Radiation Therapy for Prostate Cancer

Facts About Prostate Cancer

The American Cancer Society's most recent estimates for prostate cancer in the United States are for 2009:

  • 192,280 new cases of prostate cancer
  • 27,360 deaths from prostate cancer
  • Prostate cancer is the most common type of cancer found in American men.
  • Prostate cancer is the second leading cause of cancer death in men.
  • One man in 6 will get prostate cancer during his lifetime.

Risk Factors For Prostate Cancer

  • Age: The chance of getting prostate cancer goes up as men age. About two-thirds of prostate cancers are found in men over age 65.
  • Race: Prostate cancer is more common among African-American men and Jamaican men of African heritage than in white men.
  • Family history: Men with a father or brother with prostate cancer are more likely to get it themselves.

Screening for Prostate Cancer

Prostate cancer can often be found early by testing the amount of PSA (prostate-specific antigen) in your blood. Another way prostate cancer is found early is when the doctor does a digital rectal exam (DRE). This is when a doctor a puts a gloved finger into the rectum to feel the prostate gland. Because the prostate gland lies just in front of the rectum, during the DRE the doctor can feel if there are any bumps or hard places on the prostate. These might be cancer. If you have had routine yearly exams and either one of these test results is not normal, any cancer you might have has probably been found at an early, more treatable stage.

The American Cancer Society does not recommend routine prostate cancer screening for all men at this time. ACS believes that doctors should discuss the pros and cons of testing with men so each man can decide if testing is right for him. If a man chooses to be tested, the tests should include a PSA blood test and DRE (digital rectal exam) yearly, beginning at age 50, for men at average risk who can be expected to live at least 10 more years.

Diagnosing Prostate Cancer

Prostate cancer is most often found through a blood test measuring the amount of prostate specific antigen (PSA) in the body. Most men diagnosed with prostate cancer have no symptoms and only find their cancer because of screening. However, sometimes prostate cancer can cause symptoms. Some signs to look for include:

  • Feeling that you need to urinate urgently.
  • Having hesitancy when urinating (slow stream).
  • Pain or blood during urination.

If your doctor suspects you might have prostate cancer, some tissue will be taken from your prostate and examined under a microscope. This test is called a biopsy.

Treating Prostate Cancer

If you find out you have cancer, you should discuss your treatment options with a medical oncologist, a radiation oncologist, and a urologist. Options for dealing with prostate cancer include:

Sometimes a combination of treatments, such as surgery followed by external beam radiation, is best for your cancer treatment. Some men can safely postpone treatment and watch it closely until treatment is needed. This is called watchful waiting.

Prostate Brachytherapy

Prostate brachytherapy involves treating the cancer by inserting radioactive sources directly into the gland.

  • Permanent seed implants (also called PSI or prostate seed implants) are performed by inserting small metal seeds of radioactive iodine or palladium directly into the gland under anesthesia. The seeds are temporarily radioactive and deliver the radiation to the prostate over several weeks. After losing their radioactivity, the seeds remain in the prostate and are harmless.
  • High-dose-rate prostate implants deliver radiation to the prostate with a few treatments using a single, small radioactive iridium source on the end of a computer controlled flexible wire. The radiation is delivered through narrow tubes called catheters inserted into the prostate by your radiation oncologist. You will be under anesthesia and will not feel pain. The tubes remain in place for only one or two days. Once the treatment is complete, the tubes and the radioactive source are taken out. After this type of radiation, you will not need to take special precautions around others.

Depending on your cancer, prostate brachytherapy may be combined with external beam radiation therapy. The side effects from these treatments are similar to those seen with external beam radiation therapy, such as urinary frequency, discomfort on urination or bowel irritation. Medication helps control these symptoms that typically go away within a few months after treatment.

Hormone Therapy

Depending on your cancer, you may benefit from adding hormone therapy to radiation.

  • Works by starving the tumor of the male hormones it needs to grow. This may make your radiation therapy treatments work better.
  • May be used together with radiation therapy or before radiation to shrink the tumor.

The length of time you will receive hormone therapy depends on your cancer. Ask your doctor for more information. Side effects can include hot flashes, mild breast tenderness, diarrhea, nausea and tiredness.

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