What is external beam radiotherapy?
External beam is the commonest form of radiotherapy. These days it’s given with a period of hormone therapy. This is based on high level evidence which shows this combination gives a better outcome from a cancer point of view.
External beam radiotherapy usually takes up to seven weeks. The patient goes in from Monday through to Friday. They receive short bursts of radiotherapy on each of those days. This happens for about seven weeks. By adding hormone therapy the patients results improve a lot. This is based on recent findings. Hormone therapy means getting an injection every three to six months. The injection is an agent or a drug which will essentially knock out that man’s testosterone. The two types of treatment seem to work together, in a synergistic fashion, to give a better outcome. Interestingly hormone therapy has not been found to be a benefit in surgical patients. But it does seem to work better for patients with radiotherapy.
Complications and side effects of external beam radiotherapy
Complication rates of external beam radiotherapy, for erectile dysfunction, is certainly pretty similar. But they definitely have a lower complication rate for urinary incontinence. There is also a risk of bowel and bladder dysfunction with external beam radiotherapy. Therefore, it has actually quite similar complications to brachytherapy. This is because after all we are still delivering a radiation dose to the prostate. Techniques have become much more accurate in terms of minimising doses to adjacent organs. However, it can still be, and sometimes it has to be in fact, that a little bit of dose that reaches those organs. This is especially for cancers that are on the peripheral of the prostate.
Getting a second opinion
Getting a second opinion from a radiation oncologist or even another urologist about the external beam radiotherapy, is a great idea. This is particularly helpful for new patients. For patients who have just been diagnosed with prostate cancer. The early stages of diagnosis can be very overwhelming for a new patient. First they receive a diagnosis of cancer, and then have all of this information about what to do next dumped on them.
When you get an opinion from one person, you’ll often only take away one, or a few small parts or ideas, from that consultation. Therefore, getting a different perspective is a really good thing to do. Particularly from somebody who actually practises that type of treatment. This will give you a different perspective but even having a second consultation with the same person might also be a good idea. Just from the patients ability to retain information.
Associate Professor Dr. Jeremy Grummet – Urological surgeon and Director of Clinical Research in Urology at Alfred Health. Member of Australian Urology Associates private practice group
