The Departments of Radiation Oncology and Urology work together to provide patients with the most comprehensive multidisciplinary management of prostate cancer available. The most current and effective potency-preserving treatment approaches are provided in ultramodern settings where patient privacy and comfort are foremost.
There are two main types of radiation treatments, external and internal, that can be used based on the needs of the patient. External beam radiation is delivered using a linear accelerator that produces high energy x-ray or electron beams. Internal radiation or brachytherapy uses radioactive seeds placed within the prostate gland.
External Beam Radiotherapy
External beam radiation is the most common form of radiotherapy. It uses a linear accelerator to aim a beam of radiation at the prostate gland. Each treatment lasts a few minutes and is administered over a period of eight weeks, five days a week. There is no discomfort during the actual radiation treatment. Radiotherapy hardware, software, treatment planning and delivery methods have advanced dramatically in recent years. These advances allow us to more accurately target the prostate gland with higher doses of radiation, while minimizing damage to adjacent healthy tissue. NewYork-Presbyterian utilizes the following state-of-the-art treatment techniques during our external beam prostate treatments when required by the individual needs of each patient.
Intensity-Modulated Radiation Therapy (IMRT)
NewYork-Presbyterian Hospital uses IMRT technology, a special type of 3-D conformal external beam radiation, to treat many of our prostate cancer patients. IMRT greatly enhances the ability of our doctors to tailor the radiation dose to the each patient's individual anatomy, allowing higher doses of radiation to be targeted at the prostate gland while sparing nearby healthy tissue.
Image-Guided Radiation Therapy (IGRT)
Image-guided radiation therapy is a technology that allows our doctors to more precisely locate the exact location of the prostate gland within the body. They can use either X-ray or ultrasound based imaging devices just before treatment to verify that the patient is positioned correctly. If not, the computer will then determine the correct adjustment.
In this type of radiotherapy, a radioactive source is placed inside the prostate gland. In some cases, low-dose brachytherapy is delivered in the form of permanent radioactive "seeds" that deliver their therapeutic dose of radiation over days or months. In other cases, computer guided high dose rate brachytherapy is used to precisely deliver a highly radioactive source to the target area. After a few minutes the source is removed. No surgical incision is needed for either type.
Permanent seed implantation is one of the most effective options for many men in the early stage of the disease. Seeds are placed using ultrasound guided implantation techniques and deliver a dose of radiation to the prostate gland while sparing the normal surrounding tissues. These tiny seeds contain a radioactive material, such as Iodine-125, Cesium-131 or Palladium-103 and are permanently implanted in the prostate gland where they give off low-level radiation for days or months.
We also have the ability to use a sophisticated computer system called Real Time Treatment Planning. After each seed is placed, this system allows physicians to determine the best location to place subsequent seeds.
Another type of prostate brachytherapy is called high-dose-rate (HDR) brachytherapy. It uses computer guidance to precisely position a small, intensely radioactive source into the prostate gland at various sites. High doses of radiation can then be precisely delivered to all affected parts of the gland while sparing surrounding tissues. After treatment, the radioactive source is removed.