Radiotherapy

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High-energy radiation use to destroy cancer cells, whilst preserving healthy tissue. There are 2 types of radiation therapy in the treatment of prostate cancer:

  • External beam radiotherapy
  • Brachytherapy

External beam radiotherapy

CEE_PC_treatment_03
Stock photo. Posed by model.

External beam radiation therapy is done by a machine called a linear accelerator that radiates X-rays that affect the prostate and cause the death of cancer cells; it may be a treatment option in patients with prostate cancer belonging to any risk class. How do you identify the target? Radiologist subjects the patient to a CT (computed tomography) of the abdomen, called centering, which allows the area to be irradiated to be accurately localized, identifying cancer cells whilst protecting healthy organs. 

Next, comes a very important phase, planning the treatment: a personalized and patient-friendly plan, to safeguard at-risk organs like the rectum, bladder, femoral heads and intestines that have to be shielded from radiation. The most common treatments are the three-dimensional conformal radiotherapy (3D-CRT) and the radiotherapy of the intensity-modulated beams (IMRT), defined as conformational treatments, from the time that the radiation is modeled around the target gland (the prostate) allowing the maximum savings of the neighboring organs. 

Then there is also image-guided radiotherapy (IGRT), which allows you to localize the delivery of radiation thanks to the acquisition of images that allow identification of the prostate at each treatment with greater precision.

Brachytherapy

This form of radiation therapy involves the placement of small radioactive sources (seeds) directly into the prostate by surgery. It is a strategy that is favored for low-risk patients, while those at intermediate risk may often be associated with external beam radiotherapy or to hormonal therapy.

The sources of the plant can be:

  • Permanent: small seeds of iodine or palladium, are positioned within the prostate and are not removed;
  • Temporary: the iridium sources are positioned in the prostate in a quantity that varies in relation to the treatment plan; they are subsequently removed.

Radiotherapy and side effects

At the end of radiotherapy, the patient is subjected to periodic check-ups to assess the side effects and monitor the PSA values.

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