Radiating the Cancerous Prostate
Patients may have the option of using radiation to treat their prostate cancer. The two forms of radiation are external beam radiation and radioactive seed implants (also known as brachytherapy). When prostate cancer is localized, radiation therapy serves as an alternative to surgery.
External beam radiation therapy is also commonly used to treat men with regional disease, whose cancers have spread too widely in the pelvis to be removed surgically, but show no evidence of spreading to the lymph nodes. The goal of radiation therapy is to kill the cancer cells.
External Beam Radiation Therapy
External beam radiation therapy generally involves treatments of 5 days a week for 6 or 7 weeks. In many cases, if the tumor is large, hormone therapy may be started at the time of radiation therapy and continued for several years. The primary target is the prostate gland itself. In addition, the seminal vesicles may be irradiated (since they are a relatively common site of cancer spread).
Radioactive Seed Implants
Radiation can also be delivered to the prostate in the form of dozens of tiny radioactive seeds implanted directly into the prostate gland. This approach, known as interstitial implantation or brachytherapy, has the advantage of delivering a high dose of radiation to tissues in the immediate area.
As practiced today, internal radiation therapy relies on ultrasound or CT to guide the placement of thin-walled needles through the skin of the perineum. Seeds made of radioactive palladium or iodine are delivered through the needles into the prostate according to a customized pattern—using computer programs—to conform to the shape and size of each man's prostate.
Radiation Therapy or Surgery?
Find out how radiation therapy compares with prostatectomy (surgical removal of the prostate) along the critical outcomes of survival, cancer recurrence, incontinence and erectile function.
All surgery presents risk, including da Vinci Surgery. Results, including cosmetic results, may vary. Serious complications may occur in any surgery, up to and including death. Examples of serious and life-threatening complications, which may require hospitalization, include injury to tissues or organs; bleeding; infection, and internal scarring that can cause long-lasting dysfunction or pain. Temporary pain or nerve injury has been linked to the inverted position often used during abdominal and pelvic surgery. Patients should understand that risks of surgery include potential for human error and potential for equipment failure. Risk specific to minimally invasive surgery may include: a longer operative time; the need to convert the procedure to an open approach; or the need for additional or larger incision sites. Converting the procedure to open could mean a longer operative time, long time under anesthesia, and could lead to increased complications. Research suggests that there may be an increased risk of incision-site hernia with single-incision surgery. Patients who bleed easily, have abnormal blood clotting, are pregnant or morbidly obese are typically not candidates for minimally invasive surgery, including da Vinci Surgery. Other surgical approaches are available. Patients should review the risks associated with all surgical approaches. They should talk to their doctors about their surgical experience and to decide if da Vinci is right for them. For more complete information on surgical risks, safety and indications for use, please refer to http://www.davincisurgery.com/da-vinci-surgery/safety-information.php.
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PN 1002355 Rev A 04/2013 U 07/06/2012