Treating prostate cancer with radiation


Dr. Folkert explains radiation therapy options for prostate cancer.

Other than skin cancer, prostate cancer affects more men each year than any other cancer, according to the American Cancer Society. In addition, prostate cancer is the second leading cause of death from cancer in men.

But the disease can often be treated successfully when it’s detected early. It’s important to know your options and to discuss them with your physicians when deciding on your treatment.

Surgery and radiation therapy are standard treatments. The goal of radiation therapy is to focus treatment on cancer cells while limiting the radiation’s effect on the surrounding healthy cells as much as possible. The specific type of radiation treatment you receive depends on the size and location of your cancer.

Discuss your options

A radiation oncologist can discuss the types of available radiation-based treatments. Typical treatments include:

  • Conventional external beam radiation therapy is commonly delivered in small daily doses over eight to 10 weeks.
  • Stereotactic ablative radiotherapy (SABR), also known as stereotactic body radiation therapy (SBRT), involves higher doses of external radiation that are generally delivered in five treatments every other day.
  • Low-dose-rate brachytherapy involves the placement of radioactive “seeds” on and near prostate tumors in a single session while the patient is under anesthesia. The seeds stay in the prostate and deliver radiation over several months. For advanced cancers, brachytherapy is sometimes paired with external beam radiation.

There are many variables that must be taken into consideration when choosing among these options; your radiation oncologist will discuss them with you during your consultation and make his or her recommendation on a case-by-case basis.

Reducing radiation side effects

As you consider your options, it’s also important to learn about radiation side effects and potential risks of radiation therapy, such as bowel and bladder irritation and possible ramifications on sexual function.

Radiation side effects tend to be fewer or less severe when radiation exposure on healthy tissue is minimized. The highly focused approach used with stereotactic radiation reduces the exposure of surrounding tissue and allows radiation delivery over a shorter timeframe – just five treatments over two weeks typically. All stages of prostate cancer, including early, intermediate, and late, are potentially candidates for stereotactic treatment.

To further reduce the side effects of stereotactic radiation, UT Southwestern researchers are conducting a clinical trial that combines stereotactic treatment with an injectable, biodegradable “spacer” to slightly increase the distance between the prostate and the rectum. The few extra millimeters created by the spacer are estimated to significantly reduce the amount of radiation reaching the sensitive rectal tissues near the prostate. Our hope is that these spacers will allow physicians to treat prostate cancer with a higher radiation dose while reducing the side effects, such as short- and long-term irritation of the rectum. The spacer remains in place for about 12 weeks and then dissolves.

If the spacer trial is successful, we hope to broaden the use of spacers in the treatment of prostate cancer and extend their use to cancers in other hard-to-reach parts of the body, such as the spine, esophagus, and liver.
It’s your right to ask questions, and it’s our responsibility to make sure you have the information you need. Request an appointment with your doctor if you have questions about prostate cancer symptoms, treatment options, or the availability of prostate cancer clinical trials.