Did you know that external radiation (when employed as 1st-line therapy for prostate cancer) is prescribed for 9-weeks of daily treatment? There is a new shorter, non-invasive option that has recently become available…read on…
Patients have many options available to them for managing prostate cancer (i.e. observation/watchful waiting, surgery, external beam radiation therapy, brachytherapy, cryosurgery, HIFU, hormonal therapy, etc.)
The most commonly selected non-invasive treatment option involves a highly-effective, 9-week external beam radiation treatment course. Although there have not been any randomized controlled trials that have compared surgery to radiation therapy for prostate cancer, most of the data suggest that both approaches lead to equivalent long-term tumor control outcomes. Modern external radiation techniques employ higher radiation doses (increasing tumor control rates), daily prostate targeting (increasing accuracy and precision) and smaller radiation fields (decreasing side effects in surrounding tissues.) These advances have demonstrated improved tumor control rates and reduced toxicity in our patients compared with the external beam approaches employed only a few years ago.
You say 9-weeks is too inconvenient, but you still want a non-invasive approach to treat your prostate cancer…
A short, 5-session (5-days) course using a very precise and accurate non-invasive radiation therapy technique called, “stereotactic body radiation therapy” or “SBRT” may be your answer.
Recently reported clinical trials (in men with low-risk/favorable prostate cancer), demonstrate excellent short-term outcomes:
- 90% of patients (n=40) had no failures (as determined by PSA levels) after 48-months; (Madsen, 2007)
- 100% of patients (n=41) had no failures (as determined by PSA levels) after 33-months; (Wiegner and King, 2010)
- 95% of patients (n=45) had no failures (as determined by PSA levels) after 12-months; (UT Southwestern, 2010)
- 97% of patients (n=112) had no failures (as determined by biopsy) after 24-months; (Friedland, 2009)
- 98% of patients (n=304) had no failures (as determined by PSA levels) after 17-months; (Katz, 2010)
The early toxicity profiles (bladder and rectal) appear to be similar to the lengthy, 9-week, treatment course. Most patients experience only minimal short-term side effects from the 5-session course. Numerous clinical trials are currently underway to further evaluate the long-term effectiveness and toxicities using this convenient treatment approach. Occasionally patients report temporary symptoms, which may include reduced urinary stream, burning with urination, more frequent urination, increase in frequency of stools, loose stools and more gas with bowel movements than usual.
Patients who are interested in selecting this 5-session treatment should be enrolled in a clinical trial. If you are interested in this approach, contact the organizations below to find out if you are eligible for this treatment and if this is available in your area.
Ongoing clinical trials available through:
- 21st Century Oncology (Over 100 locations across the United States. 21st Century Oncology is the largest radiation oncology provider in the United States)
- Simmons Comprehensive Cancer Center at University of Texas Southwestern Medical Center (Dallas, TX)
- University of Pittsburgh Medical Center (Pittsburgh, PA)
- Duke University Medical Center (Durham, NC)
- UCLA Jonsson Comprehensive Cancer Center (Los Angeles, CA)
- Accuray/CyberKnife (multiple locations across the United States)
Don’t be swayed by the name of the machine (i.e. CyberKnife, Triology, TrueBeam, Tomotherapy, Novalis, etc.) when selecting the radiation oncology practice for your treatment. They all do essentially the same thing, and no studies have demonstrated that any one of them is superior. In my opinion, the most important factors in selecting the right team are the reputation, training and experience of the radiation oncologists and their support staff (physicists, dosimetrists, therapists, nurses, etc.) in treating prostate cancer using SBRT.
(learn more: nice review article on SBRT for genitourinary tumors)
