Prostate Cancer
Prostate cancer is when abnormal cells in the prostate grow out of control and cause a tumour.
The prostate is a small gland found only in men that is located in the pelvis.
Prostate cancer usually grows slowly.
People should get all the information they need to make an informed decision about prostate cancer treatment options. Patients have time to do this. It can be really disappointing to regret a rushed decision. Seeing a radiation oncologist will help work out what is best for each patient.
Ask your GP to refer you to a radiation oncologist to help you discuss your options.
Download the the Radiation Therapy for Prostate Cancer leaflet below to understand all your treatment options.
Radiation Therapy and Prostate Cancer
The best person to talk to about radiation therapy for prostate cancer is a radiation oncologist.
A radiation oncologist is a specialist doctor who is part of the team that takes care of people having radiation therapy.
You can ask your doctor for a referral to a radiation oncologist to learn if radiation therapy is an option for you.
The Treatment Team
The treating team makes a plan for each man based on:
- what grade and how active the cancer is
- where the cancer is
- what other treatments have been tried
- the person’s health.
The type of treatment a person gets is worked out by a team of doctors and health professionals often called a Multidisciplinary Team.
A highly trained radiation oncology team takes care of people having radiation therapy. This includes radiation oncologists, radiation therapists, medical physicists and radiation oncology nurses.
Role of Radiation Therapy in Prostate Cancer
Radiation therapy can cure prostate cancer without the need for surgery. It should be considered for people who are not able to or do not wish to have surgery.
If prostate cancer spreads palliative radiation therapy can help with bone pain and other symptoms.
Other treatment options for prostate cancer include surgery, chemotherapy and Androgen Deprivation Therapy (ADT).
There are 2 main types of radiation therapy used in prostate cancer:
- External beam radiation therapy
- Brachytherapy
The radiation oncologist will explain the risks and benefits of each treatment and people have plenty of time to ask questions and think about their options.
Types of Radiation Therapy Used in Prostate Cancer
External Beam Radiation Therapy (EBRT) is the most common type of radiation therapy treatment used for prostate cancer.
The treatment team use a machine called a linear accelerator to do external beam radiation therapy from outside the body.
Radiation oncologists often use Volumetric Arc Therapy (VMAT), which is an advanced type of external beam radiation therapy, to carefully deliver radiation to treatment areas.
Image Guided Radiation Therapy (IGRT) is always used as part of EBRT. It keeps checking the tumour shape and location to make sure the radiation therapy is safe and correct.
These advanced techniques allow the radiation oncologist to target the radiation on the cancer while protecting healthy parts of the body.
During treatment people lie flat and still on the treatment couch while the machine moves around them.
Doctors usually ask people to empty their bladder before treatment to make sure the prostate is in the same place for each treatment.
People usually get this type of radiation therapy daily from Monday to Friday from 4-8 weeks. Your radiation oncologist will help decide this.
Androgen deprivation therapy (ADT)
ADT is often used with radiation therapy. This is a hormone therapy which lowers testosterone levels with tablets or injections in the belly.
Stereotactic Ablative Body Radiotherapy (SABR), also known as Stereotactic Body Radiotherapy (SBRT), is an exciting new treatment for people with prostate cancer who cannot have an operation, or for those who do not want one. SABR can cure localised prostate cancer.
It can also be used when prostate cancer has spread to other parts of the body. This is called secondaries or metastases.
SABR is a targeted form of external beam radiation therapy. It gives high doses of radiation to the cancer while protecting healthy body parts. SABR is painless and no surgery is needed. It is very safe and effective.
People usually get up to 5 treatments.
With these treatments people get a higher dose of radiation over fewer sessions.
Radiation oncology teams carefully work out the best treatment type and length for each person based on what will work for them.
Brachytherapy is effective for prostate cancer because it gives a very high dose of radiation to the cancer while sparing healthy body parts nearby. It’s also very quick and treatment is often one day or just a few sessions.
During brachytherapy doctors put a small radioactive source or seed into the prostate. This source delivers targeted radiation which kills cancer cells.
Low Dose Rate Brachytherapy (LDR) is when radioactive seeds are placed in the prostate. The seeds can be left there to deliver radiation therapy slowly over a long time. Doctors often use this treatment for low to medium risk prostate cancer.
