If you’ve been diagnosed with prostate cancer, you’ll want to understand all your options and choose the approach that offers the best outcomes. For many prostate cancer patients, radiation therapy – either as a stand-alone intervention or, often, as one component of a treatment plan that also includes surgery, hormonal therapy, or other therapies – plays a key role.
At Regional Cancer Care Associates, medical oncologists with extensive experience treating prostate cancer develop individualized treatment plans that incorporate radiation therapy and other therapies, as appropriate, to best meet each patient’s specific medical situation and needs. Here, we discuss how radiation therapy for prostate cancer works.
Prostate cancer occurs when cancerous cells develop and multiply within the prostate gland. The prostate gland is a reproductive organ located below the bladder in men. It wraps around the top portion of the urethra, the tube-like structure that drains urine from the bladder. The prostate, which is roughly the size and shape of a walnut, produces semen, the fluid that transports sperm.
Prostate cancer can vary widely in its extent and rate of spread. Some tumors may be contained within a small area of the prostate gland and considered “indolent,” meaning that are unlikely to grow quickly. Others can be very aggressive, with a high potential for spreading rapidly beyond the prostate.
In recent years, there has been an increase in the percentage of patients whose cancer already has moved beyond the prostate, or “metastasized,” by the time the disease is diagnosed. As prostate cancer advances, it can become much more difficult to treat. This is why proactive medical care and regular doctor’s appointments are important to the prevention and treatment of cancers. This way, physicians can catch cancers before they worsen, and treatments can begin sooner.
A simple blood test to measure levels of a protein called prostate-specific antigen (PSA) is the cornerstone of screening for prostate cancer. Elevated levels of this protein in the blood can indicate several conditions, ranging from an age-related enlargement of the prostate gland or a prostate infection to prostate cancer. Some physicians combine this screening with a digital rectal examination (DRE), in which the physician briefly inserts a gloved, lubricated finger into the anus to assess the size and firmness of the prostate.
Men should talk with their primary care provider about the age at which they should begin having a PSA test. Different medical societies take different approaches to PSA screening, but the American Cancer Society and American Urological Association both recommend regular screening, typically beginning when the patient is in his forties, but with the optimal age determined by factors including the patient’s family history and race/ethnicity.
If one or more elevated PSA values or a patient’s symptoms cause concern that prostate cancer may be present, a physician may order additional testing, such as:
If cancer is found, these assessments also can help to determine the stage and type of the prostate cancer. This information can assist the oncologist or urologist in creating an individualized treatment plan. Once physicians identify the location, size, and stage of cancer, they can begin discussing treatment options that work best for the patient.
Radiation therapy can be an important intervention for many types of cancer, including prostate cancer. Radiation therapy employs high-energy rays or particles to shrink and kill cancerous cells.
Many people are familiar with having an X-ray for diagnostic purposes. With that type of X-ray, radiation is used to create a detailed image of the inside of the body. During this process, radiation levels are not high. For cancer treatments, however, higher levels of radiation are used to attack tumors and cancerous cells.
Radiation therapy works by changing and damaging the DNA in cancer cells. A cancer cell’s DNA directs cellular reproduction, which is critical to the spread of cancer. When administered at high levels, radiation alters cancer cell DNA, preventing cell division and cancer spread. As the cancer cells die tumors shrink and further spread is prevented.
There are two main types of radiation therapy a patient can receive for prostate cancer. The method a patient receives depends on the size, location, and stage of prostate cancer.
External beam radiation therapy is a more traditional method of radiation therapy for cancer. After identifying the location, size, and shape of the prostate tumor with MRI and CT scans, physicians focus the X-ray beam on the affected area, allowing radiation to hit the tumor directly, delivering a high dose to cancerous tissues while minimizing the impact of nearby healthy tissues.
