External Radiation Therapy

Narrator: When the cancer is not completely
contained in the prostate or when the patient is older, the treatment that is frequently
used is radiation therapy. Gunnar Zagars, M.D.: There are different forms
of radiation for prostate cancer. They really boil down to two different types. There’s
what we call external beam treatment, which is given from an x-ray machine, and there’s
a variety called interstitial implantation, which uses radioactive seeds. Both of those
treatments use radioactive sources, the difference being that in the external beam, the treatment
comes from outside the patient, whereas with the interstitial seed treatment, the radioactive
sources are inserted into the prostate. [ beeping ] Narrator: The more common form of radiation
therapy is external beam. A typical treatment takes seven weeks. Gunnar Zagars, M.D.: A patient comes in every day,
Monday to Friday. Each treatment itself is probably pretty quick—you’re probably
looking at five minutes. Technician: Hi, Mr. Fabec, how ya doing? Al Fabec: Fine. Technician: Good, you ready? Al Fabec: Oh, yes. Gunnar Zagars, M.D.: The patient doesn’t feel
anything during the treatment. You can’t really feel the x-rays going into you, and so, they
feel no different after the treatment than before. Al Fabec: They put the beam above you and
put the light on it, and when it’s perfectly set up on these markings on your body, you’re ready to go. Technician: Okay, Mr. Fabec, here we go. [ beeping ] Al Fabec: You keep your hands like this and
lay on the table. Count like, “One, two, three,” up to 15. So, just about that, and you’re finished. Technician: Okay, buddy. Al Fabec: Alright. Technician: Thank you. Gunnar Zagars, M.D.: A few side effects do
occur as you get into the treatment. Typically these patients when they get into the second
or third week have some irritation of their bladder so they end up going to the bathroom
more often. They can have some irritation of the rectum—it feels like hemorrhoidal
problems. These are usually pretty minor, and we’ve got some good medication, and they tend
to disappear usually about two to four weeks after we’re finished. Narrator: But while radiation is considered
effective, it doesn’t kill all the cancer in about half the patients who receive it,
and there’s no way to predict when or even if the remaining cancer cells will become
active again. Christopher Wood, M.D.: It’s at the ten-year
mark where the differences between success rates with radical prostatectomy and radiation
therapy become evident, and if you’re not going to live ten years, then I’m not sure
that it’s worthwhile to put you through a major operation like radical prostatectomy,
and in those situations, I do refer patients for radiation therapy—either
external beam or brachytherapy.

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