directly into the prostate, it releases radiation which helps in destroying the cancer cells present in the prostate. This radioactive source is otherwise also called implants. 

Internal radiation therapy can treat prostate cancer patients with low-grade, early-stage cancers. This treatment approach can also be used with external beam radiation in cancer patients at an increased risk of growing outside the prostate and affecting other parts of the body.

In Brachytherapy, there is less damage to the normal surrounding tissues. Brachytherapy for prostate cancer may either be permanent or temporary.

1. Permanent Brachytherapy
   1. Permanent brachytherapy is otherwise also known as low-dose rate radiotherapy (LDR).
   2. In permanent brachytherapy, the radioactive seed will be inserted into the patient's prostate, slowly releasing low radiation doses for a couple of months.
   3. This type of internal radiation therapy for prostate cancer is given to men in their early stages of prostate cancer.
2. Temporary Brachytherapy
   1. Temporary brachytherapy for prostate cancer is also known as high-dose radiation therapy (HDR).
   2. This is a technique where the radioactive seed or pellet is kept inside the patient's prostate near the cancer cells. 
   3. This radioactive source is removed after the treatment ends. 

Side effects are common with any treatment. It may be mild or severe, differs from one patient to another, and not everyone will experience it. Side effects or after-effects of radiation therapy for prostate cancer may be seen in the organs close to the prostate. 

Side Effects of External Beam Radiation Therapy for Prostate Cancer

Some possible side effects that may be seen in patients undergoing external beam radiation therapy for prostate cancer include the following:

1. Frequent urge to pee (urinate)
2. Excessive fatigue 
3. Burning sensation while urinating 
4. Urinary leakage 
5. Painful urination 
6. Leakage from the rectum 
7. Diarrhoea 
8. Blood in the stools (faeces)
9. Pain or cramps in the abdomen 
10. Bleeding in the rectum
11. Reactions on the skin like peeling, flaking, and redness
12. Lymphedema (fluid build-up in the legs and genital region)
13. Hair loss (pubic hair)
14. Erectile dysfunction 
15. Development of a secondary cancer 

Side Effects of Internal Beam Radiation Therapy

Some possible side effects that may be seen in patients undergoing internal beam radiation therapy or brachytherapy for prostate cancer include the following:

1. Pain or swelling at the site of injection 
2. Frequent urge to pee 
3. Pain while passing urine
4. The appearance of blood in the urine 
5. Burning sensation while urinating
6. Excessive fatigue 
7. Constipation 
8. Diarrhoea 
9. Erectile dysfunction
10. The appearance of blood in the stools
11. Rectal bleeding 

While side effects are common during radiation therapy, most of them start to get better after about two weeks of the treatment. There are certain things you can do to improve and manage the side effects of radiation therapy for prostate cancer. This includes the following

1. Taking adequate rest 
2. Eating a healthy, well-balanced diet
3. Drinking enough water and staying well hydrated 
4. Avoid eating foods that ae spicy, greasy and fried. 
5. If the side effects become serious and unbearable, you must contact your doctor immediately. 

There are certain do’s and don’ts that are to be followed by the patient undergoing radiation therapy for prostate cancer. 

The Dos for Radiation Therapy for Prostate Cancer 

1. Ensure wearing clothes that are loose fitted and comfortable 
2. Wash the radiation treated area using mild soap and lukewarm water 
3. Use only creams that are prescribed by the doctor on the radiation treated skin

Don’ts for Radiation Therapy for Prostate Cancer

1. Don’t apply any hot or cold compression over the radiation treated skin
2. Avoid shaving or waxing on the skin
3. Avoid the usage of lotions, creams, and powders unless prescribed by the doctor
4. Do not rub or scratch the radiation treated area

The type of radiation therapy that is to be given to the patient is decided by the doctor based on the following factors,

1. The type of the cancer 
2. The stage of cancer (spread)
3. The overall health of the patient

Prostate cancer is a serious condition where early detection and treatment are essential for improving the patient's prognosis. Radiation therapy for prostate cancer is a versatile treatment approach that can treat both early and advanced stages of prostate cancer. 

Radiation therapy for prostate cancer after surgery usually aims to destroy cancer cells. External and internal beam radiation therapy for prostate cancer are the two types of radiation therapy. Urinary issues, erectile dysfunction, diarrhoea, and fatigue are common side effects or after-effects of radiation therapy for prostate cancer.

We at HexaHealth, ensure that we provide the best services to all our patients. We provide adequate diagnosis and appropriate treatment plans to our patients. Our patients and their well-being matter to us the most, and we believe in catering the best services to them all. At HexaHealth, our experts will provide up-to-date information about the best radiation therapy and guide you through your entire surgical process.