Comprehensive Radiation Treatment For Prostate Cancer

Localised prostate cancer

 

Patients with localised prostate cancer – the cancer cells are limited to the prostate – who require immediate medical attention may be offered the following treatment options depending on their condition.

 

1) Radiation therapy

 

There are various forms of radiation therapy available to treat prostate cancer. All radiation therapy for cancer works on the principle of using high energy radiation to kill cancer cells by damaging the DNA.

Radiation therapy also has to be precisely calibrated to target cancer cells while avoiding exposing normal healthy cells to the radiation dose. Common radiation treatment for prostate cancer involves:

 

External beam radiation.

 

During external beam radiation treatment, a machine is used to direct high-powered energy beams, such as photons or X-rays, to eradicate the cancer cells. Patients typically undergo external beam radiation treatments five days a week for several weeks. This treatment can also be used after surgery to eliminate any cancer cells that might remain to prevent a recurrence.

 

Brachytherapy.

 

Brachytherapy involves placing radioactive sources in the patient’s prostate tissue. Usually, the radiation is contained in radioactive seeds, which are inserted into one’s prostate tissue. These seeds deliver a low dose of radiation over a period of time to eradicate the cancer cells.

 

Proton therapy.

 

Proton therapy uses a high-energy proton beam to deliver precise radiation to the prostate gland without injuring the surrounding normal tissues. The advantage of proton therapy is that the proton particles stop at the tumour and are less likely to damage healthy cells.

 

2) Hormonal therapy

 

Hormonal therapy is designed to counter the effects of testosterone, which the cancer cells rely on to grow and spread. Hormone therapy may rely on medications that either stop your body from producing testosterone or block testosterone from reaching cancer cells in your prostate. Another form of hormone therapy may involve surgery to remove the testicles. However this is a more permanent form of treatment.

 

Hormone therapy can be used in conjunction with radiation therapy or surgery in patients with high-risk factors to make the treatment more effective and reduce the chances of prostate cancer recurrence in patients. If after the initial prostate cancer treatment a patient’s Prostate-specific Antigen (PSA) levels are high or rising, then hormone therapy can also be indicated. For patients with high risk of recurrence after treatment, hormone therapy can help reduce that risk significantly.

 

Side effects of hormone therapy may include loss of muscle mass, increased body fat, erectile dysfunction, loss of sex drive, bone thinning, fatigue, behavioural changes, and metabolism issues. To minimise the effects, your doctor will monitor your dosage carefully during the treatment period and adjust depending on your reaction to the medication and other factors involving your risk of prostate cancer recurrence.

 

3) Surgery

 

In extreme cases, an oncology doctor may recommend radical prostatectomy, which involves the complete removal of the prostate gland, the surrounding tissue, and a few lymph nodes, to prevent the cancer cells from spreading to the other healthy tissues. This is usually an option if the cancer is still localised and not thought to have spread to other parts of the patient’s body.

 

The two main approaches to radical prostatectomy are open and laparoscopic prostatectomy. Open prostatectomy is more traditional and involves a long incision, under general anaesthesia, to remove the prostate and other tissues. In contrast, in a laparoscopic radical prostatectomy several smaller incisions are made and specialised surgical tools are used to remove the prostate. This type of surgery can either be done manually or using a robotic controller.

 

The main advantages of laparoscopic prostatectomy are reduced hospital stay, faster healing and recovery, less pain post operatively, less scaring, and a more rapid return to normal everyday activities. As such laparoscopic surgeries are becoming increasingly popular and may be preferred over open prostatectomy in many scenarios.

 

Chances of successful treatment are high with a radical prostatectomy. However, this treatment option carries possible side effects such as impotence and urinary incontinence.

 

Advance prostate cancer

 

If the cancer cells have spread to other areas of the body, an oncology doctor may recommend the following treatment procedures.

 

1) Hormonal therapy

 

Hormonal therapy can also be used to treat advanced stages of prostate cancer. There is an extensive range of approved hormonal treatment options available, with many proving to be effective in controlling the spread of cancer cells.