High Dose Rate Brachytherapy (HDR) is when doctors use a machine to move the radioactive source into different places in the prostate for a short time. This treatment is quite fast and doctors often use it for low to medium risk prostate cancer. Sometimes radiation oncologists mix HDR with external beam radiation therapy for people with more aggressive prostate cancer.
Brachytherapy is only suitable for some people and doctors can only do it in certain clinics. Your radiation oncology team will talk to you and work out if this treatment is suitable for you.
How Effective Is Radiation Therapy for Prostate Cancer?
Brachytherapy and/or External Beam Radiotherapy (EBRT) can cure localised prostate cancer. Both are good alternatives for people who cannot or do not wish to have surgery, and have cure rates that are at least as good as surgery.
Recent advances mean that radiation therapy can very effectively target the cancer while reducing the chance of serious side effects.
People can have surgery after radiation therapy for prostate cancer but this is rarely needed. Often treatment teams prefer radiation therapy over surgery as it is better at treating cancer cells that have spread outside the prostate gland.
Men should talk to a radiation oncologist about all the treatment options available and the risks and benefits of each.
General Information About Side Effects of Radiation Treatment
Radiation therapy is more effective with fewer side effects than ever before.
Recent advances mean radiation oncologists can effectively treat the cancer while getting less radiation on healthy body parts. This means much fewer side effects.
Side effects from radiation therapy vary between people, even for those having the same treatment.
While some people feel no side effects, some feel mild side effects, such as tiredness or skin redness during and/or just after treatment. These usually get better within a few weeks.
The treatment team will offer advice and medicine to help with side effects.
Serious side effects that start later (months to years after the radiation therapy) are rare.
Before starting treatment, your radiation oncologist will talk to you about side effects and answer your questions.
The side effects of radiation treatment can be split into 2 groups:
- Early side effects which occur during and shortly after radiation treatment.
- Late side effects which can occur months to years after radiation treatment.
For more information, go to the Potential Side Effects page.
Early Side Effects of Radiation Therapy for Prostate Cancer
Short-term side effects from radiation therapy for prostate cancer can include:
Fatigue: Feeling tired is common during radiation treatment, as the body works to heal.
Urinary discomfort: Radiation near the pelvic area can cause discomfort or a need to pee more often.
Diarrhoea: Radiation can upset the digestive tract. This can lead to loose or watery poo, or other changes in bowel habits. Bleeding from the back passage is very rare.
These side effects are usually short term and can be helped with medications or lifestyle changes. The treatment team can provide advice to help you manage side effects.
Late Side Effects of Radiation Therapy for Prostate Cancer
Late side effects vary between people and can happen a few months to a few years after treatment.
These side effects may never occur, occur once, continue over time, or come and go.
Bowel problems: Radiation therapy can cause bowel issues such as diarrhea, constipation, or changes in bowel habits. For a very small number of men these are severe enough to impact their quality of life.
Sexual dysfunction: Both radiation therapy and surgery can affect sexual function. This can cause erectile dysfunction.
Urinary problems: Radiation therapy may cause long-term urinary problems, such as bleeding in the pee or needing to pee more often or more urgently. Rarely it causes incontinence and this is more likely with surgery.
Lymphoedema: Surgery or radiation therapy can damage lymph nodes, leading to lymphoedema, which is swelling in the legs due to a build-up of lymph fluid.
Impaired fertility or infertility: It’s important to talk about fertility preservation before treatment starts.
Femoral neck or pelvic fracture: This is very rare and is when a bone in the pelvis breaks due to reduced strength.
Second cancers: Cancers caused by radiation therapy are a very rare side effect that can occur more than 10 years after treatment.
Other Useful Resources for Prostate Cancer
Find additional information about cancer types, research groups, and support groups.
Radiation Oncologist
The best person to talk to is a radiation oncologist. You can ask your doctor for a referral to find out if radiation treatment is right for you.
GPs and Health Professionals
Information for any health professional involved in a patient's cancer care with a particular focus on primary care providers.
Talking to Your Doctor
Your GP or other doctors in the cancer team can organise a referral to a radiation oncologist.
Treatment Centres
Search and find your closest Radiation Oncology Treatment Centre.
