Radiation therapy for prostate cancer

Prostate cancer is susceptible to radiation therapy: many types of prostate cancer respond well to treatment with radiation, as an alternative for surgery. There are two types of radiation: external beam radiation and implantation of radioactive seeds (brachytherapy)

External beam radiation therapy

Treatment with external beam radiation is usually done over a period of six weeks, five days a week. In many cases, hormone therapy must be started during radiation therapy; in some cases, this must be continued for a number of years. The primary target of the radiation therapy is the prostate gland itself. Simultaneous radiation of the lymph nodes in the lower abdomen is not standard practice. However, it may be necessary in certain circumstances.

Radioactive seed implants

Radiation therapy can also be delivered to the prostate by implanting radioactive seeds directly into the prostate. This approach is also termed brachytherapy and has the advantage that the directly surrounding tissue is treated with a high radiation doses. The seeds are implanted under general anaesthetic. Only one session is required, in contrast to external beam therapy.

Brachytherapy uses ultrasound to implant the thin needles with the seeds into the prostate. Seeds containing radioactive palladium or iodine are put into the prostate through the needles. The ultrasound measurements are processed by a computer programme and the computer proposes a suitable template. Based on this template, the correct number of seeds are implanted in as efficient as possible positions into the prostate.

Disadvantages

Despite continuing improvement of the dosing, radiation can damage healthy tissue. After radiation therapy for prostate cancer, there is a risk of long-term erectile dysfunction and urinary incontinence and increased risk of secondary (other) cancers (such as bladder or rectal cancer).

Latest publication date: 13/12/2023
Supervising author: Dr Ameye Filip