Radiotherapy for prostate cancer that has spread
This page tells you about radiotherapy for prostate cancer that has spread. There is information about
Radiotherapy for prostate cancer that has spread
Radiotherapy can help to relieve symptoms of prostate cancer that has spread. It is particularly useful for helping to control bone pain. Radiotherapy to control symptoms is called palliative radiotherapy. You may find that you can cut down on painkillers after radiotherapy treatment to areas of cancer in the bones.
If you have external radiotherapy, you may have a single treatment or several daily treatments. The treatment is painless and only takes a few minutes each time. It takes up to 3 weeks to work.
There are usually few side effects. The main effects are tiredness and sore skin in the treatment area. Other effects depend on where in the body you are having treatment. You may feel sick if your abdomen is in the treatment area, for example if your ribs or backbone are treated. If you have a large area treated, you may have low blood counts for a while and be more prone than usual to picking up an infection.
Internal radiotherapy for prostate cancer that has spread uses an injection into the bloodstream of radioactive radium or strontium. Radium and strontium tend to collect in the bones. So these substances give off their radiation directly to the cancer cells. They give off radiation for a few days.
The amount of radiation you give off is extremely small. So it is perfectly safe for you to be with other people. The treatment can shrink bone tumours and relieve pain. It takes up to 3 weeks to do this. These treatments may also delay the development of new tumours in the bones. The pain relief usually lasts for several months. You may be able to have the treatment again after that if the pain comes back.
You can view and print the quick guides for all the pages in the Treating prostate cancer section.
Radiotherapy can help to control pain in prostate cancer that has spread to the bones. It can work very well. Radiotherapy to control symptoms is called palliative radiotherapy. Many men can reduce their dose of painkillers after this treatment. The radiotherapy shrinks the areas of cancer in the bones and so relieves pain. Cancer also makes bones more likely to break or crack. You may hear this called a pathological fracture. After radiotherapy treatment, bones can start to strengthen and fracture is less likely.
The treatment does not cure the cancer, but it can give pain relief for some time. How long the pain relief lasts depends on how quickly or slowly your cancer is growing. And it also depends on how well other treatments, such as hormone therapy or bisphosphonates, work for you.
There are two ways of having radiotherapy for secondary prostate cancer. They are external radiotherapy and internal radiotherapy. The type of internal radiotherapy used to treat prostate cancer that has spread is called radioisotope therapy.
A radiotherapy machine aims radiation beams directly at the painful areas. You may have a single treatment or several treatments (called fractions) over a number of days. The number of treatments you have depends on the radiotherapy dose you need and how well you are. If it is difficult for you to get to the hospital, then it is better to try to treat you in one go. There is detailed information about external radiotherapy in this section.
If your cancer is in several areas in your bones, you may be offered hemi body irradiation. This means treating up to half your body with the external radiotherapy. If you have cancer in bones above and below your waist your doctor is more likely to offer you internal radiotherapy.
The treatment can take up to 3 weeks to give maximum pain relief. You may notice results much sooner than that. You should notice gradually that your pain is easing. Your usual dose of painkillers may become too much and this could make you drowsy or give other side effects. You can discuss changing your dose of painkillers with your doctor or specialist nurse.
Most people have few side effects with palliative radiotherapy. The effects vary, depending on which part of your body is treated. They can include
- Reddening of the skin in the treatment area
- Tiredness for a week or two after the treatment
- Feeling or being sick
- Low levels of blood cells
You are only likely to feel or be sick if you have radiotherapy to your abdomen – for example, if your ribs or backbone are treated. Your doctor can prescribe anti sickness tablets for you to take before you go for your treatment.
Hemi body irradiation is much more likely to make you tired because a large area is treated. You may also be more prone to infection for a while. Your bone marrow can be affected by radiation. For a while, you will not make enough white blood cells, which you need to fight infection. Most people recover from this on their own. Some people need injections of drugs called granulocyte colony stimulating factors (GCSF). These are natural substances, which help white blood cells to grow.
If your prostate cancer has spread to bones in several areas of your body, you may be offered treatment with radium 223 (Xofigo) or strontium 89 (Metastron). These treatments are radioactive liquids that tend to collect in areas of cancer cells in the bones. They give off radiation for a few days. It kills some of the cancer cells. You have these treatments as an outpatient.
You usually have the treatments as an injection into the bloodstream through a small tube (cannula) put into a vein. The treatment finds its way to your bones and gives off its radiation directly to the cancer cells. You can go home after the treatment. It is perfectly safe for you to be with other people. Your blood and urine will contain a small amount of radiation, so be careful of any spills. You may be advised to flush the toilet a couple of times after passing urine.
There are two benefits to this type of treatment. The treatment shrinks the cancer in your bones and can delay the development of future bone tumours. The other benefit is that it helps to reduce bone pain. It takes up to 3 weeks for this to happen. The pain relief usually lasts for several months and you may be able to have the treatment again after that.
You may not be able to have this treatment if your bone marrow has been damaged by your cancer or by previous treatment.
You can contact the Cancer Research UK nurses for information. They will be happy to help. Or you can look at the prostate cancer organisations page for sources of help and information. Some organisations can give information about secondary bone cancer and radiotherapy. Or the organisations can put you in touch with cancer support groups where you can talk to other people who have been through similar experiences to your own.
If you want to find people to share experiences with online, you could use Cancer Chat, our online forum.
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