Radiation Safety, Brachytherapy & Proton Therapy for the treatment of Prostate Cancer
Radiation Therapy - Prostate Cancer
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Transcript of Radiation Therapy - Prostate Cancer
RADIOTHERAPY PROSTATE CANCER
ANATOMY
By: Don Concordio Bauzon
PHYSIOLOGY
&
ANATOMY & PHYSIOLOGY• A donut shaped gland about the size of a golf ball which is inferior to the urinary bladder and surrounds the prostatic urethra.
• The fluid from the prostate is clear and slightly acidic (pH level of 7.2-7.9).
ANATOMY & PHYSIOLOGY
LOBES OF PROSTATE:• Anterior lobe or Isthmus - corresponds to transition zone• Median lobe - corresponds to central zone• Posterior lobe - corresponds to peripheral zone• Lateral lobe - spans all zones
ANATOMY & PHYSIOLOGY
ANATOMY & PHYSIOLOGY
ZONES OF
PROSTATE
CANCER INCIDENC
E
TRANSITION ZONE
10–20%
CENTRAL ZONE
2.5%
PERIPHERAL ZONE
70–80%
ANATOMY & PHYSIOLOGY
GEMPESAW
CAUSES SYMPTO
MSINCIDENCE RISK
FACTORS
,,
&
•Frequent urination•Urgent feeling of urination•Difficulty in starting or stopping the urine flow •Anuria
•Bladder retention•dysuria•Hematuria•Painful ejaculation
SIGNS & SYMPTOMS
• is the most common cause of cancer death in men > 75 yrs. old
PROSTATE CANCER
rarely found in men < 40 yrs. old
People who are at higher risk include the following:
1. African- American men2. Men > 60 yrs. old3. Men who have a father or brother
with prostate cancer.
Excessive alcohol intake
OTHER PEOPLE AT RISK INCLUDES:
Farmers
High fat diet (especially animal fat)
Tire plant workers
Painters
Men who have been around cadmium.
• is less common with vegetarians
PROSTATE CANCER
Benign Prostatic Hyperplasia (BPH)- a common problem
- enlarged prostate as men ages.
Year: 2012 Males
Cases 26,500
Incidence Rate (per 100,000) 121
Incidence RankDeaths
1st
4,000
Death rate (per 100,000) 19
Death rank 3rd
5- year relative survival (2004-2006) 96%
PROSTATE CANCER STATISTICS AT A GLANCE (CANADA)
1.Digital rectal examination (DRE)2. Transrectal ultrasound (TRUS)+/-3. Pelvic CT scan and MR4. Nuclear Medicine5. Contrast Enhanced Ultrasound6. Computer- Aided Ultrasonography
OUTLINE THE MODALITIES USED:
1. Serum level of PSA
2. Biopsy:• Indications:
A. Palpable mass on DRE
B. Elevated PSAC. Both high PSA
& Palpable mass
OTHER PROCEDURES TO BE DONE FOR DIAGNOSIS:
Elastography
OTHER PROCEDURES TO BE DONE FOR DIAGNOSIS:
Bauson
DIAGNOSTICEXAMINATIONS
OTHER
• HORMONE THERAPY
help some type of cancer cell to grow such as: prostate cancer
as a cancer TX may involve taking medication.
may involve surgically removing the gland that is producing the hormones
DIAGNOSTIC EXAMINATION
• CHEMOTHERAPY may be used in combination with other treatment such as:
Radiation surgery
DIAGNOSTIC EXAMINATIONS
• RADICAL PROSTATECTOMYthe entire prostate gland and
some tissue around it are removed.
DIAGNOSTIC EXAMINATIONS
• LAPAROSCOPIC RADICAL PROSTATECTOMYuses a
laparoscope and special long, thin surgical tools.
DIAGNOSTIC EXAMINATIONS
• LAPAROSCOPIC RADICAL PROSTATECTOMY
DIAGNOSTIC EXAMINATIONS
• TURP TRANSURETHRAL RESECTION OF THE
PROSTATE
DIAGNOSTIC EXAMINATIONS
• CRYOSURGERY
DIAGNOSTIC EXAMINATION
STAGINGMag-aso, Zhernan Dave
•Stage I- very small ,inside the prostate
gland
• Inside the prostate gland, larger
•Cancer has broken, grown into the tubes which carry semen
•Metastases (bones,liver
or lungs)
• LYMPHATIC METASTASIS
TREATMENT
Noveno, Bianca Lorriane D.
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PLANNING
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Pre-techniques and Procedures
Post-techniques and Procedures
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Pre-techniques and Procedures
Tumor localization through:
1.Ultrasonography
2. Urethrogram
3. Lymphangiography
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SimulationNote:•Color Red (target) – Prostate Gland•Color Light Blue – Urinary Bladder•Color Dark Blue – Rectum
Pre-techniques and Procedures
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Materials and Aids in Treatment
•Orfit
•Styrofoam Mold
Lead Blocks
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TREATMENT
SENCIO, KREZA
FOUR FIELD TECHNIQUE
PORTALS AND FIELDS
•Superiorly, the fields extends from the acetabulum and •Laterally to include the two thirds of the obturator foramen•100% Isodose line
• Lateral borders in AP and PA fields are 1.5- 1.2 cm lateral to the pelvic brim
When regional lymph nodes are included:
Superior border level of midsacroiliac joints
Inferior border is usually 1-1.5cm inferior to the junction of membranous prostathic urethra
Posterior border of the lateral field
is commonly placed
at the S2-S3 interspace
DOSE
•A cumulative dose of 45-50 Gy is delivered over 5 to 5.5 weeks. •Total dose of 72 – 86 Gy •Approximately 20-30 Gy for boost field
•Typical prescribed dose: 50.40 Gy in 28 fractions•Boost field: 28. 80 Gy in 16 fractions•Total dose delivered: 70.20 Gy in 44 fractions
PROSTATE CANCERTREATMENT
AFTER
EFFECTS
Bladder inflammationDiarrheaSore skin in the genital areaLoss of pubic hair
Long term side effectsincontinenceImpotenceInfertility
Short term side effects