27.01.2023

Types of radiation therapy in prostate cancer, the effects, rehabilitation

Radiation therapy is one of the efficient ways for treatment and control of malignant tumor of the prostate gland, the positive effect develops in the deliberate destruction of cancer cells.

For prostate cancer it is possible to perform external beam radiotherapy or brachytherapy (contact).

The method of radiation exposure to the radiologist selects, taking into account the tumor stage, the sum of scores for a Gleason score (aggressiveness of cancer), age, the result of the analysis for the tumor marker PSA, indications, contraindications, life expectancy and other factors.

Radiation therapy for prostate cancer can be used instead of the operation (at an early stage, the prostate remains) after surgical treatment (maximum destruction of atypical cells, prevention of tumor recurrence) and in palliation at late stages (to prolong life, reduce pain, while recurrent prostate cancer, metastasis). At the localized form of cancer treatment rays can be considered as drastic measures for the best effect prescribed hormonal drugs maximally blocks the production of male sex hormones.

It is proved that the relapse after combined treatment is less common.

What happens when irradiation

Radiation therapy uses high-energy x-rays (photons, ionizing radiation) and/or a stream of particles (protons, electrons). When radiation is used at high doses (many times higher than radiographic studies), it can destroy abnormal cells. Loss and damage cancer cells increases with each session. This happens at the microscopic level, the result of DNA damaged tumor cells.

Patients do not feel the radiation during the procedure, but I can hear some electrical noise and see the warning signals from the spacecraft.

What are the effects of radiation therapy for prostate cancer

Effects of radiation therapy for prostate cancer in each patient is individual, which largely depends on the initial data. Some side effects are mild and go away on their own, while others require long-term rehabilitation.

Common symptoms on the background of therapy:

  • weakness, fatigue, asthenia;
  • dysuric disorders: burning sensation, frequent urination, change in the quality of the urine stream, blood;
  • low-grade fever;
  • cutaneous manifestations (radiation burn);
  • pain and swelling in the scrotum, perineum;
  • disorders chair: the appearance of mucus, blood, diarrhea, fecal incontinence.

Disorders that can appear after Radiolaria:

Types of radiation therapy for the treatment of prostate cancer
External radiation therapy

During external radiation therapy, a machine directs radiation through the skin directly into the tumor and tissue around it. Lymph nodes also appear in the impact zone.

This type of radiation can be used as a primary treatment for prostate cancer; and also in cases when the tumor came close to the capsule or more grew through it.

Occasionally, external radiation therapy is indicated to reduce the size of malignant neoplasms of the prostate to facilitate urination and relieve pain, especially against metastatic cancer.

Sessions are held regularly (usually five days a week) for about five to eight weeks.

Conformal radiation therapy

For conformal radiation therapy uses a special device that can change the shape of the radiation beam, in full accordance to the shape and size of the tumor. This means that the maximum dose of radiation aimed at the tumor, in this case, radiation damage to normal tissues around the tumor smaller.

Types of conformal radiation therapy that can be used for the treatment of prostate cancer:

  • Three-dimensional conformal radiation therapy delivers radiation to the tumor from different directions. Image the prostate and surrounding tissue is monitored using computed tomography. The impact of the same.
  • Intensively-modulated radiation therapy – a new form of 3D therapy, where the highest radiation has on the tumor.
  • Stereotactic radiation therapy – a type of external radiation therapy (gamma knife, CyberKnife, etc.)
Proton radiation therapy

Radiation therapy proton beam is also called radiation therapy with charged particles. It uses high-energy (charged) proton particles instead of x-rays. Protons deliver a higher dose of radiation and cause less damage to nearby tissues than conventional external beam radiation therapy, because they are directed on the tumor.

Brachytherapy

Brachytherapyinternal radiation therapy, involves the introduction of implants with a radioactive isotope into the tumor or very close to it.

The radiation eventually kills the cancer cells.

After surgery brachytherapy is not carried out.

External radiation therapy and brachytherapy can be used for the treatment of prostate cancer with high risk of recurrence after treatment.

Brachytherapy with low dose

Brachytherapy for prostate cancer uses a permanent implant for continuous low-dose radiation over several weeks or months. Doctors often use transrectal ultrasound guidance for the placement of the implant.

Iodine-125 or palladium-103 radioactive substances used for low-dose brachytherapy.

In order for other people not exposed to radiation, take special precautions.

Brachytherapy with low-dose radiation used to treat prostate cancer in the initial stages and a low risk of recurrence.

Brachytherapy with high dose

HDR brachytherapy for prostate cancer uses a temporary implant with a greater dose of radiation. One session takes a few minutes, usually perform 3 sessions at intervals of 48 hours.

Iridium-192 and cesium-137 – radioactive substances, used for high-dose brachytherapy.

This method is used for prostate cancer at an early stage, with rapid growth and high probability distribution.

Systemic radiation therapy

In systemic radiation therapy isotopes pass through the body. The cancer cells absorb the radioactive material, causing their death.

Radium-223 (Xofigo)

For prostate cancer radiation therapy can be performed by attaching radioactive material to a substance, which target specific molecules (e.g., proteins) on the surface of cancer cells. This allows the radiation to kill the cancer cells, thus side effects are fewer.

