External beam radiotherapy uses high energy X-ray beams to treat
prostate cancer. The X-ray beams are directed at the prostate gland
from outside the body. They damage the cancer cells and stop them
growing.
You may be able to have radiotherapy if your cancer is still
contained within the prostate gland (localised prostate cancer).
Radiotherapy may also be suitable for some men whose cancer has
spread to the area just outside the prostate (locally
advanced prostate cancer).
External beam radiotherapy is sometimes given alongside permanent seed
brachytherapy or temporary brachytherapy
(internal radiotherapy). Radiotherapy can also be used after surgery if your PSA
level starts to rise or if there is a risk that not all the cancer
was removed with surgery.
What other
treatments are available?
Contents
Watch Ally's story for one man's experience of radiotherapy
treatment:
What are the advantages and
disadvantages?
The advantages and disadvantages of radiotherapy will depend on
your age, health and the stage of your cancer. Your specialist team
will discuss your individual situation and options with you.
Advantages
• Radiotherapy has none of the risks of surgery and having a
general anaesthetic.
• It can be given when you are considered unsuitable or unfit for
surgery.
• Some men may find the treatment position a bit uncomfortable but
the radiotherapy itself is painless.
• It is relatively quick. Daily treatment sessions last about 10 to
20 minutes, and you do not need to stay in hospital
overnight.
• You can carry on with many of your usual activities while you are
having treatment.
Disadvantages
• You will need to go to a specialist hospital for treatment five
days a week for several weeks -- and each visit could take at least
an hour. This might be difficult if you need to travel a long
distance.
• There is a risk of side effects including bowel problems, urinary
problems and erectile dysfunction.
• It may be some time before you will know whether the treatment
has been successful.
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What does treatment
involve?
You may be given hormone therapy for three to six months before
you begin radiotherapy. This shrinks the prostate and makes the
cancer easier to treat. You may also have further hormone therapy
throughout your course of radiotherapy. Men who are at a higher
risk of their cancer spreading may continue to have hormone therapy
for at least two years after radiotherapy.
Before starting radiotherapy you will have scans to find the exact
location, size and shape of your prostate. This is to make sure the
treatment is accurate and that the surrounding areas do not receive
more radiation than is necessary.
You will have one treatment at the hospital every day from Monday
to Friday, with a rest over the weekend to help your healthy cells
to recover. You can go home after each treatment session and will
not have to stay overnight. Treatment normally lasts between seven
and eight weeks.
At the beginning of each treatment, the radiographer will move you
into the right position on the treatment couch. The treatment then
starts and the machine moves around your body. It does not touch
you and you will not feel anything. The whole session lasts about
10 to 20 minutes, including the time taken to position you on the
treatment couch.
Your PSA level will be checked, usually six to twelve weeks
after your treatment has finished. It will then be checked
regularly, often at least every six months for two years, and after
that at least once a year. This is to monitor how well the
radiotherapy has worked.
If your treatment has been successful your PSA level should drop.
However, how quickly this happens, and how low the PSA level falls,
will depend on whether you had hormone therapy alongside
radiotherapy. If you had radiotherapy on its own, it may take up to
two years for your PSA level to fall to its lowest level. If you
had hormone therapy as well, your PSA level may fall more
rapidly.
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What are the side effects?
Many men will get side effects during their treatment which only
last a few weeks or months. However, some side effects can develop
later and can become long term problems.
Possible side effects include bowel problems, urinary problems,
tiredness and skin irritation. Longer term problems can include
sexual problems and infertility. There is a small chance of other
cancers developing, but this is very rare.
Side effects can often be treated, so if you have any unusual
symptoms after having radiotherapy, ask your specialist team about
it. Read our online fact sheet for more
information on managing side effects.
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Questions to ask your
doctor or nurse?
- How many radiotherapy sessions will I have?
- Will I have hormone treatment? Will this continue after the
radiotherapy?
- What side effects might I get? Will these be temporary or
permanent?
- Will I be able to continue as normal during the treatment (for
example, go to work)
- How will we know how successful the treatment has been?
- If the radiotherapy is not successful, which other treatments can
I have?
- Who should I contact if I have any questions at any point during
my treatment?
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