What is prostate cancer radiation therapy?
Radiation therapy is treatment that uses high-energy radiation to kill the prostate cancer cells. Radiation therapy works by delivering high doses of radiation to the exact targeted area while minimizing exposure to surrounding healthy tissue.
Radiation therapy for prostate cancer is personalized for each patient based on how aggressive their disease is.
Why it's done
Radiation therapy is equally effective, or sometimes more so, than surgery for treating prostate cancer. This remains true regardless of the patient’s age. Sometimes radiation therapy is used after surgery when the cancer is persistent or returns. When prostate cancer metastasizes, radiation therapy can be used to control symptoms, such as pain.
At Northwell Health Cancer Institute, our physicians are not just treating prostate cancer—they’re finding the right treatment for each patient. Treatment starts with each individual patient and includes the doctors working together to personalize the best approach.
We offer every treatment option available for prostate cancer, including leading-edge radiation therapies. More importantly, our doctors have the most experience treating prostate cancer on Long Island, many with national and international reputations.
Treatment is provided in a caring and professional environment by specialists dedicated to making each patient visit as informative and stress-free as possible. This begins with an in-depth conversation describing the treatment, including what to expect, possible side effects and goals. The personalized treatment also includes careful consideration of current health, family history, age and patient preferences.
The Department of Radiation Medicine offers the most advanced radiation therapies available for prostate cancer to offer the best possible outcome. These include:
- All types of external-beam radiation therapy
- Proton therapy
All radiation therapies, including those used to treat prostate cancer, are administered using evidence-based medicine. Your multidisciplinary team of doctors, including radiation oncologists, surgeons, pathologists, medical oncologists and radiologists, collaborate on treatment plans to ensure that every aspect of treatment is precisely coordinated for the best possible outcome. There is also ongoing peer review and chart rounds so that your care is overseen and approved by the entire faculty.
We were one of the first health care institutions in the New York metropolitan area to offer Radium-223 for the treatment of men with metastatic prostate cancer that has spread to the bones. The health system is an experienced leader in offering this treatment, having treated patients with Radium-223 as a part of clinical trials before it was approved by the FDA.
Because convenience is a priority, we offer multiple locations for radiation therapy to enable you to obtain treatment near where you live or work.
Research at Northwell
Advances in radiation oncology are continuously happening at Northwell Health Cancer Institute. With innovations in radiation therapy technology and techniques, we continue to offer leading edge approaches. Through alliances with leading research organizations, including Cold Spring Harbor Laboratory and the National Cancer Institute, the Department of Radiation Medicine offers leading cooperative group clinical trials in prostate cancer as well as physician-initiated trials exploring new approaches in treatment and symptom management.
Northwell Health Cancer Institute is known for its commitment to providing pioneering treatment for cancer patients. One such study exploring a radiation dose response for stereotactic body radiation therapy has identified that a higher-than-typical dose may impact long-term success. Additionally, the Department of Radiation Medicine continues to be one of the leading institutions in the world offering prostate seed implant, an approach that has been shown time and again to be as good as or better than external beam radiation for prostate cancer.
The ongoing focus on improving cancer treatments has contributed to significant advancements that are improving the quality of lives and increasing the number of cancer survivors.
There are several types of radiation therapy used for prostate cancer:
External beam radiation with photons
Terms that describe various forms of external beam include:
- Intensity Modulated Radiation Therapy (IMRT)—A type of external beam radiation therapy made possible with advanced computer technology. With IMRT, your doctor uses a computer to plan the exact dose of radiation that is aimed at your prostate cancer. The computer uses information about the size, shape, and location of your prostate cancer and nearby healthy normal tissues to figure out how to most safely deliver the radiation needed kill your prostate cancer cells while protecting other parts of the body. IMRT uses high doses of radiation to kill your prostate cancer cells while protecting the healthy cells that surround your prostate cancer by carefully shaping and sculpting the radiation dose to hit the cancer and avoid the healthy surrounding tissues.
