Advances in radiotherapy treatment dramatically reduce side effects

There was a time when a prostate cancer patient might go home and tell his family that he was going to have a course of radiotherapy treatment.  Now things are not quite so simple.  Radiotherapy can be delivered in several ways.

Traditional radiotherapy

There is the traditional radiotherapy treatment in which straight beams of X-rays are aimed at the location of the cancer.  Usually there are three beams fired from different angles.  Where they meet in a roughly box shaped location the intensity of the radiation is at its highest.  Inside this high intensity space there should be the cancerous tissue which gets burnt away.  Regrettably, the cancerous area is never box shaped and therefore healthy tissue also gets burnt away as well causing nasty side effects such as diarrhoea, bleeding and bowel incontinence.

Conformal radiation therapy

Alternatives to the traditional treatment include conformal radiation therapy in which the beams are 'bent' to some extent, thereby greatly reducing the possible side effects.  Another approach is to generate the radiation from radio active pellets inserted directly into the cancerous tissue.  This radiation from inside technique, called brachytherapy, also reduces the side effects.  Both conformal radiation therapy and brachytherapy are available in the UK but not at every centre.

Intensity Modulated Radiotherapy

Now there is an even newer treatment - Intensity Modulated Radiotherapy (IMRT).  The new treatment is specifically designed to help the 40% of cases where the cancer spreads to the pelvis.  When this happens the tumours often have complex shapes, curved and wrapped around healthy tissue.  Trials of IMRT are currently taking place on 90 patients whose prostate cancer has spread to the pelvis.  The trial is taking place at the Institute of Cancer Research and the Royal Marsden Hospital.  Dr David Dearnaley, senior lecturer at the Institute of Cancer Research said: "We finally have the technology to tailor radiotherapy treatment to complex 3D tumour shapes.  We will be able to mould radiotherapy to convex shapes like those of a ring doughnut or a cup shape, to precisely target these tumours.

Patient advice

If you are or know of a patient for whom radiotherapy has just been proposed, suggest to him that he shops around to find a centre where the best treatment is available.