Radiation Therapy for Prostate Cancer

Transcription

1 Radiation Therapy for Prostate Cancer Information for patients 1

2 What is radiation therapy? Radiation therapy (also known as radiotherapy), uses high energy X-ray beams, called photon beams or electron beams, to treat cancer. You may also hear the term external beam radiation therapy (EBRT), because the beams are administered from outside the body. The machines that make and deliver the radiation are called linear accelerators. Radiation therapy can also be administered by inserting a radioactive source into your body, usually on or near the site of the cancer. This is called brachytherapy. Sometimes, EBRT and brachytherapy are used together. Your radiation oncologist will advise you on which form of treatment is best for your condition. Radiation therapy is one of the best-established, most effective and well tolerated therapies for treating almost all cancers, extending lives and reducing suffering. Why does radiation work? Cancerous cells are more susceptible to radiation than healthy, non-cancerous cells. This is because of their abnormal and unstable nature. Healthy, non-cancerous cells are much better at recovering from exposure to radiation. They will normally repair themselves, however cancerous cells cannot recover. A radiation therapist carefully prepares a treatment plan for a prostate cancer patient 2

3 Preparation for treatment Before radiation therapy starts, your doctor will organise a planning or simulation appointment so that an individual treatment plan can be produced for you. The treatment plan is carefully worked out to ensure that all of the area needing treatment is included and that other areas are avoided as much as possible. At this simulation appointment, the radiation therapists will place some tiny tattoos on your skin which will help them to reposition you in the exact same position during actual treatment. You will also have a CT scan which is used to plan the precise location of the radiation beams. Receiving treatment When it comes to treatment, your radiation therapist will meet you and escort you into the treatment room. She/he will position you in the exact same position as you were in during your CT scan. She/he will then leave the room, but will remain in contact with you via TV monitors and an intercom system. When the radiation beams are switched on you will probably hear the buzz of the machine while it is working and turning, but you will not see anything. Radiation therapy is painless. Your treatment will be given daily for approximately 4-7 weeks from Monday to Friday. Treatment is usually given to your prostate as well as a small extra margin, as seen in the planning CT scan. Sometimes treatment is given over a shorter time period but your doctor will discuss this with you. 3 A radiation therapist helps position a patient before receiving treatment

4 Will there be any side effects? The side effects that may occur with radiation therapy vary depending on the site treated, radiation factors, your medical conditions and whether you are receiving other treatments e.g. chemotherapy. The following is a list of side-effects that may be associated with radiation treatment to the prostate and pelvis area. It is important to realise that many will not apply to you and that the common ones are usually minor and respond to simple treatment. Early Side Effects Early side effects should resolve 3-4 weeks after finishing radiation therapy treatment. Tiredness Patients receiving radiation therapy frequently complain of tiredness. The effect can be minimised by adequate rest, moderate exercise and a well-balanced diet. Nausea This does not usually occur and if so it is mild. Diarrhoea Patients commonly experience more frequent and loose bowel actions. A diet sheet is available from the nursing staff to help you manage any diarrhoea. If required, anti-diarrhoea mediation can be prescribed. Rectal discomfort / bleeding Rectal discomfort and occasionally rectal bleeding may develop due to inflammation of the lining of the bowel. Patients with haemorrhoids may develop discomfort earlier. This can be relieved by suppository medications and ointments. Bladder irritations This occurs commonly. You may experience frequency and stinging on urination. If your urinary stream is poor to start with it may worsen during treatment. Please inform your doctor so that the appropriate medication can be prescribed. 4

5 Late side effects Late side effects are extremely uncommon following radiation therapy treatment for prostate cancer. Skin changes In the long term, the skin around the treated area will be smoother and hairless. Rectal sensitivity Often patients find that the bowel is more sensitive to dietary changes. There may be a feeling of urgency with needing to open your bowels. Rectal pain / bleeding Some patients may experience persistent pain and bleeding many months following treatment. This usually improves over time. Occasionally, treatment such as laser therapy is required to manage rectal bleeding. Urinary problems Narrowing of the urethra and intermittent bleeding from the bladder may occur but is uncommon. If this occurs, your surgeon may need to perform a cystoscopy and/or dilatation. Occasionally, laser therapy may be required to control bleeding. Impotence Radiation treatment can cause impotence. The incidence varies with age together with the presence of medical problems such as diabetes, high blood pressure and vascular disorders. It is also more likely if you are on hormone treatment. Incontinence This is a very uncommon side effect of radiation therapy. 5

