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Prostate cancer patients who want
to pursue radiotherapy, also called external radiation
therapy, as their first line monotherapy should have
these characteristics:
- Gleason score of 6 or lower
- PSA level of 10 or lower
- Disease confined to the prostate
gland
- No extensive abdominal scar
tissue from other surgeries
Not meeting all of these criteria
does not eliminate radiotherapy as a prostate cancer
treatment option. Read on to see who else is opting
for radiotherapy and why. Then speak with a qualified
radiation oncologist to see if radiotherapy could be
right for you.
Radiotherapy
as First Line Monotherapy for Prostate Cancer
The two newer forms of external beam radiation therapy
are called IMRT (intensity modulated radiation therapy)
and 3D-CRT (3-dimensional conformal radiation therapy.
Radiotherapy is completely non invasive and works by
aiming high energy particles at the diseased tissue.
IMRT and 3D-CRT as external beam radiation therapy may
be a good option for patients who do not want to undergo
a more invasive treatment.
Patients who undergo radiotherapy
as a prostate cancer treatment should have a Gleason
score that is 6 or lower and a PSA score that is 10
or lower. These numbers indicate that the prostate is
still localized within the prostate gland. An ideal
radiotherapy treatment would eradicate the prostate
cancer and leave the surrounding organs and tissues
completely untouched. IMRT and 3D-CRT are both prostate
cancer treatments that can help a radiation oncologist
come close to this ideal. Cancer that has spread outside
of the gland either is more difficult to treat adequately
or poses greater risk to the surrounding tissue.
Radiotherapy and Patient
Age
Prostate cancer patients who are considering brachytherapy,
cryotherapy, and radical prostatectomy, may also want
to consider radiotherapy as a possible primary monotherapy.
Those who do not wish to pursue any type of invasive
procedure, even a minimally invasive procedure, may
want to consider brachytherapy. If a doctor feels a
patient will not be able to tolerate another procedure
either due to age or health, the doctor may recommend
external beam radiation therapy.
Minimizing Radiation Damage
to Healthy Tissue
External radiation therapy, however, may expose healthy
tissue of the rectum and bladder to the effects of radiation.
If a patient has had previous surgery in the abdominal
area, the scar tissue from the surgery will cause the
colon and the intestines be exposed to additional radiation.
These patients therefore may wish to pursue other types
of treatments. Finally, patients who have had radiation
treatment to the pelvic area before usually cannot receive
radiotherapy again.
Salvage Treatment
After having already received brachytherapy, however,
a patient usually does not receive radiotherapy. If
brachytherapy fails, radiotherapy is usually not use
as a salvage therapy because the prostate gland has
been treated with an extremely high and concentrated
dose of radiation. It is unlikely that radiotherapy
could destroy what brachytherapy failed to destroy.
Patients who would otherwise be good candidates for
prostate brachytherapy, but suffer from benign prostatic
hyperplasia (BPH), may want to consider radiotherapy.
Because the urinary side effects associated with brachytherapy
are exacerbated by the radioactive seeds, patients with
BPH may want to instead consider radiotherapy.
Cryotherapy is sometimes recommended
as a salvage treatment for when radiotherapy fails.
Unlike brachytherapy, cryotherapy uses freezing temperatures
to destroy prostate cancer. Where radiation fails, the
different attack method of freezing may succeed. Patients
who have advanced stage prostate cancer with bone metastasis
may be candidates for radiotherapy. Radiotherapy can
help alleviate the pain that is associated with bone
metastasis.
Radiotherapy usually cannot destroy
high-grade, aggressive cancers by itself. Most treatments
for prostate cancer cannot by themselves destroy advanced
prostate cancer. If a patient wishes to pursue radiotherapy,
he should speak with his doctors about the advantages
and disadvantages to his health.
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