Hypofractionation in early breast cancer is no more a research scholars topic. Multiple studies with robust data have proven its utility. It may hold an important role in many countries with constrained resources. This is a short presentation incorporating important completed and ongoing trials. Feel free to use this.
This is a made easy summary of ICRU 89 guidelines for gynecological brachytherapy. Extra practical questions for MD/DNB Radiotherapy exams are also attached.
Management of cacrinoma cervix: Techniques of radiotherapy (2D conventional, 3D Conformal radiotherapy (3DCRT) and IMRT with a review of various contouring guidelines.
This presentation is intended to refer while doing planning of SBRT Prostate for all practical aspects from Simulation - contouring - planning - treatment. I am sure it will be very useful presentation for any radiation oncologist who are willing to start workflow of SBRT Prostate in the department of radiation oncology
Particle beam – proton,neutron & heavy ion therapyAswathi c p
particle therapy is advanced external beam therapy used to treat cancer , which uses beams of protons or other charged particles such as helium, carbon or other ions instead of photons. charged particles have different depth-dose distributions compared to photons. They deposit most of their energy in the last final millimeters of their trajectory (when their speed slows). This results in a sharp and localized peak of dose, known as the Bragg peak.
EBCTCG METAANALYSIS
INDICATION OF POST OP RADIOTHERAPY
Immobilization devices
Conventional planning
Alignment of the Tangential Beam with the Chest Wall Contour
Doses To Heart & Lung By Tangential Fields
Hypofractionation in early breast cancer is no more a research scholars topic. Multiple studies with robust data have proven its utility. It may hold an important role in many countries with constrained resources. This is a short presentation incorporating important completed and ongoing trials. Feel free to use this.
This is a made easy summary of ICRU 89 guidelines for gynecological brachytherapy. Extra practical questions for MD/DNB Radiotherapy exams are also attached.
Management of cacrinoma cervix: Techniques of radiotherapy (2D conventional, 3D Conformal radiotherapy (3DCRT) and IMRT with a review of various contouring guidelines.
This presentation is intended to refer while doing planning of SBRT Prostate for all practical aspects from Simulation - contouring - planning - treatment. I am sure it will be very useful presentation for any radiation oncologist who are willing to start workflow of SBRT Prostate in the department of radiation oncology
Particle beam – proton,neutron & heavy ion therapyAswathi c p
particle therapy is advanced external beam therapy used to treat cancer , which uses beams of protons or other charged particles such as helium, carbon or other ions instead of photons. charged particles have different depth-dose distributions compared to photons. They deposit most of their energy in the last final millimeters of their trajectory (when their speed slows). This results in a sharp and localized peak of dose, known as the Bragg peak.
EBCTCG METAANALYSIS
INDICATION OF POST OP RADIOTHERAPY
Immobilization devices
Conventional planning
Alignment of the Tangential Beam with the Chest Wall Contour
Doses To Heart & Lung By Tangential Fields
Locally advanced Ca prostate
Courtesy : NCCN , Perez, Gunderson and Tepper
Brief outline on management
ADT, Radiotherapy, Surgery indications and Standard of care
Analysis On Global Drugs for Prostate Cancer Market Research, Demands & Produ...Pallavi Pawar
The global Drugs for Prostate Cancer market the target of analysis of the research report recently added to the expansive database in QYResearchReports.com. The extremely descriptive and insightful document chalks out a thorough and all-inclusive analytical perspective of the global Drugs for Prostate Cancer market, covering all key categories and their segments, along with the factors that have the potential of being influential on the market in the near future. The report thus presents a 360-degree analysis of the current state of the global Drugs for Prostate Cancer market to the reader.
The market has been excavated from a ground-up fashion, where rudimentary data and key, industry-specific definitions of the global Drugs for Prostate Cancer market’s elements are described in the overview. The report moves ahead to the complete analysis of global Drugs for Prostate Cancer market, sticking to aspects such as classifications, industry chain structure, applications, policies, industry overview, and recent developments.
Dr Ho Siew Hong delivered a public lecture on differentiating prostate cancer from non cancer enlargement of the prostate during the Prostate Awareness Month 2008
High Risk disease is defined as “apparent localized cancer that has a high propensity of micro-metastatic disease” (cancer that is not visible on convention radiography, such as bone and CT scans). These cancers, once removed via radiation or surgery, are likely to "return," but in fact, they were never removed in the first place because the cancer cells were outside the treated region.
Therefore, successful eradication of high risk disease requires both aggressive local control and systemic treatment with androgen deprivation therapy and extended field radiation. This lecture will review the most up-to-date data on dose-intensity radiation therapy, pelvic radiation, surgery with adjuvant radiation, and adjuvant hormone therapy. Finally, data on experimental chemotherapy and abiraterone (Zytiga) will be presented.
