Radiotherapy for Prostate Cancer

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Radiotherapy can be given three ways. 

It can be given by external beam radiation, high dose rate bracchytherapy or low dose rate bracchytherapy. 

The external beam radiation involves a patient lying down on a machine, getting external radio waves given Monday to Friday for a total of 20 minutes each for about seven weeks. 

It’s aimed at curing the cancer and patients usually have this as an outpatient and can offer work during the treatment. 

They do have some side effects such as lethargy and some nausea on occasions. 

The other side effects of radiotherapy relate to the effect of radiotherapy to adjacent organs such as the back passage and the bladder. 

So a small percentage of patients can have quite serious long term side effects such as bleeding, urgency and frequency of both the bladder and the back passage.

Usually if patients have an active or aggressive cancer we would combine hormone therapy with radiotherapy so that they have about 12 months of hormone therapy with the radiotherapy. 

So one needs to take into consideration that they might have this treatment and this hormone therapy also has some side effects. 

One of the important things is that you have radiotherapy in general you can’t have surgery afterwards because the radiotherapy leads to significant scarring and makes a subsequent operation more difficult.

Most studies show that radiotherapy in surgery offer equivalent results of 10 years but there is some contention about the results beyond 10 years. 

So in general if we have a young patient or a patient with a very long life span we would generally favour surgery to external beam radiation. 

There are also some issues regarding secondary cancers with perhaps a slightly increased incidence of bladder cancer and also some other cancers through the body but this is somewhat contentious.

So external beam radiation is a good treatment and accepted treatment. 

It’s also very important to ensure what sort of dosage is given. 

So there’s a standard way of giving external beam radiation and also a conformal way where we can increase the dose of radiotherapy that’s given. 

So it’s important that when you’re having radiotherapy that you check with the institution as to what dosage they are delivering.