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Radiation therapy uses high doses of radiation, such as X-rays, to destroy cancer cells. The radiation damages the genetic material of the cells so that they can't grow. Although radiation damages normal cells as well as cancer cells, the normal cells can repair themselves and function, while the cancer cells cannot.
Radiation therapy may be used alone or combined with hormonal treatment to treat prostate cancer. It is most effective in treating cancers that have not spread outside the prostate. But it also may be used if the cancer has spread to nearby tissue. Radiation is sometimes used after surgery to destroy any remaining cancer cells and to relieve pain from metastatic cancer.
Radiation is delivered in one of two ways.
Sometimes treatment combines brachytherapy with low-dose external radiation. In other cases, treatment combines surgery with external radiation or hormone therapy may be used along with brachytherapy.
Before radiation therapy is scheduled, your doctor probably will order a bone scan and CT scan to find out whether the cancer has spread to other parts of your body. If it has, your doctor may offer you the option of a clinical trial for treatment.
Side effects may last only as long as the treatment, or they may continue and become chronic. Some side effects occur after treatment, such as erection problems. For some men, this problem gets gradually worse over the course of several years after treatment.
When radiation therapy is given as the primary treatment for men who have prostate cancer that has not grown outside the prostate (localized prostate cancer), side effects may include:
The side effects may be different for radiation used after surgery for prostate cancer or for cancer that has spread to other parts of the body (metastatic prostate cancer).
Talk with someone on your treatment team if you want a complete list of side effects. And when you notice any side effects, be sure to report them to your treatment team. They may have ideas that will help you feel better.
Radiation therapy is used for:
For men with localized prostate cancer, radiation works about as well as surgery (radical prostatectomy). With either treatment, the chance of the cancer spreading is low. One study looked at men who had localized prostate cancer and found that the risk of dying was very low and about the same, no matter what option men chose.footnote 1
For treating advanced prostate cancer that has grown beyond the prostate but not into lymph nodes or bones, external-beam radiation combined with hormone therapy can work better than surgery. This treatment often results in controlling cancer growth and in many years of disease-free survival.footnote 2
Radiation therapy also works well to treat pain when prostate cancer has spread to the bone.footnote 3
Radiation treatment for prostate cancer may increase a man's risk for having another cancer later in life, such as bladder or rectal cancer.
For men with high-risk prostate cancer, radiation treatment is given along with hormone therapy. Hormone therapy has side effects, such as the loss of bone density and muscle mass. It can also increase the risk for bone fractures, diabetes, and heart disease.
The goal of radiation therapy is to deliver the highest dose possible to the prostate while protecting the rest of the nearby organs (such as the bladder and rectum) from unnecessary radiation. Newer ways of giving radiation, such as 3D-CRT, IMRT, and proton beam therapy, are more accurate. This has helped to reduce problems caused by radiation.
CitationsHamdy FC, et al. (2016). 10-year outcomes after monitoring, surgery, or radiotherapy for localized prostate cancer. New England Journal of Medicine, 375(15): 1415–1424. DOI: 10.1056/NEJMoa1606220. Accessed November 3, 2016. National Cancer Institute (2012). Prostate Cancer Treatment (PDQ)—Health Professional Version. Available online: http://www.cancer.gov/cancertopics/pdq/treatment/prostate/HealthProfessional.D'Amico AV, et al. (2012). Radiation therapy for prostate cancer. In AJ Wein et al., eds., Campbell-Walsh Urology, 10th ed., vol. 3, pp. 2850–2872. Philadelphia: Saunders.
ByHealthwise StaffPrimary Medical ReviewerE. Gregory Thompson, MD - Internal MedicineKathleen Romito, MD - Family MedicineAdam Husney, MD - Family MedicineChristopher G. Wood, MD, FACS - UrologyRichard M. Hoffman, MD, MPH - Internal Medicine
Current as ofMarch 28, 2018
Current as of: March 28, 2018
Author: Healthwise Staff
Medical Review: E. Gregory Thompson, MD - Internal Medicine & Kathleen Romito, MD - Family Medicine & Adam Husney, MD - Family Medicine & Christopher G. Wood, MD, FACS - Urology & Richard M. Hoffman, MD, MPH - Internal Medicine
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