How useful are advance directives in directing end of life care and do people really understand or want to know the true status of their health as the end nears?
Understanding how intermittent fasting may not only help weight loss but have multiple other health benefits including life prolongation, preventing cancer and dementia
Factory Supply Best Quality Pmk Oil CAS 28578–16–7 PMK Powder in Stockrebeccabio
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TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
2. Is there ever a need
for radiation after a
man has already had
his prostate removed
PostOp Radiation (Adjuvant Therapy) if the
pathology report from the surgery raises the
concern: “was the cancer completely removed?”
Salvage Radiation
3. PostOp Radiation
(Adjuvant Therapy): if
the pathology report
from the surgery raises
the concern: “was the
cancer completely
removed?”
• How likely is it that the cancer will
recur?
• How effective is radiation in
preventing this?
5. NCCN Advice on PostOp Radiation
RP (radical prostatectomy) PLND (pelvic lymph node dissection) RT
(radiation therapy) ADT (androgen deprivation therapy e.g. Lupron)
6. NCCN Advice on PostOp Radiation
RP (radical prostatectomy) RT (radiation therapy) ADT (androgen
deprivation therapy e.g. Lupron)
7. Adverse Features
1.Positive Surgical Margins
2.Invasion into the Seminal Vesicles
3.Extracapsular Extension
4.Detectable PSA (after surgery the
PSA should fall to undetectable by a
few weeks)
8. Prostate-specific antigen as a serum marker for adenocarcinoma of
the prostate. Stamey TA
After radical prostatectomy for cancer, PSA
routinely fell to undetectable levels, with a half-life
of 2.2 days.
N Engl J Med. 1987 Oct 8;317(15):909-16.
Prostate specific antigen in the preoperative and postoperative
evaluation of localized prostatic cancer treated with radical
prostatectomy. Oesterling JE
the half-life of prostate specific antigen was
calculated to be 3.15 days.
J Urol. 1988 Apr;139(4):766-72
9. PSA Half Life of 3 days
Surgery
6
12
Percentage
3 days
6 days
9 days
12 days
15 days
18 days
21 days
24 days
27 days
30 days
33 days
3
1.5
.75
.375
.1875
.0937
.0468
.0234
.0117
.0059 (<0.01)
.0029 (<0.01)
6
3
1.5
.75
.375
.1875
.0937
.0468
.0234
.0017
.0059 (<0.01)
50%
25%
12.5%
6.25%
3.125%
1.5625%
.0078%
.0039%
.0019%
.00098%
.00049%
Takes 4 to 5 weeks to reach undetectable
(<0.01) so most people wait 6 to 8 weeks
after surgery to check the PSA level
11. Impact of Path Reporting
Positive Surgical Margins
Odds of a PSA Relapse
Risk Group
+ Margins - Margins
Low risk
Intermediate
High
5.1%
17%
43%
J Urol. 2010;183(1):145.
0.4%
6.5%
21.5%
12. Impact of Path Reporting
Positive Surgical Margins
Odds of a PSA Relapse by 3
Years
Solitary Apical Margin
Solitary Non-apical margin
Multiple positive margins
13.0%
18.6%
27.0%
13. aboutcancer.com/medical_calculators
Adjuvant online has survival and benefit
calculators for breast, colon, lung
Breast cancer calculators here
Cancer Risk: from Harvard, various types of
cancer
Cancer Risk from X-ray Exposure
Colon cancer risk of Lynch syndrome from Dana
Farber
Colon Cancer risk from the NCI here
Head and Neck cancer survival here
Life Expectancy Calculators and Life Expectancy
for the Elderly
Life expectancy lost from smoking here
Lung cancer risk is here
Mayo clinic has calculators for melanoma
MD Anderson (breast, colon , esophagus) here
Melanoma: from the NCI, the risk of getting it
MGH has calculators for breast, melanoma, renal
Prostate cancer calculators are here
Sloan Kettering has nomograms
for bladder,breast,
colorectal,endometrial, gastric,GIST, lung,
melanoma,ovary, pancreas,prostate, renal
(kidney) and sarcoma go here
Fox Chases has many cancer
nomograms here (for kidney, prostate, bladder,
adrenal)
19. PostOp Radiation…does it work?
SWOG 8794 Trial path (425 men) = extraprostatic extension after surgery
10 Year PSA Cure Rate (seminal vesicle)
Surgery Only
Surgery Plus Radiation
12%
36%
EORTC (1005 men)
5 Year Cure Rate if Positive Margins
Surgery Only
Surgery Plus Radiation
49%
78%
German Study (Wiegel, 268 men)
5 Year Cure Rate all T3
Surgery Only
Surgery Plus Radiation
54%
72%
20. Is it Better to Treat PostOp for High
Risk Features or to Wait and Treat
later if the PSA starts rising
(salvage)?
