Prostate Radiation Therapy

Radiation therapy is a therapeutic method of destroying cancer cells using electromagnetic radiation emitted by a machine, external radiation therapy. The same, very thin radioactive seeds or wires can be inserted into the prostate to kill malignant cells (cancer cells) by sparing the maximum surrounding healthy tissue; this is internal radiation therapy. The goal of the therapy is to damage the DNA of cancer cells preventing them from dividing anarchically, the main characteristic of cancer cells.  

A prostate cancer diagnosed early may be effectively controlled or completely cured by high doses of radiation. In fact, there have been many improvements in the treatment of prostate cancer by radiotherapy over the past 20 years. Men of all ages can be effectively treated by radiation. However, it is not without side effects. To avoid complications, any side effect you experience during the treatment should be promptly considered and treated by your radio-oncologist.  

The source of radiation may be installed outside or inside the body: 

Internal RadiationTherapy - Internal radiation therapy is a form of radiotherapy sometimes used to treat cancer. Radioactive seeds, which kill the cancer cells, are introduced into the patient's body near or directly into the tumor. In the treatment of prostate cancer, the radioactive seeds are implanted into the prostate so that the cancer cells can feel directly the effects of the radiation.  

The cancer may be shrunk or destroyed by placing dozens of tiny radioactive seeds directly into the prostate gland; this method is called interstitial implantation or brachytherapy. The radioactive seeds must be very precisely implanted and not too high to avoid or minimize damage to healthy tissues surrounding the prostate gland: rectum and bladder for instance. Internal radiation therapy is not recommended for men who have a very enlarged prostate or advanced prostate cancer.   

Since the radiation source is placed internally, brachytherapy (internal radiation therapy) involves using imaging techniques, usually ultrasound, to guide the movement and the location of the needles. The procedure also requires either general or spinal anesthesia. Once the patient is anesthetized, iodine or palladium seeds are distributed into the prostate through specialized needles. In general, the implant procedure is performed in an operating room, and can take one to two hours to be complete.  

External Radiation Therapy: in external radiotherapy, the radioactive source is from an external machine that directs the radiation toward the cancer cells in the prostate gland. Unlike internal radiation therapy (brachytherapy), no hospitalization is required; the therapy is performed once a day, 5 days a week, Monday through Friday, and over a period of eight weeks. The session of external radiation therapy is virtually painless and takes only a few minutes.  

External radiation therapy, although can be prone to complications (digestive problems, rectal bleeding, diarrhea and others), along with surgery is the treatment of choice for prostate cancer. Thanks to advances in computer and medical science, it is now possible to deliver a high dose of radiation to the prostate while sparing most surrounding healthy tissues. It is also now possible to decrease the risk of urinary and digestive complications related to prostate cancer radiation therapy. A successful therapy should reduce the risk of formation of secondary tumor and improve the patient survival. 

Risks and Complications  

Radiation therapy can provide satisfying results in the fight against prostate cancer; however, it is not without risks. The radiation passes through the normal tissues of the rectum, bladder and intestines; it can damage some healthy cells and lead to health problems. However, these effects are often temporary and less serious. Some patients may also experience fatigue toward the end of their treatment.  

In rare cases, some patients may experience long term intestinal problems, including inflammation of the lining of the rectum (proctitis) associated with bleeding and bowel disorders such as diarrhea. It is not uncommon in some prostate cancer patients to experience urinary changes during treatment. Some men complain of urinary urgency and increased urinary frequency day and night; urine may be accompanied with blood.  

If it is an internal radiation, discomfort in the prostate area can occur. Another unpleasant effect of the therapy is erectile dysfunction. Fortunately, today, treatments are available to restore erections of men who have this problem.