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Radiotherapy, prostate cancer first line treatment

Prostate cancer is the second most common cancer worldwide. November is male cancer awareness month, a time to learn to confidently discuss men’s health problems and the month to grow a moustache and join a fight that takes place every day of the year at cancer centres like HC Marbella Cancer Center.

Localised treatment is the main approach in most prostate tumours, this includes surgery and radiotherapy, both supported by the highest level of scientific evidence. The results for disease control and cure are comparable for both treatments, only in high-risk cases has it been seen that treatment with radiotherapy together with hormone therapy may be more advisable.

Radiotherapy is a non-invasive, non-surgical option, with no scarring and no need to be admitted to hospital. It consists of precise and conformed radiation directed at the tumour cells, altering their DNA and causing their death either directly, or indirectly when treatment continues to have an effect even weeks and months after it has finished.

It is a treatment that may be indicated in virtually all possible scenarios or stages of the disease:

1. In low- or very low-risk tumours as an exclusive curative treatment.
2. In cases of intermediate or high-risk disease as a curative treatment in combination with hormone therapy.
3. In locally advanced disease for disease control in combination with hormone therapy.
4. When the disease has spread, with the intention of controlling the disease in cases of low tumour load or as treatment to control symptoms, for example when there is pain due to bone involvement.

With new technologies, we are able to strictly limit side effects and precisely target radiation at the prostate or treatment volume. HC is equipped with the latest generation of TomoTherapy, designed for attacking the tumour with the least possible impact on the patient’s quality of life, preserving urinary and sexual function in most cases.

Fractionation has also now been improved, reducing total treatment time from 30-35 days to new hypo-fractionated treatment standards of 20-28 days. Increasingly, patients can be offered ultra-fractionated treatments in as little as 5 alternate days. These treatments direct high doses of radiation in each fraction, they must therefore go hand in hand with the highest precision technology. At HC Marbella, thanks to the incorporation of the Synchrony (tracking) system, we can detect the movement of the prostate due to physiological rectal movements or bladder filling in real time, and at the same time respond to it, avoiding unnecessary radiation to nearby at-risk organs (bladder and rectum).

Behind all our treatments, there is a multidisciplinary team of medical oncologists, radiation oncologists, urologists and internal medicine physicians, who participate in every treatment decision. However, the most important person at the time of deciding on treatment is the patient. Today, our patients have more options than ever to successfully treat their prostate cancer, and the “best” option will be the one that fits not only their tumour but also their lifestyle, their specific personal characteristics and their general health, and not just at an oncological level. That is why we always, and especially at this time of male health awareness, encourage our patients to learn about all their treatment options, to have the power to decide on their personalized treatment with us.

 
 

Dra. Paula Sedano Ferreras
Especialista en Oncología Radioterápica

November 5, 2021