8 Year Specific Survival by Group and Therapy
Immediate RT
Positive Margins
91%
Extra-capsular Spread
92%
Gleason 7
88%
Node Metastases
88%
Delayed
67%
75%
72%
68%
Role of postoperative radiotherapy after pelvic lymphadenectomy
and radical retropubic prostatectomy: a single institute experience of
415 patients
Cozzarini. IJROBP 2004;59:674
21. Survival Benefits from PostOp
Radiation for High Risk
Patients
RT
No RT
RT
No RT
RT
No RT
22. PSA Cure Rates with Immediate PostOp
Radiation for T3 Prostate Cancers with
Undetectable PSA
23. NCCN Advice on PostOp Radiation
RP (radical prostatectomy) RT (radiation therapy) ADT (androgen
deprivation therapy e.g. Lupron)
24. Adjuvant Radiotherapy for Pathologically Advanced
Prostate Cancer. A Randomized Clinical Trial.
425 men with pathologically advanced prostate cancer who had
undergone radical prostatectomy. Men were randomly assigned to receive
60 to 64 Gy of external beam radiotherapy delivered to the
prostatic fossa (n = 214) or usual care plus observation (n = 211).
Outcome
Surgery
Metastatic free Survival
Overall Survival
13.2 years
13.8 years
14.7 years
14.7 years
Side Effects
rectal complications
strictures
incontinence
11.9%
0%
9.5%
2.8%
23.8%
3.3%
17.8%
6.5%
Ian M. Thompson, Jr, MD;
Surgery + RT
JAMA. 2006;296:2329-2335
25. NCCN Advice on PostOp Radiation
RP (radical prostatectomy) RT (radiation therapy) ADT (androgen
deprivation therapy e.g. Lupron)
26. Immediate versus deferred androgen deprivation treatment in
patients with node-positive prostate cancer after radical
prostatectomy and pelvic lymphadenectomy
Lancet Oncology Volume 7, Issue 6, June 2006, Pages 472–479
Eligible patients from 36 institutes in the USA were randomly
assigned in 1988–93 to receive immediate ADT (n=47) or to be
observed (n=51), with ADT to be given on detection of distant
metastases or symptomatic recurrences.
At median follow-up of 11.9 years, men assigned
immediate ADT had a significant improvement in
overall survival (hazard ratio 1.84 p=0.04), prostatecancer-specific survival (4.09 p=0.0004), and
progression-free survival (3.42, p<0.0001).
27. Is there ever a role
for radiation after a
man has already had
his prostate removed
PostOp Radiation (Adjuvant Therapy): if the pathology report from
the surgery raises the concern: “was the cancer completely
removed?”
Salvage Radiation: if months or
years after surgery the PSA blood
tests starts rising again
28. NCCN Advice on Salvage Radiation
RP (radical prostatectomy) RT (radiation therapy) ADT (androgen
deprivation therapy e.g. Lupron)
29. NCCN Advice on Salvage Radiation
RP (radical prostatectomy) RT (radiation therapy) ADT (androgen
deprivation therapy e.g. Lupron)
30. NCCN Advice on Salvage Radiation
RP (radical prostatectomy) RT (radiation therapy) ADT (androgen
deprivation therapy e.g. Lupron)
31. NCCN Advice on Salvage Radiation
RP (radical prostatectomy) RT (radiation therapy) ADT (androgen
deprivation therapy e.g. Lupron) PSADT (PSA doubling time)
32. NCCN Advice on Salvage Radiation
RP (radical prostatectomy) RT (radiation therapy) ADT (androgen
deprivation therapy e.g. Lupron)
33. Salvage Radiation…does it work?
Depends…
Original Pathology
What was the Gleason?
Where the surgical margins clear?
Did the cancer involve the seminal vesicles or
lymph nodes?
Was there extra-capsular spread?
How long ago was the surgery?
How fast is the PSA rising (doubling time)?
How high the did PSA get before deciding to try
radiation?
How high a dose of radiation will be used?
34. PSA Cure Rate after Salvage
Radiation Based on Gleason Score
Gleason 2-6
Gleason 7
Gleason 8-10
Time in Months
39. Cure Rate Based on the PSA Level
at the Time of the Radiation
prostate-specific antigen 0.50 or less
(blue), 0.51 to 1.00 (yellow), 1.01 to 1.50
(gray), and more than 1.50 ng/mL (red)
J Clin Oncol. 2007 May 20;25(15):2035-41.
