Men with prostate cancer that has spread outside the prostate to
other parts of the body (advanced prostate cancer) may have
radiotherapy to help relieve symptoms. This is called palliative
radiotherapy. Palliative
radiotherapy does not aim to get rid of your cancer but it can
help to slow down its growth.
There are two types of palliative radiotherapy:
- External beam radiotherapy (EBRT) uses high energy X-ray beams
which are directed at the area of pain from outside of the
body.
- A type of internal radiotherapy. This involves an injection of
a very small amount of a radioactive substance called a
radioisotope.
Palliative radiotherapy may be used to treat symptoms such as
pain, blood in the urine, and swollen and uncomfortable lymph
nodes. It can also be used to treat a rare condition called
metastatic spinal cord compression (MSCC) where cancer cells spread
to the bones of the spine (vertebrae) and press on the spinal cord.
You can read more about MSCC in our fact sheet, Metastatic spinal
cord compression (MSCC)
What other
treatments are available?
Contents
What are the advantages and
disadvantages?
The advantages and disadvantages depend on your general health,
previous treatment and how far your cancer has spread.
Advantages:
- Palliative radiotherapy may help relieve your symptoms for
several months
- It may slow down the growth of the cancer in the area that is
treated
- Treatment works quite quickly. Within a few weeks you should
have some pain relief
- You may be able to reduce the dose of any pain-relieving drugs
you might be taking.
Disadvantages:
- Like most treatments, palliative radiotherapy may cause side
effects
- You may experience an increase in pain during, and for a few
days after, treatment but this should soon improve
- The pain may come back after several months. If this happens
you may need further treatment
- Your specialist 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.
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What does treatment
involve?
External beam radiotherapy (EBRT)
Before starting EBRT you will go to a planning
session. You may have either one single dose or a series of smaller
doses of radiotherapy over a week or more.
At the beginning of each treatment a member of staff will help move
you into the right position on the table. The radiotherapy machine
moves around your body and will make a slight noise. It does not
touch you and you will not feel anything. You will need to lie
still but the treatment only lasts a few minutes. You should be
able to go home afterwards.
If you have pain in several areas of your body, you may have
hemi-body radiotherapy. This is radiotherapy to the upper half or
the lower half of your body, depending on where you have
pain.
Radioisotopes
Treatment with radioisotopes can be helpful if you have pain in
more than one area. Tell your specialist team if you are taking
prescription or over-the-counter medicines, or you have a history
of blood disorders, bone marrow problems or kidney disease.
Strontium-89 (Metastron) is a radioisotope which may be used to
relieve pain in men with advanced prostate cancer. A very small
amount is given as an injection into a vein in your arm.
After treatment
Your specialist team will monitor you and your
symptoms. Pain can sometimes get worse during treatment and for a
few days afterwards. It may be a week or more after treatment
before your pain starts to improve. The pain relief usually lasts
for several months.
If your pain or symptoms do not improve, you may be offered another
course of radiotherapy or a different treatment to help control
symptoms. You can read about these on our page Pain and advanced
prostate cancer.
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What are the side effects?
EBRT
There are usually few side effects from EBRT. If you have hemi-body
radiotherapy you may have more side effects because a larger area
of the body is treated.
Side effects may include:
- Feeling tired for a week or two after treatment finishes
- Darkening of the skin and itching in the area treated, similar
to sunburn
- Feeling or being sick if you have had radiotherapy to your ribs
or back bone
- Loose and watery stools (diarrhoea) if you had radiotherapy to
your lower body
- A slight increase in pain during the course of treatment or for
a few days after it has finished. This should soon get better
- Hemi-body radiotherapy may also affect how well your bone
marrow works.
Radioisotopes
Most side effects of radioisotopes only last a short
time and are not severe. They may include:
- An increase in pain a few days after treatment, but this should
only last for a few days
- Changes to the way your blood clots and an increased risk of
infection and anaemia. You may get a fever, chills, bruising,
bleeding or tiredness
- Feeling or being sick (nausea or vomiting) or diarrhoea. This
is not common.
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Questions to ask your
doctor or nurse
- How will palliative radiotherapy help me?
- What other treatments are available to help me with my
pain?
- Which type of radiotherapy would be most suitable for me?
- How long will the treatment last?
- Will there be any side effects from the treatment? What can
help with these?
- Are there any precautions that I need to take during
treatment?
- Who should I contact if I have any questions at any point
during my treatment? How do I contact them?
- Will I still need to see my specialist team after my treatment
has finished?
- Will having this treatment mean I am unable to have other types
of treatment (for example, chemotherapy) later on?
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