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Monday, Jun 17th

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Prostate Cancer Treatment

Brachytherapy
Brachytherapy used in the treatment of prostate cancer consists of two forms. Both involve the use of radioactive “Seeds” made of either Iodine–125, Palladium–103 or Iridium–192 which can either be permanently implanted into the prostate gland or delivered for a short period of time and then removed. The procedure can also be combined with a course of external beam radiotherapy which some believe make it even more successful.

Brachy Therapy Brachy Therapy
A. Permanent seed implants
An ultrasound probe is inserted into the rectum and provides the doctors with an image of the prostate gland. Needles are then inserted into the area between the rectum and scrotum under either a spinal or general anesthetic and approximately 100 radioactive seeds (each about the size of a grain of rice) are placed inside the prostate gland. They remain there with the strength of the radiation subsiding over a period of months.

B. High dose rate
Thin plastic tubes are inserted as before under an anesthetic and a radiotherapy machine called a “Brachytherapy Afterloading Machine” inserts a highly radioactive pellet (usually Iridium–192) into the prostate for a few minutes and then withdraws it. The whole procedure is repeated down each tube, this takes around 30 minutes. This is repeated the next day, leaving the tubes in place overnight and then removed. This form of Brachytherapy is often combined with external beam radiotherapy to ensure full coverage of the prostate gland.

Prostate Hormone Prostate Hormone
Hormone therapy
Hormone therapy is the use of hormones to stop cancer cells from growing. The treatment that is most often used is called a LHRH–agonist such as “Prostap” or “Zoladex”. These are female hormones or drugs that decrease the effect of male hormones, since male hormones (especially testosterone) can help prostate cancer grow. Though growth of breast tissue is a common side effect of this therapy. Sometimes an operation to remove the testicles (Orchiectomy) is done to stop the testicles from making testosterone.

This is usually used in men with advanced prostate cancer. Other side effects that can occur after Orchiectomy and other hormone therapies include hot flashes, impaired sexual function, and loss of desire for sex. The treatment is given by a monthly or three monthly injection into the skin of the abdomen. Many patients who have widespread cancer find treatment with these hormonal injections and drugs to be successful, allowing them to lead a virtually normal life.

Chemotherapy
Chemotherapy is the use of drugs to kill cancer cells. Chemotherapy may be taken by pill, or it may be put into the body by inserting a needle into a vein or muscle. Chemotherapy is called a systemic treatment because the drug enters the bloodstream, travels through the body, and can kill cancer cells outside the prostate. To date, Chemotherapy has not had significant value in treating prostate cancer, but clinical trials are in progress to find more effective drugs.

Biological therapy
Biological therapy tries to get the body to fight cancer. It uses materials made by the body or made in a laboratory to boost, direct, or restore the body’s natural defenses against disease. Biological treatment is sometimes called Biological Response Modifier (BRM) therapy or Immunotherapy.

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