- Image-guided radiation therapy (IGRT)—Uses X-ray, cone-beam CT scanning, electromagnetic tracking, optical surface tracking or ultrasound imaging during treatments to locate and focus radiation beams precisely at the tumors.
- Stereotactic Body radiation therapy (SBRT)—Certain patients with prostate cancer are eligible for treatment with stereotactic body radiation therapy (SBRT). SBRT is a form of external beam radiation therapy in which high doses of radiation are delivered each day in 5 total treatments instead of the usual 45 total treatments. These treatments have been found to be just as effective as the longer courses of external beam radiation therapy in appropriately selected patients with prostate cancer.
Proton therapy is a type of external-beam radiation therapy that utilizes protons rather than photons to treat cancer. While the two treatments are similar, the important distinction is that the protons stop after traveling through the patient and reaching the tumor, so there is no exit dose. Your physicians can take advantage of this property to help limit the amount of radiation exposure to healthy tissue and organs while maintaining a maximum dose to the tumor site.
Brachytherapy (internal radiation) or “seed implant”
Prostate brachytherapy is a procedure in which tiny radioactive seeds are permanently placed in the prostate gland to treat prostate cancer. The implanted seeds deliver radiation that kills cancer cells in the prostate. This means there is very little radiation exposure to nearby tissues and organs and therefore very few side effects.
Prostate brachytherapy is a proven, safe, and effective technology with a long track record. It is as effective as surgery and external radiation treatments but offers several advantages, including less risk of erectile dysfunction and a better quality of life after treatment as compared to surgery and external radiation. The seed implantation procedure is completed as an outpatient in a single day, so there is no hospital stay. Prostate brachytherapy can be done alone or in combination with external beam radiation treatments. Your doctor will tell you which is best for your cancer.
Xofigo is a drug that emits radioactive particles to treat men with prostate cancer that has spread to the bones and does not respond to standard hormone treatments. It treats the bony lesions in these patients. The drug is injected into a vein and emits radioactive particles that zero in on cancerous tissue in the bones.
In a landmark clinical trial published in the July 18, 2013 issue of the New England Journal of Medicine, treatment with Radium-223 significantly improved the survival of men with metastatic prostate cancer to bone when compared to a placebo treatment. Radium-223 treatment was associated with a 30 percent reduction in the risk of death from prostate cancer as compared to placebo treatments. Radium-223 was also found to protect the skeleton from complications, such as bone fractures that are frequently associated with prostate cancer spreading to bone, and significantly increases a patient’s chance to have an improved quality of life.
What to expect
Prior to any prostate cancer radiation treatment, you will be asked to provide a complete medical history and may have to undergo a complete physical examination to ensure you are in good health. Blood tests and other diagnostic tests may be performed. It is important for patients to notify your healthcare provider about any sensitivities or allergies to medication, latex, tape, contrast dyes, iodine or anesthetic agents.
Your attending radiation oncologist will review all treatment options and discuss the risks specific to your treatment. Because radiation treatment is typically an outpatient procedure, you will be observed for a period of time and then discharged home. You will not likely have a great amount of pain from the procedure. Over-the-counter medications, such as Tylenol or Motrin, can alleviate any discomfort.
Possible side effects
With prostate cancer radiation treatment, some patients have no side effects at all. However, when side effects do occur, they are typically related to the specific areas that are being treated. Potential side effects include:
- Frequent urination
- Difficult or painful urination
- Urinary leakage
- Blood in the urine
- Upset stomach
- Painful bowel movements
- Rectal bleeding
Most side effects usually go away after treatment ends. However, you may feel very tired for four to six weeks after your last treatment. Talk to your doctor about ways to treat potential side effects.
Cancer is challenging, but you don’t have to go it alone. At Northwell Health Cancer Institute, a wide range of support groups are available to help you cope with diagnosis, treatment and post-treatment issues.