 

For advanced prostate cancer, hormone therapy will be a lifelong treatment for most patients. While it cannot cure the cancer, it can shrink it and decrease its growth, no matter where the cancer has spread in the body. This treatment can be effective for years and has also been shown to ease symptoms of advanced cancer including bone pain.

 

How well hormonal therapy can work as a form of advanced prostate cancer treatment will vary from patient to patient. It is also dependent on other factors such as the aggressiveness of the cancer and how far it has already spread. Hormone therapy is also often used for recurrent prostate cancers.

 

2) Chemotherapy

 

Though uncommon, chemotherapy helps improve symptoms of prostate cancer if other treatment options prove ineffective. Chemotherapy generally refers to any kind of therapy that uses chemicals to kill or slow the growth of cancer cells.

 

While it may not be able to cure prostate cancer, it can have many beneficial effects such as relieving symptoms, improving quality of life for the patient, improving the success rate of prostate cancer surgery, and prolonging the lives of prostate cancer patients who no longer respond to hormone therapy. Chemotherapy is also often used in conjunction with hormone therapy to improve outcomes.

 

The chemotherapy drugs can be administered intravenously or in pill form, or both. Chemotherapy is generally recommended when the cancer cells have spread from the prostate gland to other parts of the body in the more advanced stages of the cancer. It is not a standard treatment for early stage prostate cancer.

 

Side effects of chemotherapy include hair loss, mouth sores, appetite loss, nausea, fatigue, easy bruising, and increased risk of infections. Patients undergoing chemotherapy are generally advised to take measures to help manage the side effects. Talk to your cancer doctor today to understand more about chemotherapy and how best it may be used for your condition.

 

3) Immunotherapy

 

Immunotherapy can prove to be effective in treating prostate cancer. It works on the principle of using a patient’s own immune system to fight back against the cancer cells. To achieve this, a vaccine has to be tailored to precisely match a patient’s immune system.

 

During immunotherapy treatment, the patient’s immune cells are extracted via a special machine over the course of a few hours and exposed to proteins designed to stimulate them to counter the prostate cancer cells. This exposure ensures that the patient’s immune cells are able to identify and attack prostate cancer cells. Subsequently, the immune cells are placed back in the patient’s body to treat their prostate cancer.

 

While immunotherapy may not stop a patient’s tumour from growing it does seem to positively influence outcomes and prolong lifespans. It can be an alternate option for patients who have tried other treatment modalities like hormone therapy with limited success.

 

Potential side effects of immunotherapy include minor symptoms like fever, chills, fatigue, joint and back pain, nausea, and headache. Some more serious symptoms like breathing problems and increased blood pressure are rare and usually improve with timely medical treatment. Some new immunotherapy drugs are still being researched and show good promise, Talk to your doctor about the treatment options available to you.

 

4) Radioactive bone isotope

 

An oncology doctor may recommend radioactive bone isotope if the patient’s prostate cancer cells have spread to their bones. These radioactive isotopes function similarly to calcium and are ingested by the bones. Once the isotopes are within the bones, they release radiation to eradicate cancer cells.

 

This treatment can shrink portions of cancer cells that have spread to the bone which reduces symptoms of bone pain and increases comfort levels. When prostate cancer spreads, bones are often the first places to be affected. There is no treatment for metastatic bone cancer, but options like radioactive bone isotopes are important for alleviating symptoms of pain.

 

Metastatic bone cancer occurs in more than 60% of patients who have advanced prostate cancer. It is difficult to predict life expectancy in these patients, but those who have more than one site of cancer are likely to have a lower life expectancy. Early detection and intervention may help improve prognosis.

 

Early detection can catch prostate cancer before any symptoms surface. Talk to your cancer doctor today about scheduling regular health screenings. Men above the age of 50 should go for screenings once every 3-5 years. If you are at a higher risk of getting prostate cancer, you can begin as early as 45.