Prostate Cancer (cont.)
What about radiation therapy for prostate cancer?
The goal of radiation therapy is to damage the cancer
cells and stop their growth or kill them. This works because the rapidly
dividing (reproducing) cancer cells are more vulnerable to destruction by the
radiation than are the neighboring normal cells. Clinical trials have been
conducted using radiation therapy for patients with organ-confined (localized)
prostate cancer. These trials have shown that radiation therapy resulted in a
rate of survival (being alive) at 10 years after treatment that is comparable
to that for radical prostatectomy. Incontinence and impotence can occur as
complications of radiation therapy, as with surgery, although perhaps less
often than with surgery. More data are needed, however, on the risks and
benefits of radiation therapy beyond 10 years, especially because late
recurrences (reappearances) of the cancer can sometimes occur after radiation.
Choosing between radiation and surgery to treat
organ-confined prostate cancer involves considerations of the patient's
preference, age, and co-existing medical conditions (fitness for surgery), as
well as of the extent of the cancer. Approximately 30% of patients with
organ-confined prostate cancer are treated with radiation. Sometimes,
oncologists combine radiation therapy with surgery or hormonal therapy in
efforts to improve the long-term results of treatment in the early or later
stages of prostate cancer.
Radiation therapy can be given either as external beam
radiation over perhaps 6 or 7 weeks or as an implant of radioactive seeds (brachytherapy)
directly into the prostate. In external beam radiation, high energy x-rays are
aimed at the tumor and the area immediately surrounding it. In brachytherapy,
radioactive seeds are inserted through needles into the prostate gland under
the guidance of transrectally taken ultrasound
pictures. Brachy, from the Greek language, means short. The term
brachytherapy thus refers to placing the treatment (radiation therapy) directly
into or a short distance away from the cancerous target tissue. The theoretical
advantage of brachytherapy over external beam radiation is that delivering the
radiation energy directly into the prostate tissue should minimize damage to
the surrounding tissues and organs. The actual advantages or disadvantages of
brachytherapy as compared to external beam radiation, however, are still being
studied.
Next: What about hormonal treatment for prostate cancer? »
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