Larry D. Grubb, MD
McLeod Radiation Oncologist
Prostate cancer is the most common cancer diagnosed in men in the nation. Nearly 191,930 new cases will be detected in the United States in 2020, according to the American Cancer Society. Prostate cancer is also the third leading cause of cancer deaths in men behind lung cancer and colorectal cancer. Fortunately, prostate cancer mortality rates have been decreasing since the mid-1990s in both African American and Caucasian men. This decrease is often attributed to our improved ability to detect and then treat the disease in its early stages.
Treatment for prostate cancer often involves surgery (a radical prostatectomy to remove the prostate) or radiation therapy.
As Radiation Oncologists, we treat prostate cancer using IMRT or intensity modulated radiotherapy, a special form of external-beam radiation therapy. With IMRT, we are able to precisely deliver the dose of radiation directly to the prostate, minimizing harm to the surrounding organs including the bladder, the rectum, the femoral heads and the small bowel. In addition, IMRT has been shown to be beneficial in reducing long-term side effects of prostate cancer.
Advancements in technology, treatment planning and imaging has also led to new innovations in radiation treatment such as hypofractionated radiation therapy for localized prostate cancer which we now offer at the McLeod Center for Cancer Treatment and Research.
Hypofractionated treatment involves delivering the radiation dose in larger, more powerful portions (fractions) over fewer treatment visits. It also offers the same survival and risk of toxicity as traditional radiation yet the amount of time a patient needs to undergo treatment is considerably shorter and the patient’s quality of life is not compromised.
Conventional treatment for prostate cancer with radiation involves 40 to 44 days of treatment or 25 days of treatment and a radioactive seed implant performed in an operating room. With hypofractionated treatment we can offer treatment in 20 to 28 days. This means a man would undergo five weeks of treatment as opposed to nine weeks.
At McLeod, we utilize three TrueBeam linear accelerators to deliver this form of treatment. Advantages of these linear accelerators include the degree of precision offered, the submillimeter accuracy which minimizes harm to healthy tissue and adjacent critical structures such as the spinal cord or lungs, and a platform that moves in six dimensions to position the patient in the best possible way for treatment.
Not only do these linear accelerators allow for improved images of the tumors and normal organs but they also offer faster treatment times. For example, using conventional linear accelerators it can take 15 to 20 minutes to treat men with prostate cancer, while the TrueBeams provide the capability to treat men within five minutes.
At McLeod, advanced treatment planning techniques allow for radiation treatment plans that conform exactly to targeted areas. This allows sparing of adjacent normal tissues which leads to fewer short and long-term side effects. Advanced imaging capabilities on the TrueBeam linear accelerators also allow for exact targeting of tumors by daily adjustments prior to each treatment. This precise targeting is accomplished through a variety of image guided radiotherapy techniques (IGRT).
There is no one treatment option that is better for all men. The most appropriate treatment for prostate cancer should be based on the man’s age, life expectancy, other medical problems, as well as the stage and aggressive nature of the cancer.
If you are diagnosed with prostate cancer have a thorough discussion with your physician on the treatment options available so you can decide together which one is best suited for you.
Dr. Larry D. Grubb has been caring for patients at the McLeod Center for Cancer Treatment and Research since 1992.