Radiation Therapy
 

External beam radiation therapy (VMAT/IGRT) is a painless and precise series of daily treatments of radiation directed at the prostate cancer to eradicate the cancer while minimizing damage to healthy tissue. 



The Prostate Center offers the latest radiation therapy technologies. RapidArc™ radiotherapy technology, also known as Volumetric Modulate Arc Therapy (VMAT), which allows more of the radiation to be directed at the cancer site and less radiation to reach the surrounding healthy tissue. Each treatment takes only five minutes compared to the average 15 minutes with standard radiation therapy.
 

Preparation for Treatment

A discussion with your doctor is the first step in deciding if radiation therapy is right for you. Many patients also like to visit the Prostate Center for a tour before scheduling an appointment.

If you are already an Academic Urology patient, all of your documentation will be automatically forwarded to the Prostate Center. If you are coming from outside Academic Urology, the following documents will assist us with your evaluation:

  • A copy of all your records. This can be obtained from your Urologist.  Records should include blood tests, reports of any CT scans, MRIs, bone scans, ultrasounds and biopsy report.

  • Radiology films. Please request films from the radiology facility. They will burn a CD with all the images and give it to you.

  • Pathology report.  Please request this from the lab that read your biopsy.

  • Academic Urology paperwork. Please fill out the medical history form and the registration form prior to your appointment.

  • Your list of questions or concerns.

 

Your first consultation appointment will take about an hour and consist of the following steps:

  • An Academic Urology cancer center team member will talk to you about your medical history, review medications you may be taking and answer your questions.
  • Our radiation oncologist will conduct a physical exam, review your medical history x-rays and test results and order any additional tests.
  • The radiation oncologist will speak with you about treatment options and how you may benefit from radiation therapy, explain the details of treatment and potential side effects and answer your questions.
     

If you and the radiation oncologist determine that radiation therapy is appropriate, you will undergo a series of daily treat­­­ments to accurately deliver radiation to the prostate.  The radiation oncologist will design a custom radiation treatment plan to deliver precise radiation to the prostate cancer.  To prepare for treatment, you will return to your urologist to have markers implanted into your prostate.  A week or so after the markers are in place, you will return to the radiation center for a planning simulation session.  Once completed, the images are used to locate the prostate and the markers and a custom radiation plan is designed for radiation treatment. 

Shortly after your simulation, your daily prostate cancer treatment will begin. Treatment takes place Monday through Friday at the same appointment time each day for approximately two months.

 

Food and Diet
It is important that you consume an appropriate amount of calories and protein to maintain the correct weight and can recover properly. The National Cancer Institute Booklet, Eating Hints for Cancer Patients has many useful ideas and recipes.

Exercise
Research shows that people with cancer feel better when they are active. Walking, yoga, swimming, and other activities can increase your energy. Exercise may reduce pain and make treatment easier to handle. It also can help relieve stress. Whatever physical activity you choose, be sure to talk to your doctor before you start. Also, if your activity causes you pain or other problems, be sure to let your doctor or nurse know about it.

 

What to Expect

 

The Day of Treatment
It is important that you come to your treatment with a full bladder. Therefore, prior to treatment please begin to drink approximately 28 ounces of water one hour prior to your appointment.

You should expect a smooth, comfortable and pleasant experience. You will have a scheduled 15-minute appointment time each day that you will select in advance. Most patients will have daily treatments occurring Monday through Friday. Occasionally, you may miss your weekday treatment due to holidays, equipment maintenance, and specific days off, but the total number of treatments will not change.

Our Center is designed to make you comfortable while you're here. There is a snack bar, a hi-definition TV, and a computer with free Internet and wifi available for your use.

When it is time for your treatment to begin, you will be escorted from the lounge to the treatment area by one of our technologists. Even though you and the staff will get to know each other on a first name basis after a short while, we will still ask you your name and date of birth so as to comply with established patient safety regulations. In addition, you will be asked to confirm a photo of yourself in the treatment room daily.

The treatment is delivered with you lying on a table for about 10 minutes. You are continually monitored by one of our technologists while receiving your treatment. After your treatment is finished, you are free to leave. Once a week, you will meet with a radiation oncologist who will talk to you about your progress.

Our staff is always available to assist you and answer any questions that arise during the course of your treatment.
 

Side Effects
Though a more detailed listing of side effects is available below, most of our patients have few or minimal complaints of side effects. A typical patient might experience a little tiredness 2-3 weeks into the 8 week course and might want an afternoon nap. The patient may otherwise carry out full schedules: golf, work, etc. all the way through treatment. Occasionally there may be frequent urination or discomfort while urinating. Likewise there may be a change in bowel habits and they may be softer in consistency. If these occur, they are usually resolved several weeks after treatment has ended.

Tissue Damage According to the Seattle Cancer Care Alliance, severe tissue damage can occur in less than 1 percent of men who are being treated with external radiation. Damage is very rare but a possibility.

Effects on the Bowel Bowel problems can occur during radiation therapy. Diarrhea, bowel urgency and flare-up of hemorrhoids are possible side effects. Medications can be given to effectively control these side effects.

Incontinence
Occasionally there may be frequent urination or discomfort while urinating. Likewise there may be a change in bowel habits, and they may be softer in consistency. If these occur, they are usually resolved several weeks after treatment has ended. Rarely, the urinary sphincter can be damaged during radiation therapy. Leakage and the urge to urinate, while rare, can happen and cause incontinence. This is a side effect that occurs in less than one percent of patients.

Impotence
Radiation therapy can affect a man's ability to become erect or stay erect. This can lead to impotency. 
 Impotency may affect up to 30 percent of men undergoing radiation therapy. Normally, medications can be given to help rectify this problem.

