Radiation therapy involves destroying cancer cells by hitting them with high-energy radiation (such as X-rays or gamma rays). You have two choices:
External beam radiation therapy (EBRT)
The basics: Beams of radiation are focused on the prostate gland from a machine outside the body. The treatments are painless and take only a few minutes each; you may need up to five sessions per week over a period of seven to nine weeks to get the best benefit.
It might be right for you if: If your cancer is slow-growing and is still confined to your prostate or has just started to spread into nearby tissues. If your cancer has already spread, you may still undergo radiation—but it would likely be paired with hormone therapy for better results.
What you should know: Fatigue, rectal burning and tenderness, and a frequent urge to urinate are common side effects, and they can last several months. The risk of incontinence is less with EBRT than with surgery, but the risk of erection problems is roughly the same.
Internal radiation therapy (brachytherapy)
The basics: Brachytherapy involves implanting radioactive seeds right into the prostate itself. With permanent (low-dose) brachytherapy, anywhere from 40 to 100 tiny radioactive seeds are injected into the prostate via needles inserted through the perineum. Since these seeds are very small, doctors leave them in place after their radioactive material is used up. Another option: temporary (high-dose) brachytherapy. In this procedure, needles are used to place catheters into the prostate. A radioactive substance is pumped in for five to 15 minutes and then it’s removed. This procedure is generally repeated two more times over the next two days, then the catheters are taken out.
It might be right for you if: Your cancer is localized, and it hasn’t spread far into the back of the prostate—an area that’s harder to reach with brachytherapy.
What you should know: You may experience some discomfort and bruising where the needles or catheters were inserted. You may also notice a temporary reddish-brown color to your urine and may find it more difficult to empty your bladder for a month or so. If the difficulty persists, tell your radiation oncologist or mention it during today’s visit.