Radiotherapy for advanced prostate cancer
You may be offered radiotherapy if the cancer causes symptoms, such as pain in the prostate area, or if it has spread to other parts of the body such as the bones.
In this situation, radiotherapy can’t get rid of all the cancer cells, but it can reduce symptoms. This is known as palliative radiotherapy.
It can take 7-10 days for the radiotherapy to start reducing the pain, and may take up to six weeks before the full effect is felt.
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If prostate cancer has spread to the bones, radiotherapy can be given to the affected bone or area. It may be given as a single treatment, or may be divided into a series of smaller treatments. Many men notice that the pain eases within a couple of days, while others may have to wait three or four weeks. Painkillers can still be taken in the meantime if necessary.
The radiotherapy staff will explain your treatment and its possible side effects to you beforehand.
Occasionally, if there are cancer cells in more than one area of bone, you may be given treatment known as hemibody irradiation. Treatment is given to a large area, either to the top or the bottom half of the body. This type of radiotherapy normally gives good pain relief within a few days. However, the side effects of treatment are likely to be greater than with radiotherapy to a smaller area.
Your doctor will prescribe anti-sickness drugs for you and you may have a short stay in hospital. If necessary, the other half of your body can be treated later, once the side effects have worn off.
Our section on secondary cancer in the bone gives more detail about the possible treatments available.
This treatment for secondary cancer in the bone uses a radioactive material (isotope) called strontium-89, which is taken up by the affected areas of bone. It’s useful if several areas of bone are affected and are causing pain.
The isotope is given as an injection into a vein in the arm. This can usually be done in the outpatients department. After the injection, a small amount of radioactivity is present in the urine, so men are advised to use flush toilets instead of urinals to reduce the risk of anyone else being exposed to the radiation. The hospital staff will discuss any other special precautions with you before you go home.
The amount of radioactivity is very small, so it’s safe for you to be with other people, including children. Most men feel some effect from the treatment within a few weeks, although occasionally the pain may get slightly worse before it gets better.
Radium-223 is a new treatment for secondary cancer in the bone that also uses a radioactive material. It has had encouraging results in clinical trials and, so far, has shown only mild side effects.
Advantages and disadvantages
Radiotherapy can help to relieve bone pain and strengthen a weakened bone. The aim is to make you feel more comfortable. Usually there are only a few side effects, which are generally mild.
Pain may become slightly worse before it gets better.