Radiotherapy for prostate cancer

There are two ways to deliver radiation to the prostate: external beam radiation and internal radiation (brachytherapy). The information on this page is about external beam radiation.

External beam radiation of the prostate is a common type of treatment if:

This is your first prostate cancer treatment and your tumor has not spread through the body;
Cancer cells remain after surgery;
Your prostate cancer has spread through the body, but is still limited.

The amount of sessions you will have will depend on multiple factors, such as the stage of the cancer, the size of the prostate, and any potential issues with urination you may have. Your radiation therapist or Physician Assistant will discuss the recommended amount of sessions with you, which will be anywhere between 5 and 35.

If your tumor is not too advanced and you do not experience many problems urinating, you may only need to come in for 5 sessions. We will deliver a high dose of radiation directly to the prostate with great precision. If your tumor is more advanced or if you are experiencing trouble urinating, you will have to come in for 20 sessions. If your prostate has been removed or if your lymph nodes are affected, you may need 35 sessions.

We may recommend combining your treatment with hormone therapy which suppresses the male hormone, testosterone. This treatment will take between 6 months and 3 years.

Newest techniques and latest advancements

Our Radi ation Oncology department is constantly working on the development of new techniques using the most advanced technology currently available - both in diagnostic imaging, preparation, and radiation itself. This allows us to deliver the most effective treatment possible to you, while sparing as much healthy tissue as possible.

Consultation with your radiation oncologist or Physician Assistant

You will meet with your radiation oncologist or Physician Assistant to discuss your situation and the treatment that best fits you, its goal, expected outcome preparation, execution, and side effects.

Multidisciplinary team meeting

Your situation, test results and medical history will be discussed in a multidisciplinary team meeting consisting of specialists such as gastroenterologists, surgeons, and radiation oncologists, in order to find the treatment that best fits you. Your radiation oncologist or Physician Assistant will discuss the results with you.

Research

We are constantly working to improve and develop radiation treatment through research. if your radiation oncologist knows of a trial that you may qualify for, he or she will let you know. You will receive more information to make an informed decision. Your participation is voluntary. if you decide not to participate, you will be treated according to the latest protocols and developments.

Preparation

We use great precision when delivering radiation to the prostate. Because the position of the prostate can fluctuate up to a centimeter each day, we use gold markers in the prostate that can help us determine the right location by using a CT scan attached to the radiation machine. Placing these markers will happen one week before the preparatory scans and can be compared to a biopsy procedure. At least one week after placement you will have to come in for a CT and MRI scan to plan the treatment.

if the lymph nodes in the groins have been affected as well, we will not need to use gold markers to deliver your treatment.

We will provide information about the treatment during your preparatory consultation. There will be plenty of room to ask questions.

Radiation treatment planning

Your radiation oncologist or Physician Assistant will draw the placement of the radiation field on these CT and/or MRI scans. He or she will calculate the optimal external beam radiation using special software: the treatment planning. It is important to ensure that the field receives the correct dose and that the surrounding tissue is spared as much as possible.

Radiation

Linear accelerator

Radiotherapy lab technicians ensure that you are positioned correctly on the table. The beams on your body will overlap with the tattooed dots on your body.

We will often check whether your position is still correct by using a CT scanner attached to the machine. This allows us to make small adjustments to your position in order to ensure that the radiation matches the tumor shape as closely as possible. Markers can help us increase precision. The lab technicians will follow the treatment on monitors.

The radiation machine can revolve around you to find the right angle for the treatment.

The delivery of the radiation itself will take a few minutes. The total time of the treatment will be approximately 15 minutes. The beams won’t hurt, although you will start to notice the effects of the radiation.

MR Linac

Some patients may be able to receive their treatment on an MR Linac. This is a Linear accelerator with an MRI scan attached. We use the scan to create imaging of the area receiving radiation to adjust the radiation delivery. The prostate is clearly visible on these scans, so we will not need to use markers if you are receiving your treatment with the MR Linac. The MRI scan and all preparatory adjustments will take slightly longer than the standard treatment using a Linac with CT scan. Your practicing physician can tell you whether the MR Linac is an option for you.

Check-ups with your radiation oncologist or Physician Assistant

During your treatment you will regularly meet with your radiation oncologist to discuss the progress and ask any questions you may have. Your radiation therapist will offer advice on how to deal with the side effects you are experiencing and prescribe medication if needed. You will also hear about the next step after your treatment.

Side effects

The side effects you will experience depend on your personal situation, overall shape and health, and the area that is receiving the treatment. Your practicing physician will discuss the side effects you can expect with you You may experience problems with your bowels, or trouble urinating. You may also experience fatigue, or erectile problems.

You may notice the acute side effects after two or three weeks of treatment. These will increase in severity over the course of your treatment and may linger for months after its end. Some side effects may be permanent. Your practicing physician will discuss which side effects you can expect.

If you are receiving hormone therapy, your practicing physician will tell you more about what you can expect.

What you can do

If your symptoms, situation, and overall health allow, we recommend daily exercise to improve your recovery. You could consider walking or biking, or exercise under the supervision of a physical therapist. We also recommend continuing your day to day activities as much as possible.

General nutritional guidelines apply during treatment.

Please consult your practicing physician if you wish to continue taking additional vitamins or supplements during your treatment.

Follow-up care

If you would like extra care during or after your treatment, please ask your radiation oncologist or physician assistant to the NKI Survivorship Center. Our sexuologists, physical therapists, occupational therapists, dieticians, social workers, and psychologists are experienced in care for cancer patients and would love to offer additional support during and after your treatment.

Radiotherapy for prostate cancer

Our working methods

Newest techniques and latest advancements

Consultation with your radiation oncologist or Physician Assistant

Multidisciplinary team meeting

Research

Radiotherapy: what to expect?