Radiation Therapy

Radiation Therapy Santa Barbara Urologist David Laub

Radiation therapy—killing cancer cells with high-energy rays or particles—is a common non-surgical primary treatment for early-stage, low-grade cancer that is fully contained within the prostate. In such cases, the cure rate is on a par with that of radical prostatectomy

In cases where cancer has spread to the tissues surrounding the prostate gland, radiation is often performed as a first treatment in conjunction with hormone therapy. It can also be used to treat recurring prostate cancer following surgery, or to control cancer and relieve symptoms for as long as possible in more advanced cases.

There are three main types of radiation therapy:

  1. External beam radiation
  2. Internal beam radiation (brachytherapy)
  3. Injectable radioactive medicine

Dr. Laub’s specialty is permanent, low-dose (LDR) brachytherapy.

Brachytherapy (Internal Beam Radiation)

With brachytherapy (also known as seed implantation or interstitial radiation therapy), tiny, low-dose radioactive pellets are directly delivered to the prostate, guided by trans-rectal ultrasound, CT scan, or MRI imaging. During this process, up to 100 rice-sized “seeds” of radioactive material (such as iodine-125 or palladium-103) are deposited in specific places through thin needles that penetrate the skin between the scrotum and anus.

Left in place permanently without causing discomfort, these seeds emit low doses of radiation for weeks or months in a very small radius, limiting exposure to adjacent healthy tissues. The precise dosage is determined by a special computer program.

As a stand-alone treatment, permanent LDR brachytherapy is usually limited to men with early-stage, slow-growing prostate cancer. Sometimes hormone therapy is recommended beforehand for men with larger-than-normal prostates, in order to shrink the gland and improve the efficacy of radiation seed implantation. In higher-risk cases, external radiation may sometimes be combined with brachytherapy.

Radiation therapy is performed in an operating room, and requires either spinal or general anesthesia. An overnight hospital stay may be necessary.

Risks and Side Effects

Interestingly, studies have shown that men over age 80 and those with other serious health problems have experienced better results with radiation treatment compared to those who had radical prostatectomy. Side effects are generally minor, as listed below:

  • Urinary symptoms including severe incontinence may affect patients who previously had a transurethral resection of the prostate (TURP) or have a history of urinary problems. This usually improves over time.
  • Short-term bowel issues such as rectal pain, burning, diarrhea, and/or bleeding—related to a condition called radiation proctitis—can sometimes be caused by brachytherapy.
  • Fatigue is a common side effect.
  • The risk of sexual dysfunction (erection problems) may possibly be lower after radiation therapy compared to other treatments.

Important Note About Radiation:

Since the implanted pellets will continue to emit radiation for up to several months, you should follow Dr. Laub’s precautions. For example, he may suggest that you:

  1. Wear a condom when having intercourse
  2. Strain your urine for the first week in case seeds are dislodged
  3. Temporarily avoid pregnant women and young children
  4. Plan ahead for travel, as radiation may be detected at screening points

Contact our office to discuss radiation therapy for prostate cancer treatment.