External Beam Radiation

What is it?
  • External beam radiation delivers therapeutic x-rays to a localized area in order to kill cancer cells.
  • May be a good option if age or general health makes surgery too risky.
  • Can be used in combination with other treatments although surgical removal of the prostate is very difficult after radiotherapy.
3-Dimensional Conformal Radiation and Intensity Modulated Radiation are commonly used techniques. They use either CT scans or MRIs to pinpoint where radiation is needed. The radiation beams “conform” to the prostate, sparing neighbouring tissue. This allows the
delivery of high-dose radiation to cancerous areas while minimizing risk of damage to healthy cells.

What is done?
  • Radiation works by interfering with cell division. Because normal cells are affected along with cancerous ones, radiation is given in small doses over a period of eight weeks.
  • Usually treatment is given Monday–Friday, with a break on weekends to give the healthy cells some time to recover.
What to expect?

Before treatment:
You will have one or more planning sessions (with different scans or x-rays) to identify the exact area to be treated.

During treatment:
  • A machine sends painless high-energy beams into your body. You will be fully awake for the treatment.
  • One session takes 10–30 minutes. No hospitalization is needed.
  • During treatment you will have regular meetings with your radiation oncologist to monitor side-effects and review your progress.
After treatment:
You will have follow-up appointments and PSA tests to check how effective the treatment has been.

Prostate Cancer Canada graciously acknowledges the Princess Margaret Cancer Centre for sharing this video with us.

Side effects and risks

Immediate side-effects:
  • May appear within a few weeks of radiation and disappear someweeks after treatment has ended.
  • Some men experience fatigue, decreased energy, weight loss or changes in appetite.
  • Less common are gastrointestinal or rectal problems such as diarrhea, pain during defecation and rectal bleeding.
  • Urinary problems are also possible e.g., blood in the urine, frequent urination, urine leakage.
Long-term side-effects:
  • Low risk of changes to the rectum that results in bleeding after bowel movements, which in rare cases (less than 5%) requires a local out-patient procedure to repair the damage
  • Very rare risk (less than 5% within ten years of treatment) that modern external beam radiation causes another cancer within the radiation field.
    These may appear anywhere from 6 months to several years after treatment.
  • Side-effects can range from scar tissue in the urinary passage (causing a slow urinary stream) to infertility.
  • Erectile dysfunction may occur in up to 50% of patients 
    (though many of which can achieve an erection with the use of prescription medicines).

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