Prostate cancer is Australian most steadily diagnosed cancer. One in six men might be diagnosed before the age of 85.
Cancers are abnormal groups of cells that grow uncontrollably and start to invade nearby areas. They may also spread to other organs in the body. This is called metastasis.
Treatment of early-stage disease, when the cancer is confined to the original site, focuses on that single area, most frequently with surgery or radiation therapy. Treating advanced disease once it has spread often relies on whole-body treatments similar to chemotherapy or immunotherapy.
A more advanced form of radiation therapy, called stereotactic ablative radiation therapy, may be effective in treating each early and advanced cancers. How does it work? And how does this relate to existing therapies?
Delivers a better dose to a smaller goal
Stereotactic radiotherapy uses high doses of radiation to goal and kill cancer cells. It uses newer machines that may deliver very focused beams of radiation. Combined with advances in imaging and radiotherapy planning software, this enables clinicians to “track” and goal tumors.
This ensures such high precision – with targeting accuracy of lower than 1 mm – that cancers may be safely treated with minimal risk of damage to surrounding healthy organs.
Having a better dose signifies that radiation therapy may be delivered in fewer treatments (one to five sessions over one to two weeks), whereas previously it was divided into many small doses (20 to 40) given over weeks and even months.
Stereotactic radiotherapy is increasingly used in cancer treatment brain AND lungs. However, latest data has shown that it may also effectively treat prostate cancer.
What did the latest study show?
AND test published this month in the New England Journal of Medicine compared two groups of patients with early prostate cancer whose median age was 69.8 years. Half (433 participants) received five sessions of stereotactic radiotherapy, the other half (431 participants) received standard radiotherapy consisting of at the least 20 sessions.
The researchers found no long-term differences in outcomes between the groups – 95% of patients showed no symptoms of the disease five years after treatment. These cure rates are there equivalent in patients who’ve had their prostate surgically removed.
Early evidence suggests that stereotactic radiotherapy appears to be as effective, less burdensome, and fewer invasive than currently available treatment options.
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Prostate cancer that has spread beyond its original site is unlucky incurable in most cases. Treatment of this stage of the disease is aimed toward stopping or controlling the cancer for so long as possible.
However, studies demonstrated that stereotactic radiotherapy may be used to treat disease that has spread to distant sites in patients with advanced prostate cancer. Researchers have found that stereotactic radiation therapy can free patients from clinically apparent disease for 8 to 13 months, delaying the need for hormone therapy or chemotherapy.
What are the unwanted side effects compared to other cancer treatments?
Stereotactic radiotherapy with painless radiation beams is performed every single day. In the weeks after delivery, it is common to notice soreness and/or inflammation in the treated area. This reaches the level of requiring treatment one third of the cases.
Treatment for prostate cancer often affects erectile function because the nerves and blood vessels chargeable for erection are sometimes damaged.
Other recent research comparing stereotactic radiotherapy with surgery, it was found that 48% of patients treated with stereotactic radiotherapy had problems with sexual function two years after treatment compared with 75% of patients who underwent surgery.
Precision radio-oncology
What are the costs? Who can access it?
Newer AND more advanced Radiation therapy machines can provide more precise treatment, but they’re rather more expensive than standard machines. They even have more complex maintenance and operational requirements.
However, traditional radiation therapy devices can be improved to provide stereotaxic precision.
Although the initial investment costs could also be high, the cost-benefit ratio exercise show that stereotactic radiotherapy for lung cancer costs the healthcare system lower than other cancer treatments and traditional radiotherapy. This is partly because treatment ends much faster. Formal cost-benefit analyzes haven’t been performed for prostate cancer, but they’re likely to be similar.
Stereotactic radiotherapy is now widely available in most major Australian public hospitals for the treatment of many varieties of cancer, including chosen lung cancers, kidney cancers, advanced brain cancers and bone cancers. This is without charge to patients. It is also provided in many private centers.
However, even when a middle can provide stereotactic radiotherapy, there is still significant variation in the equipment used to deliver this therapy.
Furthermore, the actual planning and delivery of radiotherapy is a fancy skill. Studies they showed that patients treated by clinicians with higher case volumes have higher outcomes due to greater familiarity with these specialized techniques.
Over the past few years, radiotherapy departments around the world have rapidly expanded their capability to provide stereotactic radiotherapy. Following the results of recent clinical trials, prostate cancer will most certainly be added to the list of cancers treated in this fashion.