By- Dr. Dodul Mondal – Director Max Super Specialty Hospital, Saket, New Delhi Oncology/Radiation Oncology
Prostate cancer is a prevalent form of cancer that primarily affects older men. Approximately 1 in 10 males will experience this condition during their lifetime. While it typically emerges after the age of 50, individuals with a family history of prostate cancer may develop it at a younger age.
Detecting prostate cancer in its early stages is crucial, as it provides an opportunity for a complete cure and a normal life expectancy following appropriate treatment. In the initial stages, most cases of prostate cancer are asymptomatic. However, patients commonly present with symptoms such as urinary difficulties, weak urine flow, frequent urination, blood in the urine, urinary retention, and back or bone pain in more advanced and metastatic stages.
To determine whether a patient has prostate cancer, a simple blood test called the Prostate Specific Antigen (PSA) test is conducted. A histopathological examination, known as a prostate biopsy, is then performed to confirm the diagnosis. The biopsy is typically done as an outpatient procedure through the rectum using ultrasound guidance.
Radiation therapy is an effective treatment option for prostate cancer. It involves the use of high-energy radiation to target and destroy cancer cells in the prostate. Here’s a description of how prostate cancer can be covered by radiation therapy:
Planning: Before initiating radiation therapy, a planning phase is conducted to ensure accurate targeting of the prostate and preservation of surrounding healthy tissues. This typically involves imaging techniques such as CT scans, MRI, or PET scans to precisely map the location and size of the tumor.
Treatment Techniques: There are several radiation therapy techniques used to cover prostate cancer:
A. External Beam Radiation Therapy (EBRT): This technique involves delivering radiation from outside the body using a machine called a linear accelerator. EBRT can be delivered in different forms:
Three-Dimensional Conformal Radiation Therapy (3D-CRT): This technique shapes the radiation beams to match the shape and size of the prostate, minimizing radiation exposure to surrounding healthy tissues.
Intensity-Modulated Radiation Therapy (IMRT): IMRT utilizes advanced computer algorithms to modulate the intensity of radiation beams, allowing for even more precise targeting of the tumor while sparing nearby organs.
Image-Guided Radiation Therapy (IGRT): IGRT combines imaging technology with radiation therapy, allowing for real-time visualization and adjustment of the treatment area to account for any changes in the prostate’s position.
B. Brachytherapy: Brachytherapy involves the implantation of small radioactive seeds directly into the prostate gland. These seeds emit radiation over time, targeting the cancer cells while minimizing damage to surrounding tissues. This technique can be performed as low-dose rate (LDR) or high-dose rate (HDR) brachytherapy.
Treatment Course: Radiation therapy for prostate cancer is typically delivered in multiple sessions, known as fractions, over several weeks. The exact number of sessions and the total radiation dose depend on various factors, including the stage and aggressiveness of the cancer.
In early-stage prostate cancer treatment options are surgery (mostly robotic surgery is performed nowadays), radiation, or observation in select cases. Surgery can be either open or robotic. Radiation treatment can be either brachytherapy (Needle or seed implant), SBRT, or conventionally fractionated radiation using IMRT or arc therapy or helical IMRT.
SBRT (Stereotactic Body Radiation Therapy) has become a preferred treatment modality for early-stage prostate cancer when the size of the gland is small and the tumor is confined within the prostate gland only. A high dose of radiation is focused on the prostate gland which kills the tumor cells without any side effects on nearby healthy cells. Typically, 5 sessions of treatments are delivered using highly precise verification methods (known as image guidance).
SBRT is beneficial in many ways compared to surgery. It does not involve an operation and by doing that it abolishes the risk of anesthesia, blood loss, and post-operative complications and most importantly reduces the risk of impotence.
It has also been seen that the chance of cancer control is the same using SBRT as in surgery.
It’s important to note that the specific details of radiation therapy for prostate cancer can vary depending on individual patient characteristics and the treatment center’s protocols. Consulting with Dr. Dodul Mondal a radiation oncologist will provide personalized information and guidance regarding the most suitable radiation therapy approach for each patient
In Conclusion:
Radiation therapy is an effective treatment option for prostate cancer. It utilizes high-energy radiation to target and destroys cancer cells in the prostate, offering a non-invasive approach to managing the disease. Whether through external beam radiation therapy or brachytherapy, radiation can be precisely delivered to the prostate while minimizing damage to surrounding healthy tissues.
Radiation therapy can be customized based on the individual’s specific needs, stage of the cancer, and treatment goals. It is typically delivered in multiple sessions over several weeks, allowing for an effective and well-tolerated treatment course. While some temporary side effects may occur, they can be managed with appropriate supportive care.
Overall, radiation therapy plays a significant role in the comprehensive management of prostate cancer, offering an important treatment option that can improve outcomes and quality of life for patients.