An introduction to SBRT
Prostate cancer treatments vary and can involve anything from simple monitoring, right through to more involved courses of radiotherapy and sometimes surgery, but the more recently developed SBRT (Stereotactic Body RadioTherapy) method now provides patients with a proven, but far less invasive option of prostate cancer treatment.
Recent specialist research¹ has shown how the SBRT radiotherapy technique is capable of curing prostate cancer patients within as little as a couple of weeks; this could effectively halve the number of treatment sessions required, as well as the overall duration of planned cancer treatment courses.
Although SBRT is delivered in as few as five treatment sessions throughout a one to two week period, it still provides the same level of radiation therapy that’s usually administered throughout a less-accurate, less intense month-long course of treatment (and the twenty sessions of radiotherapy that are typically involved).
SBRT precisely delivers concentrated beams of radiation to the patient’s prostate (or similarly affected organs as required); this is done in an outpatient capacity, often using more recognisable (but perhaps somewhat misleading) trademarked technologies such as Clinac, CyberKnife, Gamma Knife or the X-Knife.
Benefits of SBRT
Each is undeniably fast, minimally invasive and involves no actual incisions so, due to the absence of any physical surgery, commonplace risk factors such associated with bleeding, general anaesthetic or infection are avoided. Less desirable methods (such as Brachytherapy) could still prove most appropriate for some patients/individual diagnoses.
Patient preparation for SBRT treatment could include the insertion of prostate markers, which help to precisely pinpoint the intended targets for radiotherapy. SBRT sessions typically last for fifteen minutes and are painless, although patients may be required to empty their bowels beforehand, as well as maintaining a full bladder during treatment.
Various imaging technologies could also be employed throughout treatment procedures, so as well as SBRT, cone-beam CT technology, CT or MRI scans and X-rays might also help to examine and to map-out a patient’s prostate with precision. Healthcare professionals will undertake any such means so as to achieve optimal results.
Because SBRT is so exact, healthcare professionals can administer higher doses of radiotherapy far more precisely; consultant clinical oncologist Dr Alison Tree of The Royal Marsden NHS Foundation Trust commented on the recent, groundbreaking research that was also conducted in conjunction with The Institute of Cancer Research:
Our aim was to understand whether we could safely increase the dose of targeted radiation per day, allowing us to reduce the number of treatments required… This is ideal for patients as they spend less time in hospital and begin their recovery sooner… We wanted to measure if this could be done without changing the level of side effects we see with standard prostate radiotherapy… Our data shows potentially curative prostate radiotherapy can be given with very few side effects for patients in a matter of days… I think there’s a good argument for adopting it across the NHS.
Prostate cancer is the most common cancer in males and annually, it affects around 50,000 men in the UK alone. Prostatectomies (removal of the entire/partial prostate) can provide an effective solution, but commonplace side-effects such as erectile dysfunction or urinary incontinence could still persist among prostate cancer patients.
Any radiation administered is intended to kill cancerous tumours affecting the prostate, but side-effects can be experienced throughout the surrounding bladder, bowel or rectum; if vital muscles and nerves are damaged, patients could incur other serious conditions such as bowel incontinence. Reassuringly, the precision of SBRT delivery can avoid this.
Treatment effectiveness
Just one percent of SBRT trial participants experienced major side effects or treatment symptoms; ten percent of patients reported experiencing minor side effects such as urinary issues. Considering the two-year SBRT trial involved close to nine hundred participants from around the world, the results were positive to say the least.
The side effects of SBRT are minimal and patient-specific, but these should never be ignored; short-term side effects can include an increase in the need to urinate or prolonged fatigue, but longer term symptoms of treatment can include erectile dysfunction, urinary difficulties (such as incontinence) and impacted bowel movement.
When compared with the standard outcome of radiotherapy, SBRT killed cancerous cells and lowered the risk of cancer recurring just as effectively; following the trial, treatment was deemed no longer necessary for ninety percent of the low to medium risk prostate cancer patients involved.
In some instances, a course of SBRT can be administered in as little as five sessions throughout ten days, with patients often avoiding symptomatic impact or the disruption to their regular routines, work pattern or lifestyle. Not only has SBRT proved to be safe and effective, it’s also proved to be a far more efficient, minimally invasive treatment method.
SBRT does not provide a viable option for all prostate cancer patients; mild cancers are often best left monitored but untreated, whereas high-level cancers or other secondary conditions could prove too developed or severe for SBRT to prove as effective. Individual circumstance and diagnosis will often dictate your healthcare professionals’ approach.
¹ Daily Mail, Prostate cancer sufferers cured two weeks new radiotherapy, 4 September 2021
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