Palliative radiotherapy will not cure your cancer but can help slow down its growth and relieve symptoms such as pain.
Who can have palliative radiotherapy?
Palliative radiotherapy is one of the treatments used to slow down the growth of cancer and control symptoms in men with advanced prostate cancer. Advanced prostate cancer is not curable but treatment can keep it under control for months or years. Having advanced prostate cancer means that the cancer has spread from the prostate, to other parts of the body. Prostate cancer can spread to any part of the body, but most commonly to the bones or lymph nodes. ‘Bone metastases’ or ‘bone secondaries’ are the terms used to describe cancer that has spread to the bone. This can cause pain and problems with moving around. In some cases, men with advanced prostate cancer may also experience painful lymph nodes or blood in their urine, caused by bleeding from the prostate. These symptoms can sometimes be relieved with palliative radiotherapy.
Palliative radiotherapy may not be suitable for every man with advanced prostate cancer. This will depend on where your cancer has spread to, whether it is causing symptoms and what treatment you have already had. Your specialist team will help you to decide whether palliative radiotherapy may benefit you. You may be offered other treatments to help control the symptoms of advanced prostate cancer. These include pain-relieving drugs, hormone therapy, chemotherapy and drugs called bisphosphonates.
How does palliative radiotherapy treat advanced prostate cancer? The aim of all types of radiotherapy is to destroy cancer cells in the treated area, while trying to avoid damage to normal cells. Radiotherapy damages cells and stops them from dividing and growing. Cancer cells are not able to recover from this damage and die of but normal healthy cells can repair themselves more easily. Palliative radiotherapy uses lower doses of radiation than radiotherapy to treat localised or locally advanced prostate cancer and the course of treatment is shorter. The aims of palliative radiotherapy are: • To shrink the cancer cells in the bones. This may stop them pressing on the nerves and causing pain. • To slow the growth of the cancer giving your bones time to repair and strengthen. Sometimes men with advanced prostate cancer may have palliative radiotherapy to help relieve other symptoms such as blood in their urine caused by bleeding from the prostate or painful lymph nodes. There are two types of palliative radiotherapy: • External beam radiotherapy • Internal radiotherapy (radioisotopes) Your specialist team will help you to decide which type of palliative radiotherapy is best for you.
What are the advantages and disadvantages?
The benefits and risks of radiotherapy depend on your age, general health, past treatment and how far your cancer has spread. Your specialist team will discuss your individual situation and options with you.
Advantages
• Palliative radiotherapy may improve your quality of life by controlling symptoms such as pain.
• It may slow the growth of the cancer in the down area you are having treated.
• Treatment works quite quickly. Within a few weeks you should have some pain relief. • You should not need to stay in hospital overnight.
Disadvantages
• Like most treatments, palliative radiotherapy may cause side effects in some men. Generally, most men find that palliative radiotherapy does not cause them too many side effects.
• Radiotherapy may help relieve your symptoms for several months, but the pain might come back. If this happens you may need further treatment. If you are thinking about having radiotherapy, you will be referred to a specialist who treats cancer with radiotherapy, known as a clinical oncologist or radiotherapist. They should discuss with you whether you will benefit from palliative radiotherapy, which type of radiotherapy you may have, how long the treatment may take and possible side effects.
What happens afterwards?
Your specialist team will monitor you and your symptoms. With both types of radiotherapy, the pain can sometimes get worse in the first two or three days after treatment before it gets better. You may need to take some pain relieving drugs during this time or increase the dose that you may already be taking. The pain relief from radiotherapy usually lasts for several months. However, if your pain or symptoms do not improve then talk to your specialist team. If your pain has come back your specialist team may suggest another course of radiotherapy. It is possible to give a repeat course of EBRT to the same area of the body. This will depend on the dose already given. If you have a lot of bone pain in many new areas, a further course of external hemibody radiotherapy or internal radiotherapy may help. If you have had internal radiotherapy first you may also be able to have repeat doses if necessary.