Radiation therapy is used to treat a variety of neoplastic diseases ionizing radiation, trying to minimize the impact on healthy tissues and cells.
Irradiation of prostate cancer at an early stage in the Assuta
In most cases, this disease is assigned external exposure. Conformal radiotherapy uses (CRT) and intensity modulated radiotherapy (IMRT).
In some cases, the initial stages of use brachytherapy, radioactive seeds by introducing a small amount in the tumor mass. Both types (external and internal) are effective therapy. Before or after exposure may conduct hormone .
External beam radiotherapy for prostate cancer in Assuta
Treatment is carried out in the department of radiotherapy hospital, daily from Monday to Friday, with a break for the weekend. In the initial stages of the disease course of treatment lasts 4-8 weeks.
How to plan radiation therapy for prostate cancer?
The planning process is carried out clinical oncologist, it is a significant part of the exposure and may last for one - two visits. Careful preparation ensures maximum efficiency.
The patient undergoes CT scan, which examines the area to be treated. Apply a permanent marking which remains visible throughout the therapy. Doctors advise on how to care for your skin during this time. Sometimes you need to follow a special diet before planning and carrying out an enema to create a clearer picture.
IMRT and CRT radiation therapy for prostate cancer
When conformal radiation therapy (CRT) radiation beams are adjusted to the shape and form of the affected organ. This reduces the pathological effect on healthy cells adjacent organs - the bladder and rectum, reduce unwanted effects and makes it possible to increase the radiation dose for greater efficiency.
Intensity modulated radiotherapy (IMRT) is a more complex type of conformal radiation therapy, and allows the doctor to vary the dose applied to different parts of the tumor mass and surrounding tissues. IMRT - a relatively innovative way to therapy. And until now, studies have demonstrated its effectiveness similar to standard radiotherapy. They also noted a decrease of undesirable effects on the surrounding organs and tissues.
Short-term negative effects after radiation therapy for prostate cancer
Most of the effects of treatment over time disappears after completion of therapy. Professionals working with the patient, tell us what to expect. Patients should inform physicians about the appearance of any symptoms, so that they can provide assistance.
Radiation therapy for prostate cancer provokes fatigue. For this reason, it is important to give enough time to rest, but it tends to balance through regular exercises, which will give more energy.
Irradiation in the area of the prostate can cause irritation of the rectum, diarrhea and itching around the anus. To reduce these effects, the doctor prescribes drugs and recommends that certain changes in the diet.
Radiotherapy can cause inflammation of the bladder (cystitis appearance), who will be accompanied by frequent urination and a burning sensation. To improve the doctor prescribes medication. It is important to consume plenty of fluids.
These adverse effects of radiation therapy for prostate cancer usually disappear gradually, a few weeks after its completion.
A small number of people there are difficulties with urination. You may need to use a urinary catheter.
After the appearance of radiation the patient does not become radioactive. He is perfectly safe to interact with people, including children, during the whole period of treatment.
Potential long-term effects of radiation therapy for prostate cancer
A number of patients experience adverse effects of treatment, which persist or develop new months or even years. They are referred to as long-term or late.
Radiation therapy for prostate cancer may cause impotence in about 3-5 men out of 10. The probability increases if hormone therapy is also conducted. After irradiation, the disorder can occur within two - five years.
This negative effect creates difficulties in their sexual lives and relationships. Develop or not, due to age and use of hormone replacement therapy. However, there are various methods that can help.
Radiation therapy for prostate cancer can become a cause of irreversible infertility.
It happens that men are very hard to deal with it. If having children is planned in the future, save the sperm before they proceed with the treatment.
Disorders of bowel and bladder
Under the effect of radiation therapy for prostate cancer may be difficult in the above voiced bodies. Blood vessels within them become very brittle, so patients notice blood in urine or stool. Perhaps after months or years, the symptoms appear, sometimes it becomes long-term. So if bleeding occurs, it is important to tell your doctor that tests were carried out and appropriate treatment.
