Low Dose Rate ( LDR ) Prostate Brachytherapy?

In the United States, it’s estimated that roughly 1 in 5 men will be diagnosed with prostate cancer. According to the Surveillance, Epidemiology, and End Results program (SEER) of the National Cancer Institute, “the number of new cases of prostate cancer was 129.4 per 100,000 men per year. The number of deaths was 20.7 per 100,000 men per year. These rates are age-adjusted and based on 2009-2013 cases and

During the last decade, major progress has been made in the treatment of disease with radioisotopes. Treatments involving the use of medical isotopes are gaining momentum in the race against many types of cancer. FDA approved and highly promising therapies are doubling every 3 to 4 years. Some researchers predict that over 80% of cancer types should be treatable with

Firstly,the advantage of using Cesium 137 of its long half life of 30 years, the source can give out radiation for a very long time until its quantum of radiation decreases by half of its original amount (Gould 156). Since cesium has a half life of 30 years the radiation source which is implanted next to the tumour would not need to be changed repeatedly and repeated surgery would not be required.

Issue: In medicine, radioisotopes are bonded with chemical compounds to form radioactive tracers, which are then injected into the patient’s bloodstream. The radiation emitted by the tracers allows doctors to obtain images of organ systems, facilitating the early and accurate diagnosis of disease. However, to avoid radio- active contamination, care must be taken in the storage, use, and disposal of this material.

In radiation therapy, d-max is a very important factor when a patient’s treatment is being planned. According to Washington and Leaver (2010), the d-max is defined as the depth at which the radiation beam is at its maximum dose. Different energies produce a different d-max, and to properly treat the tumor, dosimetrists and radiation oncologists must be aware of each depth of maximum dose. When a doctor’s radiation therapy prescription calls for more superficial treatments, it can be hard to find an appropriate energy due to the fact that the energy can max out too deep within the patient. The use of bolus will raise the d-max, or bring the d-max closer to the surface. Bolus will attenuate some of the radiation and in turn

TREATMENT of localized prostate cancer usually includes prostatectomy and radiation therapy, occasionally augmented with hormonal therapies. However, Fu et al., (2012) have noted that recurrence of prostate cancer occurs in about 15% of patients within 5 years after prostatectomy and in about 40% patients within 10 years. Although, more than 70% of patients are expected to survive for more than 10 years after prostatectomy, radiation or hormone therapy, Cooperberg et al.,(2010) argued that localized prostate cancer patients with intermediate or high risk scores have higher mortality rate after these treatments. With chemotherapies as the existing treatment options for metastatic prostate cancers, patients are expected to have only a median survival of 12-15 months. Bono et al.,(2006). However, most of these traditional treatments are invasive and riddled with adverse side effects. Therefore, novel therapies are on high demand for the treatment of the malignant and recurrent forms of prostate cancer after these

Radiation and hormone therapy are commonly used as follow up treatments after a radical prostatectomy. A meta-analysis by Pinkawa (2010) reported that radiation doses of up to 76-87 Gy are effective in increasing survival in high-risk patients. Androgen deprivation hormone therapy is used to decrease male androgens such as testosterone (TST) and dihydrotestosterone (DHT) influencing proliferation of cancer cells in PCa. Multiple forms of hormone therapy exist, all sharing a common goal of reducing TST and DHT levels.

Due to emergence of new techniques in management of prostate cancer as cryotherapy, high intensity focused ultrasound focal laser ablation, intensity-modulated radiation therapy, radiofrequency ablation, and others. Assessment of local aggressiveness of prostate cancer became a key point in its management (Lebovici A., et al , 2014)

Potential radioactivity and how to address it by identifying the potential risk, avoiding the spread of and exposure to radioactive contamination as part of the permitting process.

