Radiation Therapy
The 2 types of radiation therapy used in treating prostate cancer are external beam radiation and brachytherapy, or seed therapy. Both are viewed as being equally effective in curing the disease. 10 years after treatment, cure rates are approximately the same for radiation therapy and radical prostatectomy. There are no surgical risks for men who have radiation therapy.
External Beam Radiation
In external beam radiation therapy, radiation is given from a device similar to an x-ray machine. This type of therapy is usually given 5 days a week over 7 weeks, which many patients find to be time-consuming. However, you don’t need any anesthesia and the side effects are milder than the side effects that can come with seed therapy.
Brachytherapy
In brachytherapy (pronounced: “break-ee-ther-uh-pee”), or seed therapy, radioactive pellets (called “seeds”) are injected into the prostate gland, and these seeds are used to focus and intensify the irradiation process.
Although seed therapy can be done with just one hospital visit because higher doses of radiation can be put right on the cancer, patients may feel more discomfort after this treatment. This type of therapy requires patients to undergo a few minutes of general anesthesia, but most are able to go home right after the treatment.
Possible Side Effects
Serious complications are rare, but a degree of uncertainty goes along with any radiation treatment. There’s no risk of bleeding, patients don’t have to stay in the hospital, recovery is quicker and patients can typically maintain daily activities during the treatments.
Incontinence is extremely rare afterward. However, surgery may give you a better chance of cure over the long term. About one half of patients become impotent within 2 years of having radiation therapy. About 15% to 30% of men who have these therapies experience urinary burning, urinary bleeding, frequent urination, rectal bleeding, rectal discomfort or diarrhea during or shortly after the treatment. Many men experience extreme fatigue at the end of the treatment period. Since the prostate gland and the lymph nodes are not removed, your doctor can’t determine the exact size of a tumor. The cancer could return many years after radiation treatment.
My Take
It’s important to remember that, once administered, radiation continues to change irradiated tissue for up to 20 years. Often, these changes include an increased loss of tissue elasticity. Because the radiation is being administered to tissue in and around the bladder, this loss of elasticity may cause incontinence. Because long-term catheterization increases the risk of infection, and such infections can be particularly significant in those with compromised immune systems, such lasting effects can be particularly dangerous to older prostate cancer patients.