Very rarely observed fecal incontinence.
Often radiation therapy for prostate cancer can improve the existing difficulties with urination process. However, for some people it can cause urinary incontinence. This occurs due to damage to the nerve endings, the coordinating body muscles. However, this is unlikely, but says after TUR or prostatectomy.
Advantages of external beam radiation therapy for prostate cancer
It is able to eliminate the disease in the early stages of development. But the benefits for small, slow-growing tumors are uncertain. Conducting hormone before and during irradiation can improve performance.
A small number of men experiencing long bowel disorders, urinary incontinence, difficulty with erection or infertility.
Brachytherapy for prostate cancer
Brachytherapy is also called internal radiation therapy.
There are two ways of its implementation:
- Application of low dose rate brachytherapy (LDR). The tumor mass is administered radioactive metal "seeds" that gradually release radiation. It disappears in about six months, "grain" is not removed. There is no risk of exposure to other people.
- HDR brachytherapy (HDR) involves the placement of tiny plastic catheters into the prostate. Therethrough administered radioactive "grain" for a certain time and then recovered along with the catheters. The computer controls the duration of therapy. The indications for this treatment of cancer of the prostate in Israel is a localized tumor in the early stages of development.
Brachytherapy is a simpler procedure as compared to external beam radiation therapy for prostate cancer in most cases, requires one session to plan the treatment process itself and one session of therapy.
It plans brachytherapy?
Before "seeds" are placed in the prostate, it is carried out a study to find out the exact size and position of the body.
Contraindication can be very large prostate. Sometimes, to decrease hormone therapy is prescribed.
The ultrasonic probe is introduced into the rectum to create images gland. Forming a three-dimensional model, which is then used to determine the number of "seed" needed to treat, and their place of accommodation.
You may need to hold the enema and compliance with a special diet for 24 hours prior to the study.
In general, local anesthesia is used during the diagnosis, but sometimes it takes the total.
Implanting radioactive seeds
The procedure is performed using general anesthesia and usually lasts about an hour. An ultrasonic probe is inserted into the rectum to visualize the prostate. Radioactive "grain" is placed under the skin between the anus and the prostate, sending to the affected organ. Sometimes there is a need for a catheter to drain urine. This is because the implants can cause swollen glands condition that clog the urethra.
As a preventive measure against infection to the patient in Assuta hospital administered antibiotics, and drugs (such as Flomax®), to improve the process of urination.
Most men are discharged from the hospital on the same day, as soon as they recover from anesthesia. Some patients in some cases have to stay the night. After implantation, the better to avoid heavy lifting or strenuous physical activity for 2-3 days.
All the radioactivity absorbed by the area of the prostate gland, so other people safe to be close to the patient. However, as a precaution, should avoid prolonged close contact with pregnant women and children. The doctor will give more information on this subject.
Radioactive seeds are within the prostate gland, but there is a small chance that one of them can be passed with the sperm during sex. Therefore it is recommended to use contraception for several weeks after implantation. During this time the "grain" may be colored in black or brown in color due to bleeding during the procedure.
Adverse effects of brachytherapy
Brachytherapy causes such negative phenomena as external beam radiation therapy for prostate cancer. It indicated moderate pain, so the doctor prescribes painkillers to alleviate the condition.
The patient may notice blood in the urine and semen. If this symptom becomes more pronounced, there is significant blood clots, you should immediately consult a specialist. It is important to drink plenty of fluids to prevent the formation of blood clots and to ensure flushing of the bladder.
As with external radiotherapy, difficulty with erection occur in 3-5 out of 10 men (30-50%), several years after treatment. Brachytherapy is able to provoke infertility.
Designated less likely to influence the internal radiotherapy on the intestine, compared to external irradiation, although the risk of difficulties with urination (for example, due to the narrowing of the urethra) above.
