Prostate Cancer
Thanks to prostate cancer screening, most men are diagnosed with prostate cancer while it is still localized and hasn't spread beyond the prostate gland. When prostate cancer is detected in its early stages, most men have time to consider treatment options before taking action. There are several therapies other than surgery that we encourage you to consider when the time is right to begin cancer treatment.
Before Starting Treatment
Active surveillance is a common approach for monitoring men with slow-growing prostate cancer. For these men, treatments are not necessary yet. Your prostate cancer doctor, which could be a urologist or an oncologist, will monitor the cancer's growth by repeating PSA tests and performing periodic prostate biopsies. By delaying the start of treatment, it's possible to avoid some long-term side effects.
If your doctor feels it's time to take action, it's a good idea to talk with both your urologist and an oncologist to see what is best for you. Many men are able to delay or avoid surgery by using cancer treatments such as radiation therapy.
Understanding Radiation Therapy for Prostate Cancer
When the time is right to start treatment, radiation therapy is often recommended. It can be used alone or in combination with other treatment therapies, such as hormone therapy and surgery, to destroy cancer cells in the prostate. It can also be used to relieve pain if prostate cancer advances and forms tumors in other areas of the body.
There are two categories of radiation therapy used for prostate cancer: external beam radiation therapy and internal radiation therapy.
External Beam Radiation Therapy for Prostate Cancer Treatment
External beam radiation therapy uses high-energy radiation beams at the prostate gland from a linear accelerator machine located outside the body. This precise targeting helps spare surrounding healthy tissue from radiation damage.
Two common types of external beam radiation therapy used to treat prostate cancer include:
- Image Guided Radiation Therapy (IGRT): Three-dimensional conformal radiation therapy (3D-CRT): This technique utilizes images from CT, MRI, and PET scans to plan the treatment area accurately. This planning process, known as simulation, ensures that the radiation beams conform accurately to the shape of the tumor.
- Intensity Modulated Radiation Therapy (IMRT) with SmartArc: This advanced form of external beam radiation therapy allows the oncologist to adjust the intensity of different radiation beams, enabling the delivery of a higher dose of radiation to the tumor while minimizing exposure to surrounding healthy tissues.
Hypofractionated Radiation Therapy Provides Shorter Treatment and Fewer Side Effects
When possible, hypofractionated external beam radiation therapy is used. Higher doses are given during each treatment with no additional side effects. This shortens the treatment duration from six to eight weeks to just three to five weeks, with sessions occurring five days a week.
WVCI treats prostate cancer with hypofractionation and the use of a temporary, injectable hydrogel. This gel protects the rectum during radiation therapy for prostate cancer. This combination specifically results in a shorter treatment duration and patients are back to their normal routine faster while reducing the risk of rectal complications from treatment.
Stereotactic Body Radiation Therapy: Precise, High-Dose Radiation in Just Five Days
Another type of external beam radiation, Stereotactic Body Radiation Therapy (SBRT) delivers a precise, high dose of radiation to the tumor. It's an encouraging option for patients with early-stage prostate cancer and can be used to treat tumors that are medically inoperable or have returned after previous radiation treatments. Most patients are finished with their SBRT treatments after five days compared to a few weeks with other types of external beam radiation.
Internal Radiation Therapy for Prostate Cancer Treatment
Internal radiation therapy, or brachytherapy, involves placing radioactive material (known as seeds) directly into or near the prostate to kill cancer cells. There are different methods of brachytherapy including Low-Dose-Rate (LDR) and High-Dose-Rate (HDR) brachytherapy*.
*WVCI does not currently treat prostate patients with brachytherapy.
Common Side Effects of Prostate Cancer Radiation Therapy
There are some side effects of radiation therapy, especially while going through the treatments, which could include:
- Irritation around the rectum
- Bowel issues like diarrhea
- Urinary problems, including frequent urination, blood in the urine, or urinary incontinence
- Fatigue
- Erectile dysfunction
It’s important to note that most of these side effects are not long-term or permanent. However, if these symptoms do not improve after treatment, it is best to discuss them with your oncologist.
Radiopharmaceuticals for Advanced Prostate Cancer
Advanced or metastatic prostate cancer can sometimes be treated with a new radiopharmaceutical drug called Pluvicto™. This drug uses radioactive elements to specifically target prostate-specific membrane antigen (PSMA), a protein located on the surface of prostate cancer cells, while minimizing damage to healthy surrounding tissue. Patients will receive this treatment through infusions every six weeks, typically over a period of 6 to 9 months. *WVCI does not currently offer this treatment, but intends to offer it in the future.
When is Radiation Therapy Included in a Prostate Cancer Treatment Plan?
The specific type and timing of radiation therapy are recommended by your cancer care team based on the stage of cancer, previous treatments you may have received, and your overall health condition. The radiation oncologist may suggest radiation therapy in several situations, such as:
- The initial treatment for men whose cancer is contained within the prostate
- In combination with hormone therapy for cancer that is growing beyond the prostate gland and invading nearby tissues
- After surgery to eliminate any remaining cancer cells that could "leak" out of the prostate as cancer cell leakage
- To treat advanced, metastatic prostate cancer in the prostate or in other areas of the body.
- To help manage pain or other symptoms by shrinking tumors outside the prostate
Deciding Which Treatment is Right for Your Prostate Cancer
Each patient with prostate cancer is unique, which means treatment plans vary from one individual to another. Your oncologist will consider factors such as the stage and grade of the cancer (Gleason score), age, overall health, and personal preferences.
Some men receive radiation therapy with or without other treatments such as hormone therapy, radiopharmaceuticals, immunotherapy, or targeted therapy. Chemotherapy is usually only used for advanced prostate cancer.
Related read: What Are My Prostate Cancer Treatment Options Other Than Surgery?
Radiation for Prostate Cancer Treatment is Available in Willamette Valley
At Willamette Valley Cancer Institute, our prostate cancer specialists are here to help you. We develop personalized treatment plans when the time is right that often include radiation therapy. WVCI cancer centers offer the latest radiation therapies including stereotactic body radiation therapy and hypofractionated treatments.
If you were newly diagnosed with prostate cancer or are seeking a second opinion, our oncologists will discuss your choices and finalize a plan that you're comfortable with. You can request a consultation with one of our oncologists at a location convenient to you in Albany, Corvallis, Eugene, Florence, Lincoln City, Newport, or Springfield, Oregon.
