Extra radiation will not keep the doctor away, so why do we use it? According to a recent study published in the Oct. 9 issue of the Journal of the American Medical Association most men who are given radiation to control pain from bone metastasis accompanying advanced prostate cancer undergo more treatments than they really require.
One of the most common ways to ameliorate bone pain once the prostate cancer has made it into the bones is with simple radiation therapy. In the past decade there have been studies that showed that just one radiation treatment is enough for most men.
However, has reported by many men the practice of using one radiation treatment has not become mainstream. Researchers looking at Medicare claims data found that single-session treatments were done in only about 3 percent of men receiving radiation for prostate cancer that had spread to the bones. What’s more, half of the patients went through more than 10 treatments.
Studies have found that one treatment, at a relatively larger dose of 8 Gy, is as effective for pain relief as 20 Gy given over five treatments, or 30 Gy given over 10 treatments. “But it’s just as surprising that so many patients had more than 10 fractions (radiation sessions),” said Lawton, who chairs the board of directors for the American Society for Radiation Oncology. Dr. Lawton expressed surprise that the there is such a low rate of single fractions being used in clinical practice. Good treatment of men with bone pain from advanced prostate cancer is one fraction, it is more convenient for the man as well as being better for their quality of life. In most cases when there isn’t additional surrounding tissue involved it should be the standard of care.
I am not going to guess why so many men are subjected to so many unnecessary radiation fractions. It could be economic greed of some doctors, or it could be the lack of knowledge by the doctor. The reason doesn’t matter for you, what does matter is that you stop your doctor and explore a single fraction of 8 Gy with the doctor instead of 10 fractions.
Joel T. Nowak, M.A., M.S.W.