Thus consideration of absorbed dose to minimizing dose delivery and assessment of radiation damage to bone marrow is important. To attain effective radionuclide therapy, it is essential to identify appropriate radionuclides as well as to develop better bone seeking agents that could result in good in vivo localization and desired excretion [12]. There are two major groups of radionuclides for treating painful bone metastases including, β emitting radionuclides; 32P,89Sr, 90Y, 153Sm, 166Ho, 177Lu, 186Re, 188Re and α emitting radionuclide;223Ra [13-19]. The 32P and 89Sr were the first radioisotope to be evaluated for palliative treatment of bone metastases [20, 21]. Currently, there are several commercially available β emitting radionuclides for bone pain palliation as 89SrCl2, 153Sm-EDTMP and 186Re-HDEP [22, 23]. However, another radionuclide is under research for palliative treatment of bone metastasis, such as 90Y, 166Ho, 177Lu and 188Re. Recently, 223RaCl2 that uses the bone-seeking α emitter 223Ra has become available and it approved by the FDA for clinical use in 2013 [24-27]. For each atom of 223 Ra, 4 alpha particles are released that they are representing 94 % of the total radiation energy emitted

After carefully researching the different types of treatments available to treat prostate cancer, I realized that similar to many things in medicine every case is circumstantial and vary from one patient to another. Some of the things to consider when choosing the best or appropriate treatments are: what stage is the cancer in, the patient’s age, medical history, side effects of the treatment and most importantly is it right for the patient. Although it might be ranked one of the most successful treatments doesn’t mean it is perfect for you. It is very important that the patient has a good relationship with their doctor so that they can both choose the best plan of action. It is very important that the patient knows that if one treatment doesn’t work there are other approaches that can be taken.

The treatment of prostate cancer depends on the stage of the disease and which symptoms a patient may be experiencing. One type of treatment used is radiation therapy. The two major forms of radiation therapy are teletherapy and brachytherapy. Teletherapy involves almost seven weeks of radiation therapy at a prescribed dosage. Alternatively, Brachytherapy uses radioactive seeds that are implanted while the patient is under anesthesia. In Brachytherapy, “[e]ighty to 100 seeds are placed directly in the prostate, and the patient returns home after the procedure” (Pellico, 2013, p. 957). However, the patient should avoid close contact with infants or a woman who is, or may become pregnant. If a patient is receiving radiation therapy, the nurse can start implementing safety procedures to ensure the wellbeing of the patient. The nurse should also answer any questions a family member may have about the procedure, such as equipment being used, how long the procedure may be, potential of immobilization, and likelihood that the patient may experience pain. The nurse should also regularly check the patient’s skin, oral mucosa, nutrition status, and

In recent years, radiation therapy has improved tremendously. It targets tumors more accurately and minimizes damage to the surrounding

About one in two people born today will be diagnosed with some form of cancer in their lifetime (ref 1 cancer research uk). Almost two-thirds of all cancer patients receive some form of radiation therapy during the course of treatment predominantly with external-beam photon therapy (ref 40). Proton beam therapy (PBT) is a novel form of external beam radiotherapy technique that utilises positively charged particles in cancer management (ref required). However, the idea of using charged particles for cancer treatment is not new. Robert R. Wilson was a famous American phycist who proposed that, heavy particles could be used to treat cancer (Wilson, 1946). Thereafter, in 1954, the first cancer patient was treated using PBT at the Berkeley Radiation Laboratory in America and at Uppsala in Sweden in 1957. To date, over 60 000 patients with different cancer have been treated with PBT worldwide (ref 70).

In 2007, it is predicted that almost 1.5 million people will be diagnosed with cancer in the United States (Pickle et al., 2007). More than half of these cancer patients will undergo the use of radiation as a means for treating cancer at some point during the course of their disease (Perez and Brady, 1998). Cancer, a disease caused by an uncontrollable growth of abnormal cells, affects millions of people around the world. Radiotherapy is one of the well known various methods used to treat cancer, where high powered rays are aimed directly at the tumor from the outside of the body as external radiation or an instrument is surgically placed inside the body producing a result of internal radiation. Radiation is delivered to the cancerous regions of the body to damage and destroy the cells in that area, terminating the rapid growth and division of the cells. Radiation therapy has been used by medicine as a treatment for cancer from the beginning of the twentieth century, with its earliest beginnings coming from the discovery of x-rays in 1895 by Wilhelm Röntgen. With the advancements in physics and computer programming, radiation had greatly evolved towards the end of the twentieth century and made the radiation treatment more effective. Radiation therapy is a curative treatment approach for cancer because it is successful in killing cancerous tumor cells and stop them from regenerating.