MEN'S HEALTH MATTERS:Cancer cells are more susceptible to the effects of ionizing radiation than normal body cells, writes Thomas Lynch
Q I AM 68 years old and have had some tests which have confirmed that I have prostate cancer. I have seen the specialists and have been left with two main treatment options - either surgery or radiation therapy. Can you please explain about radiation therapy for prostate cancer.
ARadiation therapy is a very effective method to treat many types of cancer. It relies on the fact that cancer cells in the body are more susceptible than normal body cells to the damaging effects of ionizing radiation. This property of cancer cells allows them in many cases to be effectively eliminated.
Prostate cancer is one such cancer, and the cure rates with radiation are very high. It can be administered in two ways: external beam (EB) radiation and brachytherapy (BT).
EB is administered as an outpatient, over approximately a two-month course. It takes about 10-15 minutes per day, five days per week, over seven to eight weeks.
BT refers to the direct insertion (single-day treatment) of radioactive sources into the prostate gland itself, to treat the prostate cancer. The sources can be temporarily implanted or, more commonly, permanently implanted.
The latter is often call "prostate seed implantation". This is a "minimally invasive" procedure, performed under general or spinal anaesthesia.
Whatever way the radiation is administered, temporary symptoms may be present during and after the treatment. These symptoms include fatigue, and a short-term effect on urination and bowel function.
These usually resolve within three to six months and rarely persist into the long term. Along with surgery, radiation therapy is one of the main curative options for men with localised prostate cancer. It can also be a highly effective way of treating men in the later stages of this disease.
Q I AM 62 years old and have recently suffered a minor stroke. I am getting over this and am nearly back to normal but my doctor said that I must give up cigarettes. He also started me on a blood pressure lowering drug and a blood-thinning tablet.
Is he being over cautious or it is important that I comply with his advice and take the medications?
AIt is absolutely imperative that you give up smoking as smokers have up to four times the incidence of strokes and heart attacks over those who are non-smokers.
Giving up smoking has an immediate beneficial effect on the circulation as the "stickiness" of the blood almost immediately decreases. In addition, smoking significantly reduces the potential benefit of the blood-thinning drug on which you were started.
Treating high blood pressure reduces the possibility of a major stroke or heart attack by about 40 per cent and the aim of your doctor is to achieve a blood pressure level as close as possible to 130/80 without you experiencing a drop in blood pressure when you stand which might make you dizzy. Your doctors will check your blood pressure lying and standing to make sure that this does not occur.
Blood-thinning tablets (eg aspirin) can reduce the incidence of heart attacks and strokes by about 25 per cent and it is imperative that you comply with this therapy. If you are planning to take aspirin, it is important that your doctor knows if you have a history of heart burn or peptic ulcers.
In this situation you can be prescribed a medicine that will help protect the stomach against potential side effects of these blood-thinning agents.
Your doctor may also start you on a cholesterol-lowering drug. People who suffer a mini stroke are often started on cholesterol-lowering treatment even if they have a normal cholesterol as these drugs not only reduce the cholesterol level but they can also help to reabsorb the cholesterol from the artery wall and may smoothen the inner lining of the wall itself.
Overall, the combination of stopping smoking, controlling blood pressure, blood-thinning and cholesterol-lowering treatment can reduce the possibility of a further stroke or heart attack by up to 80 per cent.
The combination of these therapies have had a revolutionary effect on the further reduction in strokes and heart attacks in patients who experience one of these events.
Your medication may require some adjustments from time to time and it is very important that you make every effort to fully comply with all the therapies that are prescribed for you. Should you have any side effects or new symptoms, then you should report them to your doctor and appropriate action can be taken.
• This weekly column is edited by Thomas Lynch, consultant urological surgeon, St James's Hospital, Dublin with a contribution from Prof Frank Sullivan, consultant in radiation oncology, University College Hospital, Galway and Prof Bernard Walsh, consultant physician, St James's Hospital, Dublin