The Princess Margaret - Radiation Therapy Centre
Once it has been decided to treat your cancer with radiation therapy, a number of procedures have to be followed to design your treatment program.
The first step is to outline precisely the area to be treated. The Radiation Oncology team do this with the help of a planning CT scan.
The prostate moves naturally within your pelvis depending on how full or empty your bladder and rectum are. In addition to the image-guided treatments using cutting-edge technologies, we try to reduce the movement of the prostate by having you follow a daily routine of filling the bladder and emptying the rectum. You will be asked to come for a simulation appointment (no radiation is given) before treatment begins. Your team will work on your treatment plan in order to offer you an accurate and safe treatment. After a rigid quality assurance process, if all technical requirements are met, your team will approve your radiotherapy plan and you may begin treatment.
Your radiation oncologist, oncology nurse and radiation therapist will provide you and your family with all the detailed information you need for your treatment.
Further information on the overall radiation therapy process can be found in a series of video modules available at the Radiation Therapy Centre Website
The radiation oncologist will review your treatment program weekly with you, checking for side effects. These side effects are usually temporary and should improve 1-2 weeks following treatment.
Occasionally following treatment, blood may appear in the urine and/or in the stools. A few patients may have these symptoms even years later. When it happens, this is often transitory but your radiation oncologist should be consulted. A small number of patients are troubled by late effects that appear months or even years following treatment. These effects are dependant upon a number of factors that you should discuss with your doctor. Once your treatment sessions are complete, you should find your energy level returning to normal.
Cancer only responds after treatment is complete, so check-ups usually take place a few months later. Following radiation treatment, your PSA should drop slowly and gradually; your PSA may not reach its lowest level until 18 months or more after treatment. If you have indication of hormone therapy alongside radiotherapy your PSA level may fall more quickly. After treatment, you will be monitored on an ongoing basis with PSA tests.
Some men begin to experience fatigue toward the end of the radiation treatments, but most can manage their daily routine. There is a small chance of developing bladder irritation (burning with urination, or an urgency to urinate) and/or rectal irritation (pain, frequent bowel movements). Some patients may also experience diarrhea and worsening of hemorrhoids. Most often, these side effects are mild and disappear following completion of treatment.
With external beam radiation, there is a 30% to 40% chance of developing impotence, but this importantly depends on the patient’s erectile function prior to treatment and on other clinical factors. For more information on impotence visit the Support section of the Prostate Centre.