The Radiation Oncology Department at Beaumont is known nationally and internationally for developing new radiation therapy techniques and for expertise in treating prostate cancer. Many of the radiation treatments for prostate cancer were pioneered or improved on by Beaumont doctors.
Radiation oncologists and physicists at Beaumont possess the technical skill and expertise to plan radiotherapy, handle radioactive sources, calculate doses, and coordinate care with other specialists. Your oncologist can discuss the best radiation treatment for prostate cancer for you.
- External beam radiation therapy (EBRT) delivers X-rays (photons) from outside the body to the area to be treated. You will lie on a table while the linear accelerator X-ray machine rotates around you, delivering painless radiation from multiple angles. This radiation treatment for prostate cancer will not hurt, feel hot or cause you to be radioactive in any way. EBRT typically involves daily treatments, Monday through Friday, for approximately eight weeks. Appointments last for about 30 minutes.
Your first appointment is a simulation or planning session that includes a CT scan. The scan helps radiologists target the exact areas that will receive radiation. Sometimes the radiation oncologist will recommend planting tiny markers or seeds in the prostate to help with targeting.
- 3-D conformal radiotherapy (3DCRT) uses a CT scan to plan for radiation. 3DCRT outlines the prostate, as well as surrounding normal tissues such as the bladder and rectum. X-ray beams are then arranged according to the CT outlines.
- 3-D conformal pelvic radiotherapy delivers radiation to the prostate and surrounding pelvic lymph nodes. This therapy is typically considered for higher-risk patients with confirmed or likely cancer spread beyond the prostate. Sometimes pelvic radiation is combined with “internal” radiation (brachytherapy).
- 3-D conformal prostatic fossa radiotherapy is sometimes recommended after prostate surgery. A recent article in the medical journal Lancet showed the superiority of postoperative radiation therapy over observation alone for patients with:
- cancer that has spread beyond the capsule of the prostate (extracapsular extension)
- cancer in the seminal vesicles (glands that sit above the prostate and produce semen)
- tumor cells touching the edge of the tissue that was removed during surgery (positive margin)
- a PSA that does not go to 0 after surgery
- a PSA that starts to rise after having been undetectable after surgery
- Adaptive radiotherapy (ART) improves the accuracy of radiation therapy. Rather than relying on a single CT scan for positioning, radiologists at Beaumont perform a series of CT scans early in the treatment process. The scans track how the prostate and surrounding normal organs change position from day to day. This is why Beaumont developed a treatment method called “Adaptive Radiotherapy” (ART) to improve the accuracy of radiation delivery. ART significantly improves the probability of hitting targeted tissue and reduces the amount of normal tissue that must be irradiated to ensure that the target is not missed.
- Intensity-modulated radiotherapy (IMRT) and ART combines 3DCRT with ART to deliver radiation treatment for prostate cancer. Intensity modulation changes the strength of the dose within each X-ray beam, dividing the beam into smaller “pencil” beams. Aiming these beams makes it possible to deliver high doses of radiation to target tissues, while delivering only low doses to tissues such as the bladder and rectum that should be protected.
Beaumont was one of the first institutions to offer IMRT for the treatment of prostate cancer. Many physicians and physicists from Beaumont have served as IMRT instructors for courses offered in the United States and around the world. These courses are sponsored by professional organizations such as the Radiation Therapy Oncology Group (RTOG) and the American Society of Therapeutic Radiology and Oncology (ASTRO). Image-guided hypofractionated adaptive radiotherapy combines the conformal, IMRT and ART methods described previously with real-time (online) image guidance. They place simulation CT scans on the treatment machine to image the prostate before turning on the X-ray beam, ensuring the highest level of precision. The new technology has the potential to shorten radiation treatment courses from eight weeks to between one and four weeks.
Your radiation oncologist will discuss this radiation treatment for prostate cancer option with you if you meet eligibility requirements.