Internal radiation therapy (also called brachytherapy) is another type of radiation treatment that’s effective against prostate cancer. With this method, surgeons place a capsule device directly inside the prostate near the tumor. The capsule contains radiation that is slowly emitted over time. This allows consistent treatment of the affected area, and it can keep surrounding cells and tissues healthy.
For external beam radiation, treatment sessions typically take about 15 minutes, although a patient may be at the treatment facility for a longer period to complete any needed paperwork, change from his clothes into a hospital gown, and confer with the radiation oncologist or technician. With internal radiation therapy, surgery must be performed to insert the radiation capsule. For the procedure, patients are given anesthesia, and a short hospital stay may be required. Both methods of radiation treatment have the potential to cause uncomfortable symptoms.
A third form of radiation therapy used in advanced cases of prostate cancer involves the infusion of a radiopharmaceutical agent into the body via an intravenous line. The agent then travels to the site of metastases, where the radiation acts against cancerous cells.
Immediately following their radiation therapy session, patients receiving external beam radiation can leave the facility and return home. They can be around other people without exposing those individuals to radiation.
With external beam radiation, patients receive treatment multiple days a week for a few weeks. This means patients can expect to return to the facility for treatment regularly. For internal radiation, patients may need to stay in the facility for a couple of days after surgery. This allows physicians to monitor the patient’s condition.
Patients who receive internal radiation therapy may need to follow specialized instructions to keep others safe from radiation exposure. For example, patients often are instructed to avoid being around pregnant women and people in poor health for a specified amount of time after the sealed source of radiation has been implanted in their bodies.
The effects of radiation therapy can vary from person to person. Certain side effects can arise because radiation therapy harms healthy cells and tissues near the cancer. Common side effects of radiation therapy include:
Often, symptoms of radiation therapy do not emerge until later in a patient’s treatment, with many occurring around two or three weeks after treatment begins. Once radiation therapy is completed, symptoms can remain for several weeks or, in uncommon cases, longer.
To achieve symptom relief and allow patients to be comfortable throughout their treatment, physicians typically prescribe medications for symptoms such as nausea or skin problems.
After a patient is diagnosed with prostate cancer, he may receive many different types of treatments. This is especially true for patients with later-stage cancers. However, some patients with mild cases of prostate cancer may not require immediate treatment. Physicians may instead choose to closely monitor the tumor for growth over time in an approach known as active surveillance.
The most common treatment for prostate cancer is surgery. Surgeons remove the prostate gland in a procedure called a radical prostatectomy. During the procedure, surgeons also remove affected prostate gland lymph nodes and nearby tissues. If surgery fails to excise the entire tumor, patients may need additional treatments, including radiation therapy, to eliminate cancerous cells.
Other prostate cancer treatments that patients may receive after surgery include:
Hormone therapy is used to reduce the amount of testosterone produced by the body. Testosterone, a sex hormone, fuels the growth of prostate cancer cells.
Immunotherapy treatment enhances the body’s natural immune system response to cancer.
Chemotherapy involves using specialized drugs to shrink and kill off cancerous cells. This type of treatment is administered through an intravenous (IV) drip or pill.
Targeted therapy treatment is designed to specifically target and attack the genetic makeup of cancerous cells while not affecting healthy cells.
Finding the best medical care after being diagnosed with prostate cancer is imperative. Regional Cancer Care Associates delivers comprehensive, evidence-based cancer treatment. At 22 community-based, conveniently located care centers across New Jersey, Connecticut, Maryland, and the Washington, D.C. area.
To learn more about the comprehensive treatment of prostate cancer, contact us today or request an appointment.
For more information or to schedule an appointment,
call 844-346-7222. You can also schedule an appointment by calling the RCCA location nearest you.
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More than 80 medical oncologists and hematologists affiliated with Regional Cancer Care Associates (RCCA) – one of the nation’s largest networks of oncology specialists — are on the frontlines of the fight against cancer in New Jersey, providing care to well over 100,000 people each year in 19 community-based practices across the Garden State.
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