This blogpost is the first in a series posts to help educate men on choosing the right treatment for prostate cancer.
In order to avoid suffering a recurrence of your prostate cancer or experiencing significant side effects from your treatment, you need to read the information below. Most men who have bad outcomes from prostate cancer therapy do so because they choose the wrong facility.
Advances in radiation therapy
There are multiple advances for external beam radiotherapy (EBRT) which have made prostate cancer treatment more effective while lowering side effects.
The major side effects of radiotherapy that can be minimized or avoided include urinary bother (urinary frequency, urinary urgency and discomfort on urination), bowel irritation (loose bowel movements) and erectile dysfunction.
Make sure your treating facility provides you with the following technology as part of your treatment.
High quality CT simulation for IMRT treatment planning.
A dedicated CT scan of the pelvis is required to plan EBRT. Your radiation oncologist uses this CT scan to accurately delineate the prostate and avoidance structures (rectum, bladder, penile bulb and femoral heads).
Without a state of the art CT scan, delineation of these structures will be inaccurate. Avoid facilities with CT scans over 5 years old, those who do not have a CT scan that is not dedicated specifically for radiation oncology or radiation oncology facilities that do not have their own CT scan located within a radiation oncology department.
Intensity modulated radiotherapy (IMRT)
Intensity-modulated radiation therapy (IMRT) is an advanced form of EBRT. IMRT allows for extremely accurate delivery of radiotherapy, which results in
higher doses of radiation to the prostate and lower doses to other tissues such as the bladder and rectum. IMRT creates patient-specific doses that tightly conform to your anatomy that allows the radiotherapy to be precisely delivered to the prostate while avoiding the rectum and bladder.
Accounting for organ motion
The prostate actually moves based on rectal and bladder filling. This movement can affect the accuracy of radiation delivery and cause “geographic misses”. These “misses” result in under-
dosing of the prostate and over-dosing of the bladder and rectum. Cone beam CT (CBCT) is a CT scan build into your radiation machine. CBCT acquires a 3D CT image in real-time just before treatment. Make sure your treatment facility performs high quality CBCT prior to radiation treatments.
Small details make a big difference when it comes to achieving a successful outcome with prostate cancer. Attention to detail matters and the right technology matters!! Does your radiation oncology facility have the best equipment to ensure that you have the best outcome?
Lav Goyal MD MBA
Holy Cross Hospital
Fort Lauderdale, FL