prostate area

Posted by mtsenior @mtsenior, 6 days ago

Does the area/position (base,posterior,anterior) of the cancer on the prostate possibly affect decisions on radiation type/choice? For Example 1 or 2 positive biopsy cores on left base. All other benign.

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xahnegrey40 | @xahnegrey40 | 6 days ago

AI says:Yes, the location, size of the tumor, and Gleason score significantly affect the type, dose, and duration of External Beam Radiation Therapy (EBRT) for prostate cancer. These factors are critical in determining the risk group (low, intermediate, or high), which directs whether EBRT is combined with other treatments like androgen deprivation therapy (ADT) or a brachytherapy boost.
ScienceDirect.com
ScienceDirect.com
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Impact of Gleason Score (Aggressiveness)
High Gleason Score (8–10): Indicates aggressive, fast-growing cancer. Patients with high-grade tumors often require more intensive, combined treatment, such as EBRT combined with long-term Hormone Therapy (ADT) (18–28 months) to improve survival.
Low/Intermediate Gleason Score (≤7): Generally requires shorter or no hormonal therapy combined with radiation.
Dose Escalation: Higher Gleason scores are often treated with higher doses of radiation (78 Gy or higher) to ensure biochemical control.
European Urology
European Urology
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Impact of Tumor Size and Location (T-Stage)
Tumor Size/Volume: Larger tumor volumes and a maximum tumor diameter (MTD) > 24 mm are associated with higher risks of biochemical failure and metastasis. These cases are more likely to require the addition of a brachytherapy boost to the EBRT.
Location/Extension: If the tumor extends outside the prostate (Stage T3) or into the seminal vesicles, the treatment field must be expanded, increasing the total duration of the treatment plan to include pelvic lymph nodes.
Large Prostate Gland: A very large prostate gland can make it challenging to deliver SBRT safely, potentially leading to the use of conventional IMRT over a longer period or pre-treatment with ADT to shrink the gland.

brianjarvis | @brianjarvis | 6 days ago

No matter the localized prostate cancer you have, they’ll be administering the radiation to the entire prostate.

Depending on where the lesions are in your prostate, (based on the FLAME protocol) a boosted radiation dose can be administered where it’s needed, and less where it might not be needed. (My oldest brother recently had 28 IMRT sessions using the FLAME protocol, where at each session, three different Grays of radiation were administered, more Grays to areas of concern, thereby minimizing certain risks near areas of less concern.)

Also, if using radiation, caution should be taken to avoid radiation to the penile bulb, in order to avoid late ED issues.