About 3-4% of men immediately after the treatment need a catheter to drain urine for a certain period of time. Sometimes there is narrowing of the urethra after weeks or months, causing urination disorders.
The likelihood of urinary incontinence - 1: 100 (1%). In some cases, there is pain during urination, and frequent and weaker process. Usually the cause is the implantation of radioactive "seeds" into the prostate gland, the condition improves over the three - twelve months. Reduce these symptoms will promote the use of large amounts of fluid, with the exception of caffeine intake.
The vast majority of men will be able to return to normal activities after one - two weeks after the treatment.
The advantages of brachytherapy
Brachytherapy can cure the disease completely in the early stages of development, but as with external irradiation of prostate cancer, the benefits of treatment in the case of small, slow-growing tumors are uncertain.
This is a simple procedure, it usually involves only one planning and one treatment session. Hospitalization for the most part is not required, but sometimes you need to stay in hospital for 1-2 days.
disadvantages of brachytherapy
Side effects associated with damage to the bladder such as cystitis, heavier, compared to remote radiotherapy, but irregularities in the bowel and erectile dysfunction are less common. Scar tissue can cause gradual narrowing of the urethra, it will require treatment.
Radiation for prostate cancer therapy in locally advanced tumors
Mainly applied external radiation therapy, CRT and IMRT.
Socially prescribed brachytherapy is suitable only to a small number of men with locally localized prostate cancer. It depends on the spread of the disease beyond the boundaries of the body. Typically, it gives, in combination with external irradiation of prostate cancer.
Taking into account the peculiarities of each situation disease doctor may suggest hormone spend before or after prostate cancer radiation treatments.
External radiation therapy is able to control the progression of the disease at this stage for many years, in fact, sometimes completely cures. Carrying hormone therapy before and during exposure can increase the effectiveness of the treatment as a whole.
A small number of men may experience long-term disturbances in bowel habits, such as diarrhea and bleeding, as well as incontinence, impotence or infertility.
prostate cancer radiation therapy at later stages in the Assuta
In this phase of the disease to the patient offer exposure, if the cancer is causing symptoms such as pain in the prostate gland, or if he got into other parts of the body - the bone tissue.
In this situation, radiation therapy is not able to rid the body of all malignant cells, but it can lessen the symptoms and is known as palliative.
For the treatment need 7-10 days, the pain gradually began to leave, and up to six weeks for the full effect.
Palliative radiation therapy for prostate cancer
Radiation exposed bone or the entire affected area. It can be a separate procedure or a number of minor treatments. Many men say that the pain goes away after a couple of days, while others pass expect three or four weeks. If necessary, apply anesthetics.
Doctors tell us in detail about the treatment and its undesirable consequences in advance.
If abnormal cells hit by more than one region of the bone tissue may be recommended irradiation of the upper or lower half of the body. This facilitates pain. However, the side effects are more pronounced.
You may need to be a short stay in the hospital. If there is a need for radiation therapy of the other half of the body, treatment plan later, when adverse effects are reduced.
This therapy is of secondary bone cancer uses radioactive material (isotope) called strontium-89, which penetrates into the affected areas. It is useful when the disease has covered several areas, and this causes considerable pain.
Strontium-89 is introduced into the body through intravenous injection. The procedure is performed in the outpatient department. Thereafter, a small concentration of the radioisotope will be present in urine.
The level of radioactivity is very low, so this therapy is safe for the patient and other people, including children. Most of the men feel some effect of therapy for several weeks, although sometimes the pain first become stronger before will start to subside.
Radium-223 - a new method of treating secondary bone cancer, presence of radioactive material. Clinical trials show encouraging results and so far only mild side effects.
Such radiation therapy for prostate cancer can strengthen the weakened bones and relieve pain. The goal - to improve the patient's condition. Usually marked by a few side effects tend to be quite soft.
Lack - pain may first be amplified before begin to subside.