43. Does Salvage Radiation Improve
Survival?
Mayo (2657) No improvement in 10 y mortality
(70% versus 69%)
Hopkins (635) Improved cancer mortality at 10
years 86% versus 62%
Duke (519) All cause mortality at 11 years was
reduced by 47%
J Urol. 2009;182(6):2708
JAMA. 2008;299(23):2760.
44. Does Salvage Radiation Improve
Survival?
Mayo (2657) No improvement in 10 y mortality
(70% versus 69%)
Hopkins (635) Improved cancer mortality at 10
years 86% versus 62%
Duke (519) All cause mortality at 11 years was
reduced by 47%
J Urol. 2009;182(6):2708
JAMA. 2008;299(23):2760.
45. Does Salvage Radiation Improve
Survival?
Mayo (2657) No improvement in 10 y mortality
(70% versus 69%)
Hopkins (635) Improved cancer mortality at 10
years 86% versus 62%
Duke (519) All cause mortality at 11 years was
reduced by 47%
J Urol. 2009;182(6):2708
JAMA. 2008;299(23):2760.
47. CT scan is obtained at the time of the
Simulation
CT images are then imported
into the treatment planning
computer
48. Goal = radiation zone precisely around
the prostate cancer with small margin
bladder
Radiation zone
prostate
rectum
49. IMRT (intensity
modulated radiation
therapy) using 7
different beams to
target the prostate
The computer can
determine the optimal
number of beams to
deliver the radiation
dose to hit the target
and avoid other
structures
50. After IMRT was established then
IGRT (image guided) was
introduced
51. Lower Risk of Side Effects with Image
Guided IMRT compared to IMRT
52. Better Cure Rates with Image Guided IMRT
compared to IMRT for Prostate
Intermediate Risk
High Risk
53. The most sophisticated technique for image guided IMRT is
Tomotherapy.
Combine a CT scan and linear accelerator to ultimate in
targeting (IGRT) and ultimate in delivery (dynamic, helical
IMRT) ability to daily adjust the beam (ART or adaptive
radiotherapy)
54. There is significant movement of the
prostate gland based on daily gas in
rectum
Planned
target
No Rectal gas
Planned target,
missed badly if
rectal gas
pushes the
prostate forward
Rectal gas
55. Using Tomotherapy to tightly target
the prostate with very little radiation
hitting the bladder or rectum
60. Composite MRI showing relapse
sites at the anastomosis (red) or
behind the bladder (green)
61. PostOp Radiation (after a previous radical
prostatectomy)
rectum
bladder
pubic
Area of
recurrence
62. Principles of Radiation Therapy PostProstatectomy (NCCN)
• Patients with positive margins and slow PSA
doubling time (>9 months) may benefit the most
from PostOp radiation
• In the salvage setting indications are when an
undetectable PSA becomes detectable on 2
subsequent measurements, treatment is most
effective if slow doubling time and PSA still less
than 1
• The recommended dose is 64 to 70Gy
• The target should include the prostate bed and
may include the nodes, but not the whole pelvis
64. Side Effects of Prostate Radiation
rectum
bladder
Is related to the
size and area of
normal structures
that are over
lapped by the
radiation
zone…the goal is
to keep the
radiation zone as
small as possible
65. Side Effects of Prostate Radiation
rectum
bladder
With IMRT and
image guided
techniques the goal
is to shape the
radiation zone very
precisely based on
the pathology
report and the
location of the
cancer, e.g.
margins or seminal
vesicles or lymph
nodes
66. Side Effects of Prostate Radiation
rectum
bladder
Radiation
Zone
The structures that will get hit by radiation
and have inflammation or irritation:
bladder, urethra and rectum
67. Short Term Side Effects:
Irritation of bladder, urethra
and rectum
1.
Urinary frequency (getting up at night very few hours,
take NSAID’s, or may benefit from medication)
2.
Slight burning or stinging with urination (drink cranberry
juice)
3.
Diarrhea or more frequent, softer bowel movements,
rectal soreness (take Imodium)
4.
Mild skin irritation is now rarely seen
5.
Fatigue is common
68. Long Term Side Effects:
Irritation of bladder, urethra
and rectum
Chronic radiation cystitis or proctitis: about 6% of the
men will have occasional episodes of blood in the urine or
with bowel movements, this usually responds to
medication (e.g. cortisone suppositories) The risk of
serious damage to the bladder and rectum is now less than
1%
Impotence: about 30% of men with intact prostate have
problems after radiation, in men with previous
prostatectomy this is even higher