Stage I or II Prostate Cancer Treatment

Stage I or II Prostate Cancer Treatment: Radiation Therapy

Radiation therapy uses high-energy x-rays, either beamed from a machine or emitted by radioactive seeds implanted in the prostate, to kill cancer cells. When prostate cancer is localized, radiation therapy serves as an alternative to surgery. External beam radiation therapy is also commonly used to treat men with regional disease, whose cancers have spread too widely in the pelvis to be removed surgically, but who have no evidence that cancer has spread to the lymph nodes. In men with advanced disease, radiation therapy can help shrink tumors and relieve pain.
External Beam Radiation Therapy
External beam radiation therapy generally involves treatments 5 days a week for 6 or 7 weeks. The treatments cause no pain, and each session lasts just a few minutes. In many cases, if the tumor is large, hormonal therapy may be started at the time of radiation therapy and continued for several years.
The primary target is the prostate gland itself. In addition, the seminal vesicles may be irradiated (since they are a relatively common site of cancer spread). Radiating the lymph nodes in the pelvis, once common practice, has not proven to produce any long-term benefits for most patients, but it may be necessary in certain circumstances.
Possible Problems With External Radiation Therapy
Because the radiation beam passes through normal tissues -- the rectum, the bladder, the intestines -- on its way to the prostate, it kills some healthy cells. Radiation to the rectum often causes diarrhea, but the diarrhea -- as well as radiation-induced fatigue -- usually clears up when treatment is over.
Radiation therapy for prostate cancer can also cause a variety of long-term problems. These include:
  • Proctitis
  • Inflammation of the rectum (with bleeding and bowel problems, such as diarrhea)
  • Cystitis
  • Inflammation of the bladder (leading to problems with urination).
In addition, some 40 percent to 50 percent of men treated with radiation therapy become impotent.
With newer techniques, available at state-of-the-art radiation therapy centers, side effects may be fewer. Higher-energy radiation beams can be more precisely focused, while computer technology allows a radiation oncologist to tailor treatment to the anatomy of the individual patient.
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