6 Important instructions for all prostate cancer patients PLEASE READ THE FOLLOWING INFORMATION CAREFULLY. It is important that you understand and follow the instructions as described. If you have any questions please speak to your treating doctor, nurse or radiation therapist. Pre-treatment information: Bowel and bladder instructions It is important that your bowel and bladder are of a consistent volume for your planning CT simulation and during your radiotherapy. Please follow the following instructions for the day of your CT scan and every day of treatment. Bladder instructions 45 minutes prior to each radiation therapy appointment, empty your bladder and then drink 600mls of water. Do not empty your bladder again until after your appointment. Your bladder is to be comfortably full for the CT scan and Treatment. Bowel instructions Empty your bowel as close as convenient to the time of your appointment. Your bowel is to be emptied as close as possible prior to each of your CT scan and treatment appointments. If you are in distress You may empty your bladder. If you do so, please notify the radiation therapy staff. You will need to drink more water and wait up to 45 minutes so your bladder is full again. 6

7 Important instructions for patients receiving gold seeds PLEASE READ THE FOLLOWING INFORMATION CAREFULLY. It is important that you understand and follow the instructions as described. If you have any questions please speak to your treating doctor, nurse or radiation therapist. Gold seed patient instructions How to Prepare? Gold Seed Insertion on: / / at : Planning CT Scan is on: / / at : Radiation therapy starts on: / / at : 1. One week before your Gold Seed insertion a. Stop your b. Commence bowel instructions as per Pre Treatment Information: Bowel Instructions leaflet. 2. Two days before your Gold Seeds Insertion a. Have a blood test. b. Start antibiotics (1 capsule twice a day). Continue antibiotics until packet finished. 3. The night before your Gold Seeds insertion Insert 1 Microlax enema. This can be bought at any pharmacy, without prescription. 4. The morning of your Gold Seeds Insertion Insert 1 Microlax enema. 5. The day after your Gold Seed Insertion a. Restart your b. Please continue the bowel instructions. 6. On the day of your Planning CT Scan a. Follow the bladder instructions as per the Pre- Treatment Information: Bladder Instructions leaflet. 7

8 What happens after my treatment has finished? Once your treatment has finished your doctor will organise your next appointment. This often occurs 1-3 months later, depending on whether you have appointments with other specialists. Typically, you will have a series of PSA blood tests and a clinical review. Support services Cancer Council Helpline Prostate Cancer Foundation of Australia Additional information targetingcancer.com.au GenesisCare Radiation Oncology Centres: St Vincent s Basement Level, Building C 41 Victoria Parade Fitzroy VIC 3065 Tel: (03) Fax: (03) Epping Epping Medical & Specialist Centre GF, 230 Cooper St Epping VIC 3076 Tel: (03) Fax: (03) Berwick c/- St John of God Specialist Centre 55 Kangan Drive Berwick VIC 3806 Tel: (03) Fax: (03) Footscray c/- Western Private Hospital Cnr Eleanor & Marion Sts Footscray VIC 3011 Tel: (03) Fax: (03) SN GEN4434 Frankston c/- Frankston Private Frankston-Flinders Rd Frankston VIC 3199 Tel: (03) Fax: (03) Ringwood c/- Ringwood Private Hospital 36 Mt. Dandenong Rd Ringwood East VIC 3135 Tel: (03) Fax: (03) Albury Wodonga c/- Albury Wodonga Regional Cancer Centre Cnr Borella Rd and East St East Albury NSW 2640 Tel: (02) Fax: (02) Cabrini c/- Cabrini Hospital Malvern 183 Wattletree Road Malvern VIC 3144 Ph: (03) Fax: (03) ROV-FRM- 123