There are different types of EBRT.
| intensity- modulated radiation therapy (IMRT) | IMRT shapes the radiation beams to allow different doses to be given to different areas. Volumetric modulated arc therapy (VMAT) is a specialised form of IMRT that delivers radiation continuously as the treatment machine rotates around the body. |
| image-guided radiation therapy (IGRT) | IGRT uses a treatment machine that takes CT scans and x-rays at the start of each session to check that you are in the correct position for treatment. This improves accuracy and reduces the risk of side effects. Markers (usually grains of gold) may have been inserted into or near the cancer so they can be seen in the x-rays or scans and used to guide positioning. |
| stereotactic body radiation therapy (SBRT) | This is a newer treatment and is not widely available. SBRT is delivered in 5–7 treatments over two weeks. Not all prostate cancers are suitable for this very short-course treatment – you can discuss this with your radiation oncologist. |
| proton therapy | This uses protons rather than x-rays beams. It is useful when the cancer is near sensitive areas, such as the brain, eyes and spinal cord. Proton therapy is not yet available in Australia, but has been used in the USA to treat prostate cancer. At this stage, there is no evidence that it provides better outcomes for prostate cancer than standard radiation therapy with x-ray beams. |
Reducing the risk of bowel side effectsTo move the bowel away from the prostate, the radiation oncologist may suggest a spacer. Before treatment begins, a temporary gel or balloon is injected into the space between the prostate and bowel. This procedure is usually done as a day procedure under a light anaesthetic. |
Dr Amy Hayden, Radiation Oncologist, Westmead and Blacktown Hospitals, and Chair, Faculty of Radiation Genito-Urinary Group (FROGG), The Royal Australian and New Zealand College of Radiologists, NSW; Prof Shomik Sengupta, Professor of Surgery and Deputy Head, Eastern Health Clinical School, Monash University, and Visiting Urologist and Uro-Oncology Lead, Urology Department, Eastern Health, VIC; A/Prof Arun Azad, Medical Oncologist, Urological and Prostate Cancers, Peter MacCallum Cancer Centre, VIC; Ken Bezant, Consumer; Dr Marcus Dreosti, Radiation Oncologist, GenesisCare, and Clinical Strategy Lead, Oncology Australia, SA; A/Prof Nat Lenzo, Nuclear Physician, Specialist in Internal Medicine, Group Clinical Director, GenesisCare Theranostics and The University of Western Australia, WA; Jessica Medd, Senior Clinical Psychologist, Department of Urology, Concord Repatriation General Hospital, and HeadwayHealth Clinical and Consulting Psychology Services, NSW; Caitriona Nienaber, 13 11 20 Consultant, Cancer Council Western Australia; Graham Rees, Consumer; Kerry Santoro, Prostate Cancer Specialist Nurse, Southern Adelaide Local Health Network, SA; A/Prof David Smith, Senior Research Fellow, Cancer Research Division, Cancer Council NSW; Matthew Starr, Consumer. We also thank the health professionals, consumers and editorial teams who have worked on previous editions of this title. This booklet is funded through the generosity of the people of Australia.
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