Fatigue
Fatigue is a common side effect to radiation therapy. Fatigue normally goes away within a month or two after treatment has ended. Talk with a nutritionist about the kind of diet that will help lessen fatigue.

 

Frequently Asked Questions

How does radiation work?
When radiation enters a cell, it causes damage to the cell. Most normal cells have the ability to repair the damage caused by radiation. A cancer cell does not have the ability to repair the damage caused by radiation. After repeated treatments that cause damage, the cancer cell will die.

Will I have side effects?
Most people experience some radiation-related side effects, but these are typically very mild and arise gradually. There are three side effects typically associated with radiation to the prostate.

  • Fatigue. You may feel a bit tired from your radiation treatment. This is due to the energy your body used to repair healthy tissue that may be damaged from the radiation. Fatigue may present around the third to fourth week of treatment. It should not preclude you from any of your normal activities. You may feel a bit tired toward the end of the day, especially at the end of the week. This side effect is typically the first to resolve and you should be back to your normal level of activity within two weeks of finishing your treatment.
     
  • Urinary Frequency. You may see an increase in the frequency of urination during your radiation treatment. This may occur both during the day and at night. We have some suggestions to help you with this side effect, including dietary changes and medications, so be sure to mention it at your on-treatment visits. This side effect should resolve within 2-3 weeks of the completion of your treatment.
     
  • Bowel Frequency. You may notice that you begin to move your bowels more frequently each day, and the consistency of the bowel movement may begin to soften. Please be sure to mention this, as we are able to make some recommendations so that this does not become too bothersome. This side effect should resolve within 2-3 weeks of completion of your treatment.

Can I be sexually active?
Yes. You can maintain sexual activity while you are receiving radiation treatment. The radiation cannot be passed to your partner.

Will radiation Treatments change my sex drive?
The radiation treatments should not affect your sex drive.

Am I radioactive?
No. Once the radiation treatment is completed each day and you leave the treatment room, you do not carry any active radiation with you. You do not need to avoid other people while you are undergoing this type of radiation treatment.

Will the markers activate metal detectors?
No. The gold fiducial markers are too small to alert metal detectors.

When do I come to the Prostate Center to recieve my Treatment?
We treat patients from Monday through Friday, except on major holidays. You should come to The Prostate Center every day for the complete number of treatments that were prescribed for you.

What happens if I need to miss a day?
We understand that unexpected situations may arise during your treatment period. It is acceptable to miss a day of treatment. However, we ask that you do not schedule a vacation in the middle of your treatment since the effects of radiation are cumulative.

Can I change the time of my treatment?
If you need to change the time of your treatment on a specific day, please alert the radiation therapists so that they can adjust your schedule. We are very flexible and can usually accommodate your needs.

Do my treatments change from day to day?
The amount of radiation that you receive at each delivery site is the same from the first day to the last day of treatment. There may be adjustment changes to your position on the table, but the treatment remains the same.

Can I continue to exercise during my radiation treatment?
We encourage you to continue your normal exercise routine throughout the radiation, with the exception of swimming and excessive lower extremity weight training. If these forms of exercise are part of your normal routine, you should speak with the Radiation Oncologist to discuss if these activities will need to be modified.

Will these treatments affect my appetite or cause nausea?
The radiation treatment to the prostate should not affect your appetite or cause you any nausea.

Should I follow a speacial diet when I am having radiation?
You can continue to follow your regular diet while you are having your radiation treatments. If you experience changes in your bowel or bladder habits, we will recommend some dietary modifications to help you better manage these side effects.

Will I feel the radiation?
Most people do not feel the radiation. On rare occasions, a person may experience a light vibratory sensation while they are having their treatment.

How will you know if the radiation treatments are working?
We cannot see the daily changes to the prostate while you are undergoing treatment. However, we will check you PSA value at 4-6 weeks after you complete your course of treatment and that should show us the effects of the radiation.

What will my PSA value drop to?
Our goal is cause the PSA to drop to a value of 1.5 or lower. This may take from 12-18 months to reach, but will gradually decline during that time period.

Will I have a Repeat Biopsy, CT scan or Bone Scan after I finish treatment?
We do not routinely schedule these tests after you finish radiation. We will monitor your progress with the PSA and examination. A biopsy, CT scan or Bone Scan will only be performed in the future if necessary based on the results from your follow-up visits.

How will I Prepare for each of my treatment visits?
We ask that you arrive for your treatment with a full bladder. This typically requires that you drink 24-30 ounces of fluid within 45-60 minutes of your treatment. You should have a "comfortably full" feeling when you are receiving your treatment. After your treatment is completed, you should have the desire to void.

Why do I need to fill my bladder?
When the bladder is full, it is distended up and away from the area that is receiving radiation. This should decrease the amount of radiation to the normal bladder tissue and reduce the risk of side-effects to the area.

How do you know if you are aiming the treatment at the right spot?
We use a variety of mechanisms to assure that your treatment is aimed correctly. The first are the green light beams that are aligned with the permanent marks we place on your hips. The second are the markers that are placed in your prostate (if you have an intact prostate). The final mechanism is through the use of two X-ray images that are taken when you are lying on the table each day. These images are superimposed over the CT scan to assure that your bony structures are aligned.


 

 
  • The Prostate Center is the most experienced center in the area focused exclusively on the care of men with prostate cancer

  • “I will always remember fondly the fact that your kindness and consideration during this difficult time did not falter.”

  • The Prostate Center gives you more choices. We have several cancer clinical trials underway at any given time.

Contact The Prostate Center

211 South Gulph Rd. Suite 200
King of Prussia, PA 19406

Phone: 610-382-5900
Fax: 610-382-5919

Learn more about this location

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