External Beam Radiotherapy
Radiotherapy involves the use of various types of X-rays (radiation) to treat cancer.
External beam radiotherapy (EBRT) has been the traditional method of delivering the radiation. Short pulses of tightly focused beams of X-rays are delivered from outside the body into the prostate for a few minutes each day. Treatment continues five days a week for seven weeks. Conformal radiotherapy or IMRT, allows the X-rays to be directed very accurately to the prostate in three dimensions. EBRT has a track-record of success in “curing” cancers confined to the prostate that is very close to that of surgery or brachytherapy. The long term overall quality of life after EBRT has also been shown to be the same as for patients undergoing surgery or brachytherapy. It is quite common for doctors to recommend hormone therapy immediately before or after radiation as part of the total treatment. This is particularly true for patients who have Gleason 7-10 or a PSA over 10. In these situations, hormone therapy has been shown to improve cure rates.
From a patient’s perspective, the advantages of EBRT are that it is less intrusive and stressful than surgery, with no risk of infection. In general it is more suitable for older patients, particularly in those with other health problems that make the risk of surgery greater. The disadvantages are that time for treatment is much longer and may involve travel and accommodation problems, particularly for country patients.