Radiotherapy for Metastatic prostate cancer
Radiotherapy is a treatment option for prostate cancer that has spread to other parts of the body, known as metastatic or advanced prostate cancer.
The testicles
The testicles are two small, oval-shaped organs located below the penis, enclosed in a skin pouch called the scrotum.
Image of the testicles (cruk)
Starting from puberty, the testicles begin producing sperm. Inside the testicle, small tubes come together to form the epididymis, a single tube that becomes wider as it exits the testicle. This wider tube is known as the spermatic cord.
The spermatic cord leads to a short passage called the ejaculatory duct, which opens into the urethra, the tube that carries urine and semen out of the body through the penis.
Testosterone:
The testicles produce the hormone testosterone, which is responsible for developing male characteristics such as:- A deeper voice
- Facial hair growth
- Increased muscle mass
- The ability to achieve an erection
- Male sexual drive (libido)
Where does testicular cancer start:
The testicles consist of various cell types, and the kind of cancer you have depends on the specific cell where it begins. Most testicular cancers arise from germ cells, which are responsible for producing sperm. Doctors classify germ cell cancers into two main types:- Seminoma
- Non-seminoma
It involves using high-energy waves, similar to x-rays, to target and destroy cancer cells in the prostate. There are two main types: external beam radiotherapy and internal radiotherapy. External beam radiotherapy directs radiation beams at the cancer from outside the body, whereas internal radiotherapy delivers radiation directly to the cancer from within.
For metastatic prostate cancer, internal radiotherapy options like Radium-223 and Lutetium-177-PSMA may be recommended. Lutetium-177-PSMA is a newer type of internal radiotherapy treatment.
The goal of radiotherapy for metastatic prostate cancer is to reduce the size of the cancer, alleviate symptoms such as pain, and improve overall comfort.
External radiotherapy for metastatic prostate cancer:
External radiotherapy is a treatment option for metastatic or advanced prostate cancer, which indicates that the cancer has spread beyond the prostate to other parts of the body.
In advanced stages of prostate cancer, curing the disease becomes unlikely. However, radiotherapy can effectively manage the cancer, alleviate symptoms, and improve overall well-being.
This treatment is administered in the hospital’s radiotherapy department. While undergoing external radiotherapy, you may experience discomfort from lying on the radiotherapy couch.
Additionally, another form of radiotherapy, known as Radium 223 (Xofigo), may also be recommended in some cases.
When you might have external radiotherapy for metastatic prostate cancer:
Certainly! Here’s the information in different wordings:
External radiotherapy can be used to alleviate symptoms like pain caused by the spread of prostate cancer, or to help manage and control the cancer itself.
For symptom relief, which is termed palliative treatment, you may undergo one or multiple sessions over several days. These sessions, referred to as fractions, aim to ease discomfort and improve quality of life.
To manage the cancer, external radiotherapy might target the prostate gland. This approach is often combined with hormone therapy or administered after completing chemotherapy.
Your treatment plan will specify the number of sessions or fractions of radiotherapy needed. Typically, if targeting the prostate, treatments occur once weekly for about 6 weeks. Additional treatments may be required for other affected areas like the bones, typically ranging from one to five sessions.
Planning your radiotherapy treatment:
Before commencing external radiotherapy, your radiotherapy team undertakes a meticulous planning process to determine the precise dose and target areas for treatment. This planning session typically lasts between 15 minutes to 2 hours.
A key component of this planning involves a CT scan conducted in the radiotherapy department. This scan provides detailed images of the cancer and its surrounding tissues. Additional scans or x-rays may also be used to assist in planning your treatment. Importantly, the plan created is customized specifically for you.
Following the planning session, radiographers and doctors collaborate to develop your individualized radiotherapy plan. They ensure that the cancerous area receives a concentrated dose while minimizing radiation exposure to nearby healthy tissues. This approach helps reduce potential side effects both during and after treatment. The entire planning process can take several days to up to 3 weeks before treatment begins.
The radiotherapy room:
Radiotherapy machines are large and might be intimidating at first sight. These machines can either be stationary in one position or rotate around your body to deliver treatment from various angles. Importantly, the machine does not come into physical contact with you during treatment.
Before your initial treatment session, radiographers will provide a detailed explanation of what you can expect to see and hear during the procedure. Some treatment rooms even offer facilities for you to connect music players, allowing you to listen to your preferred music while undergoing treatment. This personalized approach aims to make your experience more comfortable and reassuring.
Image of the radiotherapy room
Before each treatment session:
You might need to drink a specific amount of water before each treatment to ensure your bladder is full. This helps keep your prostate in the same position for each session and minimizes the radiation exposure to your bladder. It’s important to drink the same amount of water each time so your bladder remains the same size.
The radiographers will assist you in getting positioned on the treatment table and align the radiotherapy machine using the marks on your skin.
After that, the radiographers will leave the room, and you’ll be alone for up to 25 minutes while the treatment is being administered.
During the treatment:
You need to lie very still during the treatment. The radiographers might take some images (x-rays or scans) beforehand to ensure you’re positioned correctly. The machine will make whirring and beeping noises, but you won’t feel anything during the procedure.
The radiographers will monitor you on a CCTV screen from the next room. They can communicate with you through an intercom, sometimes asking you to hold your breath or breathe shallowly. You can also use the intercom to talk to them or raise your hand if you need to stop or feel uncomfortable.
You Won’t become radioactive:
This kind of radiotherapy won’t make you radioactive. It’s completely safe to be around others, including pregnant women and children.
Daignosis
If you have any symptoms, your first step is usually to visit your GP. They will discuss your symptoms with you and conduct an examination. Based on their findings,
Treatment options
A team of healthcare professionals (multidisciplinary team) will determine your treatment plan. Most people undergo surgery to remove the affected