Treatments for prostate cancer include:
- External beam radiation therapy (EBRT or radiation therapy)
The most suitable treatment for you depends on many factors to do with your health and your specific cancer. There are often choices when it comes to working out the most suitable treatment approach.
Your treatment decisions will be made in consultation with the specialists who manage prostate cancers: your urologist (surgeon), who usually makes the diagnosis using biopsies, and the radiation oncologist.
What is external beam radiation therapy?
External beam radiation therapy is radiation delivered from outside the body and directed at your cancer site.
External beam radiation therapy is a very common treatment option, and many people with cancer have it. It’s painless, and you don’t see or feel the actual treatment. In most cases, you’ll be able to continue with your daily routine after each treatment.
How does external beam radiation therapy work?
External beam radiation therapy is often performed using Intensity-Modulated Radiation Therapy (IMRT).
IMRT is a modern technique which delivers high doses of very targeted radiation to the prostate using X-rays - with minimal impact on the surrounding tissues.
A faster, more flexible type of this treatment is known as Volumetric Modulated Arc Therapy (VMAT). This technique uses one or two 360 degree rotational beams.
This treatment also uses a technique called ‘image-guided radiation therapy’ to help ensure millimetre accuracy. It’s able to match the daily position of the prostate (the prostate’s position can move slightly from day to day according to bowel or bladder filling).
How often do I need treatments?
External beam radiation therapy is usually delivered once a day, Monday to Friday, over around 7-9 weeks.
The treatment sessions typically take 10 minutes – though you may need to allow for around 20 minutes in your first treatment session.
Am I radioactive after treatment?
No. Because the treatment uses X-rays, you won’t be radioactive after treatment. There is no radiation in your body when you leave the treatment room. The beam is on then off – just like when you have a regular X-ray.
Do I only receive the radiation therapy in the prostate region?
Depending on the stage of the cancer, its grade, what your scan results say and any changes in blood tests, radiation therapy may be recommended to regional lymph nodes in the pelvis – as well as to the prostate region.
The benefits of External Beam Radiation Therapy include the ability to treat prostate cancer that has invaded locally outside the capsule surrounding the prostate, or into tissues around the prostate. It involves no stay in hospital apart from the gold seed marker placement which may be recommended.
Is external beam radiation therapy combined with other therapies?
External beam radiation therapy is often combined with androgen deprivation therapy – a therapy which temporarily blocks the male hormone testosterone.
Studies have suggested combining these two therapies improves the long-term outcome when compared with having external beam radiation therapy alone.
What is brachytherapy?
Brachytherapy is a type of radiation therapy that inserts radioactive implants near the cancerous tissue.
There are two types: low dose rate, and high dose rate.
What is low dose rate or LDR prostate brachytherapy?
Low dose rate or LDR prostate brachytherapy involves implanting many small metallic seeds containing radioactive Iodine-125 into the prostate.
This is done under general anaesthetic by an experienced urologist and radiation oncologist.
This therapy delivers very targeted radiation inside the prostate. It’s used to treat low to intermediate risk localised prostate cancer.
The seeds are implanted permanently, and deliver radiation doses slowly over several months.
This treatment is usually given without the need for any other treatments, and can be done with either an overnight hospital stay or as a day-stay procedure.
What is high dose rate or HDR prostate brachytherapy?
High dose rate or HDR prostate brachytherapy gives a targeted dose of radiation using one single radioactive Iridium-192 pellet.
The pellet is threaded into specially placed rods or catheters inserted into the prostate gland, guided by ultrasound control.
High dose rate prostate brachytherapy is given in hospital with a general or spinal anaesthetic.
The treatments are given in a special treatment room in the radiation therapy department, and usually take 10-15 minutes per session.
The rods are removed after the procedure, which takes one to two days, as more than one session may be recommended, depending on the protocol used.
This treatment can be the only treatment needed, but it’s more commonly combined with a five-week course of external beam radiation therapy. It can be used for intermediate and high grade or volume tumours.