Radiation Therapy In Advanced Prostate Cancer
- Even after prostate cancer has spread, radiation therapy — traditionally used to treat cancer confined to one area — can still play an important role.
- Radiation can be used to help manage symptoms and in some cases, slow the spread of disease. The way it’s used depends on the situation, your symptoms, and the number and location of cancer spots.
- When cancer has spread to only a few spots, a condition known as oligometastatic prostate cancer, targeted radiation may delay cancer progression and, in some cases, extend survival.
- The most common method is stereotactic body radiation therapy (SBRT), which delivers high doses of radiation very precisely over one to five treatment sessions.
- Radioligand therapy (RLT) is a newer form of treatment for advanced prostate cancer. Instead of delivering radiation from outside the body (like standard radiation therapy), RLT delivers radioactive particles directly to cancer cells through the bloodstream.
But even after prostate cancer has spread, radiation therapy — traditionally used to treat cancer confined to one area — can still play an important role. The way it’s used depends on the situation, your symptoms, and the number and location of cancer spots. In some cases, radiation can help relieve pain or discomfort. In others, it may slow the spread of disease.
Read MorePalliative Radiation Therapy
When prostate cancer spreads to the bones, it can sometimes cause pain, swelling, or fractures. These symptoms can significantly affect mobility, sleep, and daily activities. Palliative radiation therapy is a targeted form of radiation aimed at easing these symptoms rather than curing the disease.
With this approach, a focused beam of radiation is directed at the area of the bone where cancer has spread. The goal is to shrink cancer in that spot, reducing inflammation and relieving pressure on nearby nerves or tissues. It’s usually given over a short course — sometimes even a single treatment — depending on your needs.
Relief can start within days to weeks. Side effects, such as fatigue or skin irritation over the treated area, are generally mild and short-lived.
Studies show palliative radiation can be effective in reducing pain in up to 70-90% of patients with bone metastases. For some, pain relief lasts months or longer.
Radiation For Oligometastatic Prostate Cancer
Oligometastasis is a medical term describing cancer that has spread, but only to a limited number of spots — often defined as three to five areas. For prostate cancer, these metastases are often found in bones or lymph nodes.
Traditionally, once cancer spreads beyond the prostate, treatment was focused only on controlling it throughout the body, not trying to eliminate specific spots. New research suggests that aggressively treating these limited metastases with targeted radiation may delay cancer progression and, in some cases, extend survival.
“If there’s a small number of areas, we would call that oligometastatic prostate cancer,” Dr. Hamstra explains, noting radiation can be very effective in this setting.
The most common method is stereotactic body radiation therapy (SBRT), which delivers high doses of radiation very precisely over one to five treatment sessions. SBRT minimizes damage to nearby healthy tissue and allows for quick recovery.
Potential benefits include:
- Delaying the need to start or escalate systemic therapy
- Prolonging the time before cancer spreads further
- Improving the quality of life by keeping the cancer burden lower
Men with a small number of metastatic spots seen on advanced imaging (such as PSMA PET scans) and good overall health (ability to tolerate short-term radiation) may qualify.
Radioligand Therapy
Radioligand therapy (RLT) is a newer form of treatment for advanced prostate cancer. Instead of delivering radiation from outside the body (like standard radiation therapy), RLT delivers radioactive particles directly to cancer cells through the bloodstream.
A radioactive molecule is attached to a targeting agent — often a molecule that binds to PSMA (prostate-specific membrane antigen), which is commonly found on prostate cancer cells. When injected into your bloodstream, it travels to cancer cells anywhere in the body and delivers a dose of radiation from the inside out. This radiation damages the cancer cells while sparing most normal tissues.
Radioligand therapy is usually given as an outpatient infusion every few weeks.
Side effects may include:
- Dry mouth
- Mild fatigue
- Nausea
- Temporary drops in blood counts
RLT has been shown in recent clinical trials to improve survival for men with metastatic castration-resistant prostate cancer (mCRPC) who have already tried other treatments.
It offers another option for patients whose cancer continues to grow despite standard therapies.
Am I A Candidate For Radiation?
The decision to use radiation in advanced prostate cancer is highly individualized.
Your doctor will consider several factors, such as:
- Your overall health and treatment goals (Is the goal to relieve symptoms, slow progression, or both?)
- Your ability to tolerate the type of radiation being considered
- Number and location of metastases
- Other treatments you’re receiving
- Type of imaging used
- Potential side effects vs. benefits
Your doctor will weigh the likelihood of symptom relief or disease control against risks like fatigue, skin irritation, or effects on nearby organs.
Questions To Ask Your Doctor
- What is the goal of this treatment in my case: pain relief, slowing progression, or both?
- What type of radiation do you recommend?
- How many treatments will I need, and over what time frame?
- What side effects should I expect in the short-term and long-term?
- How will we measure if the radiation is working?
- Will I still need systemic therapy if I have radiation?
Content independently created by SurvivorNet with support from Novartis Pharmaceuticals Corp.
Learn more about SurvivorNet's rigorous medical review process.
ANSWER QUESTIONS
