Prostate Cancer Care in the Carolinas
The prostate is part of a man’s reproductive system, located in front of the rectum and under the bladder. It surrounds a tube called the urethra, through which urine flows from the bladder. The prostate is responsible for making part of the seminal fluid that helps carry sperm during intercourse. Prostate cancer in its early stages rarely causes symptoms, though patients can have alterations in their ability to urinate from enlargement of the prostate, or have blood in the urine, or have changes in their erection capability.
How Does Someone Get Prostate Cancer?
What are the Symptoms of Prostate Cancer?
External Beam Radiation
External beam radiation therapy for prostate cancer treatment with a machine called a linear accelerator consists of an 8 to 8 ½ week course of therapy, with treatments delivered Monday through Friday.
Stereotactic Body Radiosurgery
In 2013, the national organization for radiation oncologists, the American Society of Therapeutic Radiation Oncology (ASTRO), publicized a notice that in select prostate cancer patients, utilization of a very short course of radiotherapy for curative treatment of prostate cancer had enough clinical follow up as to be deemed a reasonable option to offer patients. This short course of treatment is also called stereotactic body radiosurgery (SBRT). It consists of a total of 5 treatments given over 2 to 3 weeks. The dose given at each treatment is higher than the standard dose given in an 8-week course of therapy, but the extraordinary accuracy allows for even less of a margin of normal tissue inclusion within the beams, allowing this therapy to be done safely. SERO has had several years of experience using this technology at one of our facilities with a special linear accelerator called the CyberKnife, and we are pleased to offer this as yet another cutting-edge method of treatment for prostate cancer patients.
Radioactive Implant Therapy
Some patients are best served with a radioactive implant of the prostate using small radioisotope pellets that are implanted into the prostate, with or without supplemental external beam treatment. These implants are done under anesthesia, and several of our facilities offer this. These are done in partnership with our urologic physician colleagues. The results from treatment with a single radiation implant for appropriate patients with prostate cancer have been excellent, in excess of 90% cures reported. This type of therapy has over 15 years of follow-up information in the medical literature, assuring us that these treatment outcomes are permanent.
Focal Radiation Beam Therapy
Radiation also has value in treating patients with advanced prostate cancer that has spread to other sites in the body. The initial treatment for patients with spread of prostate cancer is anti-testosterone hormone administration, a shot given every one to six months, administered by the urologist. If prostate cancer spreads or is advanced at diagnosis, the cancer tends to travel to bone. Focal radiation beam therapy for a short course, one to ten treatments to an area of pain, is often effective at reducing or eliminating pain.
Injectable Intravenous Radium-223
Patients can also benefit from a new treatment with injectable intravenous Radium-223, that has been used to treat the bone sites of cancer spread by traveling by the bloodstream to the areas of disease in bone. This very targeted therapy has a minimal effect on blood counts. One of the radiation therapy facilities staffed by SERO has been on the forefront of use and research of this agent and has been recognized as a national leader with the experience gained with Radium-223.
SERO physicians in Charlotte, NC and surrounding locations have performed prostate seed implants since the mid-90s working with our urologic peers. SERO continues to manage a robust prostate seed implant program at most of the centers and have over 10 physicians trained in this technique. Since inception of the prostate seed implant program at SERO, thousands of patients have enjoyed the good results discussed above at a lower cost of care. All prostate cancer patients deserve a Multidisciplinary Approach as recommended by the American Urologic Society and Commission on Cancer which should include a direct evaluation by a radiation oncologist who is skilled in this procedure.
What are the Side Effects of Radiation Therapy for Prostate Cancer?
The side effects of radiation for prostate cancer include:
- Urinary leakage or incontinence
- Frequent, difficult, and/or painful urination
- Bloody urine
- Stomach cramps
- Bleeding or leaking from the rectum
- Painful bowel movements
- Skin reactions that may look like a sunburn
- Lymphedema, or swollen lymph nodes, especially in the groin area
- Sexual dysfunction, such as decreased semen volume or erectile dysfunction
Most side effects are mild, however. Using more advanced radiation technologies that can deliver a high targeted dose of radiation to prostate cancer cells, while sparing surrounding healthy tissues, may help reduce the severity and duration of radiation side effects.
How Long Do Side Effects of Prostate Radiation Therapy Last?
Side effects of radiation for prostate cancer can last from days to weeks, and occasionally longer. Issues, such as bowel and urinary incontinence, typically persist for up to six weeks following the last radiation treatment. In rare cases, side effects may arise months after treatment.
What is the Success Rate of Radiation Treatment for Prostate Cancer?
Both of the main types of radiation treatment for prostate cancer, including brachytherapy and external beam radiation, have a five-year survival rate of about 90 percent. Success rates are even higher in patients who have only localized prostate cancer, in which the cancer hasn't spread to other areas of the body. Radiation is considered a highly effective prostate cancer treatment.
How Long is Radiation Treatment for Prostate Cancer?
Radiation treatment for prostate cancer generally lasts for one to two months, at a frequency of about five days per week. External beam radiation usually takes less than one hour per session. The total number of treatments needed depends on individual factors, including how large the prostate cancer is, whether the cancer has spread to other parts of the body, and the patient’s overall health.