External Beam Radiotherapy

Radiotherapy aims to destroy prostate cancer cells whilst minimizing damage to the healthy cells in this area. Treatment is delivered Mon – Fri for a period of 4 – 6.5 weeks. Radiotherapy is delivered using a Linear Accelerator, a.k.a a LINAC, which is pictured below.

            

You will be on the treatment couch for approximately 15 mins. We will begin by positioning you using reference marks that will be made at your CT planning scan. Once we are happy that you are in the correct position we will leave the room. You are being watched throughout your treatment on CCTV so if you need us wave and we will come back into the room. We will take a CT scan initially to assess the treatment area the Dr has outlined. This scan will also enable us to assess how adequately prepped you are. If we are not satisfied with the position of your prostate, bladder, rectum or small bowel we may need to get you off the treatment bed to re-prep. If we are happy with everything we will proceed with treatment. The machine will move around you delivering radiation. There is nothing to feel or see. When you have had your treatment you will be able to go home.

The video below gives a detailed overview of what to expect when coming for Radiotherapy to the Prostate at Plymouth Oncology Centre.

 

The prostate is a gland. It is usually the size and shape of a walnut and grows bigger as you get older. It sits underneath the bladder and surrounds the urethra, which is the tube that carries urine out of the body. The prostate's main job is to help make semen – the fluid that carries sperm.

As the diagram shows, the prostate sits in close proximity to the bladder and rectum. The position of the prostate or prostate bed can therefore be affected by the contents and size of your bladder and rectum.

There are several stages to the Radiotherapy process as detailed below. You will have several telephone consultations prior to the CT planning scan. This is to ensure that you are adequately prepared for this. Following a successful CT scan the Radiotherapy planning team alongside your consultant will produce a customized treatment plan. This process generally takes 4 weeks. You will then begin Radiotherapy treatment which will be delivered Mon- Fri.  

 

As part of the Radiotherapy process you will be asked to attend for a CT planning scan. This is not a diagnostic scan and is used solely for the purpose of planning your treatment.

Prior to your CT appointment you will receive two telephone consultation calls. Here we will ask you several questions about your bladder and bowel habits. These will help us identify any potential issues and help us determine any changes that may need to be made ahead of your planning scan. We urge you to follow any advice given as not doing so may lead to delays in your treatment.

On the day of your CT scan you can expect to be in the department for approximately 1.5 hours. At this appointment we will require you to carry out the preparation discussed above.  The Radiographers will explain this in detail when you come for your scan. When you have carried out the necessary prep you will be placed in the treatment position. This is the position that we require you to be in for all of your treatments. It is important that you are relatively comfortable and able to lay still for approximately 15 mins. Once we are happy that you are in a good position we will draw some reference marks on your pelvis. These are used during treatment to set you up in the correct position. Following your CT scan we will make these reference marks permanent by making small tattoos. After the scan you will be given a letter that details the specifics of your Radiotherapy preparation. Please carry this letter with you when you attend for your appointments to assist with your individual preparation. The planning process takes approximately 4 weeks from the date of your CT scan. Once your individual plan is ready you will be called back for your Radiotherapy treatment.  

 

Because the position of the prostate can be affected by the size and shape of the bladder and rectum, this needs to be taken into consideration when having Radiotherapy. It is important that we try to maintain a reproducible position where possible. This is be done by following a set sequence of preparation which will be discussed in the video below.

 

 

We are there to support you through this process so if you have any questions please do not hesitate to ask. 

This leaflet explains the preparation required for your Planning CT Scan and Radiotherapy Treatment. Ideally, we would like you to follow this advice for at least two weeks before your planning CT scan, but if this is not possible please start as soon as you can.

Download the information sheet here.

We have made a short video with lots of helpful hints and tips to guide you through your Radiotherapy Journey.

 

 

Top Tips

We have come up with a list of top tips that will help you prepare for Radiotherapy and assist you through your treatment.

• Bring two micro-enemas and a 500ml bottle of water with you for each appointment (including your CT scan)
• Please wear loose fitting clothing and slip on shoes to speed up treatment and prevent delays
• Carry a bottle of water with you wherever you go as a reminder to hydrate
• Aim to drink around 2-3 litres (4-6 pints) of water a day (can add squash to flavour the water)
• Drink this water gradually over the course of the day to ensure you are well hydrated
• Aim to finish drinking this water before 7pm if you struggle with going to the toilet throughout the night
• Reduce your intake of caffeine, if possible switch to decaf tea and coffee

There are several side effects that you may experience during your prostate radiotherapy treatment. These most commonly affect your bladder and bowels.

Many patients undergoing Radiotherapy find that they experience fatigue and tiredness. Staying well hydrated and carrying out some gentle exercise can help with this.  

Please watch the video below, which discusses some of the common side-effects experienced during radiotherapy.

 

 

URINARY

• You may pass urine more than normal.
• You may experience a sudden urge to pass urine.
• You may find that you have a slower urinary flow than normal and experience hesitancy when trying to empty your bladder.
• You may have to get up through the night to go to the toilet.

BOWEL

• You may find that you have to empty your bowels more frequently.
• You may suddenly have to empty your bowels.
• Your stools may be looser than normal and you may find that you are passing more mucous or wind than normal.

 

It is important that you talk to a radiographer if you experience any of these side effects during the course of your treatment. We can then assess if you need to be reviewed by one of the medical team and prescribed medication if necessary. Following treatment you will be given a card with our contact details. This card is valid for a period of four weeks and we encourage you to get in contact if you are struggling with side effects from treatment.

Please watch this short video by Dr Parslow listing some of the possible long term side effects. The majority of men report very few longer term side effects that have a detrimental impact on their quality of life. If you have any concerns please discuss these with your Uro-Oncology team. 

 

During Radiotherapy, tiredness can accumulate as you go through your treatment. Keeping gently active each day will help your resilience to cope with your treatment even if you are tired. Try our exercise video to get started!