NCCN Guidelines for Patients
: Prostate Cancer
Part 4: Overview of cancer treatments
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3D-CRT and IMRT use photon radiation beams. Photon beams are a stream
of particles that have no mass or electric charge. In recent years, some cancer
centers have built radiation machines that use proton beams. Proton beams are
a stream of positively charged particles that emit energy within a short distance.
In theory, protons may reach tumors deep within the body with less harm to
nearby tissues. However, proton therapy is not recommended for routine use
at this time. Research hasn’t shown proton beams to be the same or better for
treating prostate cancer than conventional external beams.
Brachytherapy is another standard radiation therapy for prostate cancer.
This treatment involves placing radioactive seeds inside your prostate.
Brachytherapy is also called interstitial radiation—a seed treatment.
Brachytherapy may be used alone or combined with EBRT, ADT, or both.
The seeds are about the size of a grain of rice. They are inserted into your
body through the perineum and guided into your prostate with imaging tests.
Treatment planning is done beforehand to design the best course of treatment.
You will be under general or spinal anesthesia when the seeds are placed.
Brachytherapy can be given either as permanent LDR (
temporary HDR (
LDR brachytherapy uses thin needles to place 40 to 100 seeds into your
prostate. Placement of the seeds is done as an outpatient procedure. The seeds
usually consist of either radioactive iodine or palladium. They will remain in
your prostate to give low doses of radiation for weeks or months. The radiation
travels a very short distance. This allows for a large amount of radiation within
a small area while sparing nearby healthy tissue. Over time, the seeds will stop
feeling with or without loss
of wakefulness caused by
A test that
makes pictures of the
insides of the body
between the scrotum
= Androgen deprivation