External Beam Radiation for Prostate Cancer

Overview

External beam radiation targets prostate cancer cells using focused high-energy beams like X-rays or protons. A linear accelerator creates these beams and directs them at the prostate gland from outside the body. The treatment breaks down the cancer cells’ genetic material, stopping them from growing and spreading.

Key Points:

  • Treatment Types: Applies to both localized and high-risk prostate cancer.
  • How It Works: Destroys cancerous cells while minimizing damage to healthy tissue.
  • When Used: Suitable for first-time treatment or if cancer recurs after surgery.

Considerations:

  • Both cancer cells and some healthy cells near the prostate may be affected.
  • Possible side effects include urinary or bowel discomfort.
  • The main goal is to protect as much normal tissue as possible.

Reasons for Using External Beam Radiation

Doctors choose external beam radiation for several clear reasons. It serves as the main treatment when prostate cancer is found early and remains limited to the prostate. For more serious cases still restricted to the prostate, doctors often pair it with hormone therapy to help lower testosterone and slow cancer growth.

After a radical prostatectomy (surgery to remove the prostate), doctors may use external beam radiation to lower the chance of the cancer coming back. They may also recommend it if signs like rising PSA levels show that cancer has returned or spread in the pelvis. In advanced prostate cancer, when cancer has spread to other areas such as the bones, radiation helps control symptoms and relieve pain.

Treatment Purposes Table

SituationUse
Early-stage cancerMain treatment
High risk or advanced cancerWith hormone therapy
After surgeryLower chance of return
RecurrenceTarget remaining cancer
Advanced/Metastatic cancerEase pain, control symptoms

Types of External Radiation

  • Three-Dimensional Conformal Radiation Therapy (3D-CRT): Uses imaging to direct beams more accurately.
  • Stereotactic Body Radiation Therapy (SBRT): Delivers high doses in fewer sessions with precise targeting.

These options allow clinicians to focus beams tightly around the prostate while minimizing exposure to nearby organs.

Treatment Process

Planning

  • Imaging scans like CT or MRI help the care team map out the treatment area.
  • Some patients receive a SpaceOAR device to shield the rectum.
  • Small skin marks may be placed for daily alignment.

Sessions

  • Most patients receive treatment 5 days a week over several weeks.
  • Each session lasts under an hour, with setup being the longest part.

Delivery

  • Patients lie on a table while the machine rotates to deliver beams from multiple angles.
  • The staff uses immobilization devices to maintain precise positioning.

Radiation oncologists oversee sessions and make adjustments as needed.

Risks

External beam radiation for prostate cancer can cause different side effects. The amount of radiation and the amount of healthy tissue affected influence these effects. Most problems are mild and gradually improve after treatment ends. Some may appear later, but serious long-term issues are uncommon.

Common Side Effects

SymptomArea Affected
Frequent urinationUrinary system
Painful urinationUrinary system
Blood in urineUrinary system
Urinary leakageUrinary system
DiarrheaBowel function
Abdominal crampingDigestive system
Rectal bleedingBowel function
Rectal leakageBowel function
FatigueWhole body
Painful bowel movementsDigestive system

Some people may also notice skin changes, like redness or irritation, and changes in sexual function. Rarely, another cancer can form in the treated area years later. Each person reacts differently, so talking to a doctor helps manage any problems that arise.

How to Get Ready

Before beginning external beam radiation therapy for prostate cancer, patients go through a thorough planning phase. This stage ensures the radiation goes exactly where needed while protecting healthy tissues.

The care team works with the patient during a process called simulation to find a comfortable position and help the patient stay very still. Sometimes, they use special devices so the patient can hold the same position during every session. Staff may make small marks on the skin to help line up the treatment each day.

Another important part involves getting planning scans, such as a CT scan (computed tomography) and sometimes an MRI scan. These scans help the team find the exact area that needs treatment. Some people may have a device called SpaceOAR placed to help protect the rectum during therapy.

The radiation team uses this information to choose the type and dose of radiation based on the person’s cancer stage and health. Staying hydrated before scans and treatments is also often advised.

What to Expect During External Beam Radiation

People receiving external beam radiation for prostate cancer follow a set schedule or treatment plan. Sessions usually take place at a clinic on an outpatient basis, so patients return home the same day. Treatments are commonly scheduled five days a week, spread out over several weeks.

Most appointments last less than one hour. The longest part is getting ready. Staff position the person on a table and may use special supports to keep them still. The linear accelerator (the radiation machine) is carefully adjusted to aim from different angles. Here is a basic outline of each session:

StepDetails
PreparationPatient lies on the table and is positioned.
PositioningImmobilization devices may be used.
Radiation DeliveryMachine rotates and delivers beams.
MonitoringTeam watches and communicates if needed.

Patients do not feel pain during the treatment. Lying still and breathing normally is important so the beams are accurate. The staff stays close by in a room with cameras and speakers to offer help or answer questions. Most people are able to return to their normal activities after each visit, with little disruption to daily life.

Treatment Response and Patient Outcomes

Patients attend regular follow-up visits after external beam radiation therapy. Doctors check cancer response and discuss any changes in quality of life. Most experience mild side effects that often improve over time.

Patient Follow-up Checklist

  • Monitor cancer response
  • Track side effects
  • Assess quality of life

Table: Key Outcomes

MeasureObservation
Tumor responseMonitored regularly
Quality of lifeOften improves
Side effect statusUsually mild

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