Friday, 23rd April 2021
HEALTH & WELL BEING Article
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This Month's Magazine

RADIOTHERAPY AND PROSTATE CANCER

It is estimated that prostate in Spain cancer causes up to 7% of cancer deaths in men in Europe. Dr. Paula Sedano Ferreras Radiotherapy doctor


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Localized prostate cancer is radically treated with local therapy, generally surgery and/ or radiation therapy, while advanced/ metastatic prostate cancer is treated with hormone therapy, chemotherapy, and/ or targeted therapies, requiring radiation therapy in some cases to alleviate symptoms or improve. Local control.

Radiation therapy is an e sential treatment for the multidisciplinary management of this tumor. This treatment has been gaining importance over the years as it presents excellent disease control figures, comparable to surgical treatment1, with the advantage of being a non-invasive treatment. The prevalence of prostate cancer  reaches almost 60% in men over 80 years old. Therefore, in this more fragile population of patients, the ideal is to be able to count on a treatment that avoids the  patient having to undergo surgery with the risks that this may entail.

RADIATION THERAPY IS GIVEN WITH CURATIVE INTENT:
• In patients with localized tumor, either low, intermediate or high risk.
• In higher risk patients. Association with hormonal treatment is. required for not only local control. but also systemic control of the disease.
• In patients who after surgery have micro-disease or certain risk factors. The trend now in some of these patients is to actively monitor the possible recurrence /  relapse of the disease, and if it occurs, treat the patient with early rescue radiotherapy 2,3

RADIATION THERAPY TO ALLEVIATE THE SYMPTOMS OF THE DISEASE
• In those patients in whom the disease is more advanced, radiotherapy can improve the symptoms derived from the disease, such as pain.
• Prostate cancer tends to have a predilection for bones, which is why metastases are usually located at the level of the bones of the spine and pelvis. Radiotherapy achieves an improvement  in pain of up to 70%.
• When dissemination is limited, radical. intention treatment can also be. performed at the affected site / locations.. In summary, radiotherapy treatment is a fundamental part that can be offered in the. different stages of the disease and always with a high level of evidence.

HC radiation therapy in prostate cancer

IMPROVE SURVIVAL FIGURES:
• The treatment of prostate cancer with tomotherapy achieves excellent control of the disease, reaching 5-year relapse-free survival rates of up to 98.9% without  associating severe acute toxicity.
• In patients at higher risk (high or very high risk) after treatment with tomotherapy together with hormonal therapy, a relapse-free survival at 5 years is .observed . between 91-99%. Furthermore,. tolerance to treatment was good, with.. 10% or less of the patients presenting long-term moderate-severe genitourinary or  gastrointestinal side effects.

RADIOTHERAPY THAT FOLLOWS THE TUMOR
• The prostate moves up to 12-15mm due to changes in the volume of the bladder or rectum (the organs next to it). Other. more conventional radiotherapy systems. do not detect this movement, with the risk of not treating the entire area well or of having to widen margins and therefore increase the volume that will receive radiotherapy..
• Our radiotherapy has a tracking system known as Synchrony, capable of following the movement of the tumor in real time during each radiation session.
• This is achieved after the placement of fiducials inside the prostate, which the. system is capable of tracking and thus.. administering the treatment with high precision.
• This precision is ideal for those extreme hypofractionation treatments (SBRT) that manage to eliminate the disease with. less treatment sessions.



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