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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 to be exposed to additional
radiation. Therefore, these patients may wish to pursue
other types of treatments. Finally, patients who have
had prior radiation treatment to the pelvic area usually
cannot receive radiotherapy again.
Salvage Treatment
After having received brachytherapy, however, a patient
usually does not receive radiotherapy. If brachytherapy
fails, radiotherapy is usually not used 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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