Although not one of the things most men — or their loved ones — like to consider, prostate cancer is a real health risk, striking 1 in 9 men in their lifetime, according to the American Cancer Society.
Prostate cancer affects the small, walnut-shaped gland that sits just below the bladder and in front of the rectum. Depending on the stage and location of the cancer, a doctor may suggest radiation treatment as an alternative to surgery.
“Modern radiation therapy is incredibly advanced,” explains Dr. Geoffrey Weinstein, medical director of radiation oncology at Sharp Memorial Hospital. “Using sophisticated technology, we can better target the prostate with a higher dose of radiation, lowering the risk of side effects by protecting nearby healthy tissue, thus improving outcomes.”
The two most common types of radiation treatment are external beam radiation therapy (EBRT) and brachytherapy.
External beam radiation therapy (EBRT)
Of the two therapies, EBRT is more commonly used to treat prostate cancer. Advanced machines called linear accelerators produce high-power X-rays that penetrate deep into the body and disrupt the DNA of cancer cells.
Before treatment, a three-dimensional outline is created using imaging tests such as MRIs or CT scans to determine the exact location of the prostate. With millimeter accuracy, the shape of the X-ray beams is then specifically contoured to an individual’s prostate.
For irregularly shaped tumors, linear accelerators can also alter the power of each beam to better target the radiation and protect surrounding healthy tissue. This technique is called intensity modulated radiation therapy, or IMRT. Newer linear accelerators also use imaging scanners to pinpoint the precise location of the prostate each day before radiation begins.
External beam radiation lasts for several minutes, during which patients are exposed to radiation. Men typically receive radiation once per day, five days a week, for between five and eight weeks.
A doctor may suggest an alternate form of external beam radiation called stereotactic body radiation therapy, which shortens the length of treatment to five daily, higher-dose treatments.
Brachytherapy is an effective treatment for men with early-stage prostate cancer. One form of the treatment involves implanting between 90 to 120 radioactive pellets, or “seeds,” into the prostate while a patient is under anesthesia.
Each seed, about the size of a grain of rice, gives off low doses of radiation for several months. The seeds stay in the prostate after the radioactive material decays.
What to expect post-treatment
Men considering prostate cancer treatment should discuss the possible side effects of radiation therapy with their doctors. The most common side effects — though usually mild — include urinating more frequently, a weaker stream of urine, burning with urination, diarrhea, rectal bleeding and fatigue. Erectile dysfunction can also occur, especially in older men or men who had prior erection problems.
“The good news about prostate cancer is that it can be slow growing, and most cases are found in the early stages,” says Dr. Weinstein. “Of these early-stage cases, survival rates are excellent — 98 percent of patients live at least a decade after being diagnosed and many men live much longer.”
Although the causes of prostate cancer are not completely understood, several factors might affect a man’s risk of getting it, including age, family history of prostate cancer, race, geography and diet. Men should begin discussing prostate cancer screenings with their doctor around age 50, and even earlier if they are at a higher risk of developing the disease.