Radiotherapy, or radiation therapy, is a cancer treatment that uses focused and targeted radiation (such as X-rays) to kill or damage cancer cells so they can’t grow or spread.

Radiation therapy can be delivered:

• from outside the body – using external beam radiation therapy
• inside the body – using brachytherapy.

Radiation Oncologists are the cancer specialists who oversees this treatment, and they work closely with Radiation Therapists in its delivery. Radiation Oncology Nurses will also be involved in your care.

Brachytherapy is a targeted, internal radiation therapy where the radiation source is placed inside the body. Giving radiation doses directly to the prostate can limit potential damage to nearby tissues and organs.

There are two forms of brachytherapy. At St Vincent’s, we offer permanent brachytherapy.

• Permanent brachytherapy – Radioactive seeds, about the size of a grain of rice, are put into the prostate under a general anaesthetic. Over the next 3 to 6 months the seeds slowly release radiation, killing prostate cancer cells, until they are no longer radioactive. Permanent brachytherapy is sometimes combined with a short course of external beam radiotherapy.
• Temporary brachytherapy – High doses of radiation are delivered through plastic tube applicators that are inserted into the prostate under a general anaesthetic. You may need to stay in hospital overnight if you are having multiple treatments. Temporary brachytherapy is given with a short course of external beam radiotherapy.

Depending on what type of brachytherapy you have, you will need to take some safety precautions after your treatment. Your health care professional can give you more information.

• Your body may give off radiation, although the levels gradually fall with time.
• You will need to take care around pregnant women and young children for a few weeks or months after the seeds are inserted. Your treatment team will explain this in more detail.
• You should use a condom during sex for the first few weeks after treatment, in case a seed comes out. However, this rarely happens.

Your planning appointment will last for one to one and half hours and will involve a computed tomography (CT) scan.

• Your dedicated team will explain the process to you. You will then have a CT scan in the simulation room, which will take around 30 minutes.
• The staff will make some markings on your skin to ensure you are positioned you accurately for treatment on each visit.

If your Radiation Oncologist plans to treat you using the MRI Linac, these steps will also happen:

• Your team will ask you to fill in an MRI safety questionnaire.
• You will be asked to change into a gown and remove any metal objects such as jewellery, hearing aids, glasses or dentures.
• You will have an MRI scan on the MRI Linac, lying on the couch in the same position as during treatment. This will take 15 minutes.

Your health care team will tell you what you need to do before treatment. Each treatment will take around 25 to 40 minutes.

For MR Linac treatments, before each treatment session:

• you will have a new MRI scan
• any changes in the size, shape or location of your cancer and internal organs (such as bowel) will be seen
• a new adapted and precise radiotherapy treatment plan will be created in real time to account for these changes.

During treatment:

• you will hear a ‘whirring’ sound when the radiation beam is turned on
• you will not feel or see the radiation being delivered
• you can talk to your healthcare team regularly through a two-way intercom system.

The loud noises you hear during an MRI will not last the whole time. If you like, you can choose specific music or podcasts to listen to during the treatment.

During your treatment course:

• your nurse will review you and talk you through the possible side effects you may experience and how best to manage these
• you will be given contact details for your care team so you can call if you’re worried about anything.

After your treatment has finished:

• your specialist will plan any further treatment you may require
• member of your care team will call to see how you are feeling and answer any questions you may have
• you will need to attend a follow-up appointment six to twelve weeks after your treatment, where your Radiation Oncologist will review your results.

Your MR-Linac team will continue to follow up on your recovery and wellbeing through appointments, phone calls and emails. You can contact them on 02 8302 5400.

Radiation therapy for prostate cancer may be recommended to provide:

• curative treatment for your prostate cancer
• treatment to other sites that your prostate cancer may have spread to.

Your health care team will advise you on whether radiotherapy is an appropriate treatment for your particular situation. Speak to them if you have any questions at all about this treatment option.