This type of radiation therapy used most often for prostate cancer with bone metastases.

Side effects of radiation therapy

Side effects on the background, or after radiation therapy for prostate cancer in every case: some patients have a lot of them, others almost none.

Complications can develop in a few days or weeks after exposure to the rays.

Late side effects can appear after months or years, some of them fails completely.

It depends on several factors:

  • irradiation area;
  • the total dose of radiation;
  • type of radiation exposure;
  • cancer.
Answers to frequently asked questions on radiation therapy for prostate cancer
What to do about skin changes after radiation exposure?

If the radiation goes through the skin, there are some changes: redness, swelling, hypersensitivity, hair loss, reduced sweating.

These reactions of the skin are reversible.

Long-term effects of pronounced hyperpigmentation, enlarged pores, changes of sensitivity, parts of the seal.

For sensitive skin can be maintained with mild soap and warm water. Dermatologists advise not to RUB the skin and wipe off with a soft repeated press.

Any ointments, lotions, alcohol or powder on the problem area without the advice of a specialist to apply it is impossible.

A few tips:

  1. Refrain from wearing clothing made from rough fabrics (wool, corduroy, etc.), these fabrics irritate the skin.
  2. Instead, choose clothes made of natural material.
  3. Do not apply a bandage or use a plaster.
  4. Do not expose the area exposed, cold or heat.
  5. Avoid insolation, as the sun can intensify the unwanted reaction and cause burns.
  6. Choose a sunscreen with SPF 30 or higher.

List the tools that may be useful:

  • sea buckthorn and olive oil;
  • Aloe liniment;
  • Panthenol;
  • Solcoseryl;
  • Methyluracyl ointment, etc.
How to fight fatigue during radiation therapy?

People differ in temperament, energy levels, mental reactions, so radiation therapy affects each person differently.

Men often complain of fatigue after several weeks of treatment, but for most patients asthenic syndrome is expressed moderately.

To minimize the weakness while receiving radiation therapy follow these simple recommendations:

  • Get enough sleep the amount of time (at least 8 hours).
  • Eat right.
  • Often carry on to rest.
  • Do not forget about walks in the fresh air and active exercise.
How to treat radiation proctitis and cystitis?

For the treatment of cystitis, use of uroseptic, herbal remedies, vitamins.

If proctitis designate candles with Methyluracil, sea Buckthorn oil microclysters, drugs to reduce flatulence.

Removed from the diet of sour, spicy, salty, smoked food, pickles, sodas, etc.

How to recover potency after irradiation?

Unfortunately, the violation of erectile function in the treatment of prostate cancer is common.

The severity depends on the therapy: when brachytherapy the chances of maintaining sexual function than after radical prostatectomy. Value comorbid disease (diabetes mellitus, atherosclerosis, hypertension) and bad habits.

Reception of dietary supplements, national ways of treatment of impotence in this case is ineffective.

If there are no contraindications, you can take Viagra or its counterparts (Levitra, Cialis, etc.).

Some patients performed penile prosthesis that is a drastic solution to the problem.

What will happen to the results of your PSA after radiation therapy?

If radical prostatectomy was performed in combination with radiation therapy, the PSA level decreases sharply.

If irradiation was performed as monotherapy, initially allowed a rising PSA (does not indicate the progress of the disease), but if the treatment was effective, after some time, the level of tumor markers gradually decreases. Until full stabilization may take several months (12-18).

How long discomfort after radiolucency?

All different, but on average, from 2 to 4 to 8 weeks. Often feel better on the background of drug therapy and surgical procedures is rarely.

If you do the surgery whether you need radiation therapy?

It depends on the incidence of cancer. If it means a radical intervention in the early stages, no.

In all other cases, the issue is solved individually.

Can I have surgery after radiotherapy?

After the exposure operation is performed very rarely as it is associated with serious complications.

Often use brachytherapy or stereotactic therapy. Some patients get systemic medications.

Does diet affect prostate cancer treatment?

Good nutrition is an important part of recovery from the side effects of radiation therapy. When sufficient calorie the body has the energy to fight the disease.

How to know if it helped radiation therapy?

The doctor can not immediately answer this question, as, for example, after surgery.

Need a few months to see the result and fix it with the help of laboratory and instrumental methods of examination.

Dead cancer cells are gradually removed from the body, some cells lose the ability to reproduce, but continue to function for some time before death.

This explains the slow decline in PSA levels after irradiation.

Every 3 months a visual inspection is conducted which includes transrectal ultrasound examination, a blood test for prostate specific antigen, digital rectal.

About the relapse or progression of disease after radiation therapy indicates a 3-fold increase in PSA level after minimum achieved values.

Are there any contraindications to radiation therapy?

Yes, there is. These include:

  • the earlier exposure of the pelvic organs;
  • functioning of a transurethral catheter;
  • acute recta;
  • obesity.

Relative contraindications:

  • microcyst (reduction of the capacity of the bladder);
  • ulcerative colitis;
  • chronic diarrhea;
  • severe violation of outflow of urine on the background infravesical obstruction.

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