Radiotherapy for prostate cancer

What is radiotherapy for prostate cancer?

Radiotherapy is a medical treatment that uses high-energy radiation to kill cancer cells. It works by damaging the DNA of cancer cells, which prevents them from growing or multiplying. Over time, the damaged cells die and are naturally removed by the body.

For the treatment of prostate cancer, radiotherapy focuses on the prostate gland specifically. It can be used as a primary therapy, in conjunction with other treatments such as hormone therapy, or as an adjunct to surgery to kill any residual cancer cells.

The precision of modern radiotherapy techniques enables your oncologist to deliver radiation doses to the prostate while minimising damage to nearby healthy tissues, such as the bladder and rectum.

What types of radiotherapy are available for prostate cancer?

There are two types of radiotherapy for prostate cancer:

External beam radiation therapy (EBRT)

EBRT uses an external machine, called a linear accelerator, to deliver targeted radiation beams to the prostate gland from outside the body. Advanced techniques, including intensity-modulated radiation therapy (IMRT) and image-guided radiation therapy (IGRT) are often used to improve precision and limit exposure to surrounding tissues. 

Brachytherapy

Brachytherapy, also known as internal radiation, involves placing radioactive seeds or radioactive sources directly into the prostate gland. These seeds deliver high doses of radiation to target cancer cells from within over a designated period.

There are two types of brachytherapy:

• Low-dose rate (LDR), where seeds are placed in the prostate and remain there for several weeks or months.
• High-dose rate (HDR), where radioactive material is temporarily placed into the prostate for a few minutes during each treatment session.

Is radiotherapy painful?

Radiotherapy is painless. During EBRT, you will lie on a treatment table as the machine delivers radiation, but you won’t feel the radiation itself. Similarly, brachytherapy involves a minor surgical procedure to implant the radioactive seeds, but this is performed under anaesthesia to ensure your comfort.

Any discomfort related to radiotherapy stems from its side effects rather than the treatment. For example, potential irritation of the bladder or rectum can cause symptoms like urinary urgency or mild discomfort, but these effects are typically manageable. 

What are the side effects of radiotherapy for prostate cancer?

Radiotherapy can lead to side effects, which vary in severity. Common side effects include:

• fatigue
• urinary symptoms, such as increased frequency, urgency, or a burning sensation
• bowel changes, such as diarrhoea or rectal irritation
• skin changes in the treatment area, such as redness or dryness
• erectile dysfunction

How long does radiotherapy treatment for prostate cancer take?

The duration depends on the specific type of treatment:

• EBRT: Daily sessions (Monday to Friday) over 4-8 weeks. Each session takes only a few minutes, but preparation time may extend the visit to 30 minutes.
• Brachytherapy: LDR brachytherapy is completed in a single session, but the radioactive seeds remain in place for several months. HDR brachytherapy involves multiple sessions over a few days, with each session lasting a few hours.

Your oncologist will determine the exact schedule based on your specific treatment plan.