External Beam Radiation for Prostate Cancer

What is External beam radiation?

External beam radiation is a standard treatment which kills cancer cells within the prostate gland using high-energy beams such as X-ray or proton beams. A linear accelerator machine generates these beams and are aimed at the prostate. The beams destroy the genetic material which controls the growth and division of cancer cells.

External beam radiation may affect surrounding healthy cells and tissue touched by the beam, this will be kept to an absolute minimum and will commonly induce side effects.

There are numerous reasons why your doctor might recommend this particular option for your prostate cancer treatment, anytime from diagnosis to the conclusion of your treatment pathway.

External Beam Radiotherapy for Prostate
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How external beam radiation is used

Applications are as a primary treatment for early-stage cancer or where cancer has further progressed.  Treatment is commonly used in conjunction with other treatments such as hormone therapy; these specifically apply to patients where cancer is confined to the prostate..

External beam radiation for may also be used to treat patients if cancer has returned following surgery to lower the chances of cancer returning; the same is true for patients whose cancer has returned, either with an increase in their PSA (prostate-specific antigen) score or where cancer is clinically evident within the pelvis.

What the treatment involves

External beam radiation therapy is often an out-patient course of treatment usually requiring five daily sessions per week for approximately eight weeks. Despite radiation treatment taking just minutes, sessions usually take around an hour each. The therapy is painless, but discomfort could be experienced and patients should notify their consultant if this is the case.

Initial CT scans will accurately identify radiation targets within the prostate. Patients must remain still throughout and a simulation will help dictate a patient’s resting position and indicate any need to use an immobilisation device to maintain the patient’s body position. Immobilistaion devices are now commonplace and some are tailor-made to suit individual patients.

To optimise procedure accuracy, patients simply need to lie still, relax and breathe regularly. The linear accelerator moves around them delivering beams of radiation into the affected prostate from multiple angles. Target markers will also be applied to the skin or prostate. Despite being in another room, patients can talk to consultants throughout sessions, via audio and video connections.

Possible side effects

External beam radiation typically affects any exposed healthy tissue cells and may cause both short lived and long-term side effects. The size of the tissue area exposed and the radiation dosage level will each dictate the nature and severity of side effects. The temporary side effects are usually manageable and often diminish following treatment.

Common side effects include fatigue, a sunburn-like skin reaction, pain and discharge due to abdominal, bowel, erectile, rectal or urinary issues. Areas exposed to external beam radiation can also see the growth of secondary cancer and although most side effects are mild, they can present years later.

Treatment results

Following external beam radiation therapy, patients will need regular appointments, ongoing consultation and long-term monitoring; this is to gain an accurate evaluation of the patient’s cancer and response to treatment. Some of these measures could be taken years after treatment, putting your mind at rest and quickly dictate if further treatment is necessary.

¹TM Pisansky, Mayo Clinic Proceedings, External Beam Radiotherapy as Curative Treatment of Prostate Cancer, 1st July 2005

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