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Radiotherapy treatment for advanced prostate cancer

You might have radiotherapy for advanced prostate cancer. This might be external radiotherapy or radioactive liquid treatment (radium 223). 

Advanced cancer means cancer that can’t be cured. It might have come back after your original treatment or have spread to other areas of the body.

Treatment can often control the cancer and relieve symptoms. Your doctors and nurses will help you to make the most of life and feel as good as possible for as long as possible.

How radiotherapy helps

Radiotherapy for advanced prostate cancer is called palliative radiotherapy. It can work very well and might mean that you can reduce your dose of painkillers. Radiotherapy can be very helpful for cancer that has spread to the bone. 

There are two ways of having radiotherapy for advanced prostate cancer. They are external radiotherapy and radioactive liquid treatment (radium 223).

External radiotherapy

Before you can start external radiotherapy for advanced prostate cancer, your radiotherapy team need to plan your treatment. This means working out the dose of radiotherapy you need and exactly where you need it. Your planning appointment takes from 15 minutes to 2 hours. 

You usually have a planning CT scan in the radiotherapy department.

The scan shows the cancer and the area around it. You might have other types of scans or x-rays to help your treatment team plan your radiotherapy. The plan they create is just for you.

After your planning session, your radiographers and doctors create your radiotherapy plan. They make sure that the area of the cancer will receive a high dose and nearby areas receive a low dose. This reduces the side effects you might get during and after treatment. It can take a few days or up to 3 weeks before you start treatment.

Having external radiotherapy

During treatment, you lie on a radiotherapy couch and your radiographers get you in the correct position. You have radiotherapy to the areas that your cancer has spread to. You might have a single treatment (also called fraction), or a number of treatments for a few days.

Before each treatment session

Before each treatment session you may have to empty your bowel.

You may also have to drink a certain amount of water and wait before having the treatment. Your radiographers let you know if you have to do this.

During the treatment

You need to lie very still on your back. Your radiographers might take images (x-rays or scans) before your treatment to make sure that you're in the right position. The machine makes whirring and beeping sounds. You won’t feel anything when you have the treatment.

Your radiographers can see and hear you on a CCTV screen in the next room. They can talk to you over an intercom and might ask you to hold your breath or take shallow breaths at times. You can also talk to them through the intercom or raise your hand if you need to stop or if you're uncomfortable.

You won't be radioactive after external radiotherapy. It's safe to be around other people, including pregnant women and children.

Side effects of external radiotherapy

You might have a few side effects with palliative radiotherapy. The effects vary, depending on which part of your body is treated.

Radioactive liquid treatment

You might have liquid internal radiotherapy treatment if you have cancer in several areas of your bone. Radioactive liquid therapies (radio isotopes) include radium 223. You have radium 223 as an injection into a vein. The radium 223 circulates throughout the body. The areas of cancer cells in the bone take up the radioactive liquid and it destroys them. 

This type of treatment can help to control pain. It can also slow down the rate of growth of the cancer in the bones.

Travelling to radiotherapy appointments

Tell the radiotherapy department if you prefer treatment at a particular time of day. They can try to arrange this.

Car parking can be difficult at hospitals. It’s worth asking the radiotherapy unit staff:

  • if they can give you a hospital parking permit
  • about discounted parking rates
  • where you can get help with travel fares
  • for tips on free places to park nearby

If you have no other way to get to the hospital, the radiotherapy staff might be able to arrange hospital transport for you. But it might not always be at convenient times. To see if you're eligible they usually work it out based on your earnings or income.

Some hospitals have their own drivers or can arrange ambulances. Some charities offer hospital transport.

Information and help