RADIATION THERAPY FOR PROSTATE CANCER
Non-Surgical Options Facts to Help Patients Make An Informed Decision

External Beam Radiotherapy

External beam radiotherapy involves a series of daily outpatient treatments to accurately deliver radiation to the prostate.

There are two principal methods for delivering external beam radiation.

• 3-dimensional conformal radiotherapy combines numerous radiation treatment fields to deliver precise doses of radiation to the prostate. Tailoring each of the radiation beams to accurately focus on the tumor targets the prostate cancer while at the same time avoiding nearby organs such as the bladder or rectum.
• Intensity modulated radiation therapy or IMRT is the most current advance in the delivery of radiation. IMRT improves on 3-D conformal radiotherapy by modifying the intensity of the radiation within each of the radiation beams, allowing more precise adjustment of radiation doses to the tissues within the target area. This potentially allows an increased radiation dose to the prostate and reduced doses to nearby normal tissues. Higher doses to the prostate mean a greater chance for cure, while lower doses to surrounding organs result in fewer side effects.

Both types of external beam radiotherapy are suitable treatment; IMRT offers advantages for many but not all prostate cancer patients. With either type of therapy, painless radiation treatments are given in a series of daily sessions, each under half-hour in duration, Monday through Friday for seven to ten weeks.

Potential side effects, including fatigue, increased frequency or discomfort of urination, and loose stools, usually resolve within a few weeks after completing treatments. Impotence is also a potential side effect of any prostate cancer treatment. However, many men who receive radiation therapy for prostate cancer are able to maintain sexual function.

Prostate Brachytherapy

Prostate brachytherapy, better known as implanting seeds, is usually done in the operating room.

There are two methods of delivering internal radiation for prostate cancer:

• Permanent seed implantation.
• High-dose rate temporary seed implantation.

Both treatments are designed to deliver a very high dose of radiation to the tumor by inserting radioactive seeds directly into the prostate gland under ultrasound guidance while the patient is under anesthesia. Isotopes of iodine or palladium are used most often. The seeds are approximately four millimeters long and less than a millimeter in diameter. In certain situations, both prostate brachytherapy and external radiation may be recommended to treat the tumor.

Seed implant side effects are similar to those experienced with external beam radiotherapy. Patients usually experience discomfort in urination and urinary frequency. These effects may be eased with medication and usually dissipate over the course of three to six months.

Proton Beam Therapy

In some parts of the country, proton beam therapy is being used to treat prostate cancer.

Proton therapy is given much the same way as external beam therapy, but it uses protons rather than x-rays to irradiate cancer cells.

Hormone Therapy

Some patients may benefit from hormone therapy in addition to radiation. Sometimes hormone therapy is used in combination with radiation therapy to improve cure rates.

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