Dear Editors,
Prostate cancer is a major global health issue, being the most prevalent cancer in men. Recent developments in radiation therapy have enhanced treatment outcomes, enabling many men to achieve long-term survival. Nevertheless, the journey from diagnosis to becoming a survivor is intricate and multidimensional, requiring a thorough grasp of the illness, its therapy, and its repercussions.
Diagnosing prostate cancer typically requires a combination of clinical evaluation, imaging tests, and biopsy. Advances in imaging techniques, such as multiparametric magnetic resonance imaging and biomarkers, have significantly improved diagnostic accuracy. These tools allow medical professionals to identify patients with high-risk conditions and customize treatment accordingly.1
Once a treatment plan is established, patients often undergo radiotherapy as part of their cancer treatment regimen. Radiation therapy aims to target cancer cells in the prostate gland while minimizing damage to surrounding healthy tissue. The two primary forms of radiotherapy for prostate cancer are external beam radiation therapy and brachytherapy. External beam radiation therapy involves directing high-energy radiation beams from an external source to the prostate gland, whereas brachytherapy entails implanting radioactive seeds directly into the prostate gland.2 Both forms of radiotherapy have proven effective, with treatment choice depending on factors such as the patient’s age, cancer stage, and overall health.3
Radiotherapy plays a crucial role in treating prostate cancer due to its high effectiveness and minimal adverse reactions. Advances in radiation technology have enabled precise and tailored treatment delivery, reducing damage to adjacent tissues. Techniques like intensity-modulated radiation therapy and volumetric-modulated arc therapy have improved treatment outcomes, lowering the risk of rectal and urinary side effects.4
After completing radiotherapy, patients often experience various acute and long-term side effects. Immediate symptoms, such as fatigue and frequent urination, typically improve within a few weeks to months. However, managing late complications such as erectile dysfunction, urinary incontinence, and bowel dysfunction can be more challenging. These issues can significantly impact the quality of life, underscoring the importance of patient education and supportive measures. Patients are often provided with supportive care, including medication, therapy, and counseling, to manage these side effects. It is essential for patients to openly discuss any side effects with their healthcare providers, as early intervention can alleviate discomfort and improve overall well-being.5
Prostate cancer patients not only face the physical effects of treatment but also the emotional impact of their diagnosis. The fear of recurrence and uncertainty about the future can be overwhelming. It is crucial for medical professionals to focus on patient-centered care, addressing both the psychological and emotional needs of patients.
Managing prostate cancer during the survivorship phase is critical and requires a comprehensive approach. This includes ongoing monitoring for recurrence, evaluation for delayed adverse reactions, and providing supportive care. Survivorship refers to the experience of living through and overcoming cancer, with an emphasis on overall physical, emotional, social, and spiritual health.6 For many individuals, survivorship represents a new beginning, as they navigate recovery and ongoing care. Healthcare professionals should prioritize educating and empowering patients to make informed decisions about their treatment. Regular follow-up appointments with oncologists and urologists are essential for tracking progress and managing potential cancer recurrence. Additionally, survivors are encouraged to adopt healthy lifestyle practices, such as regular exercise, a balanced diet, and smoking cessation, to reduce the risk of cancer recurrence and enhance overall health.7
Radiotherapy has long been a cornerstone in the treatment of breast cancer, significantly reducing local recurrence rates and improving overall survival, particularly in patients with early-stage disease. The combination of radiotherapy with hormonotherapy, such as tamoxifen or aromatase inhibitors, has further enhanced treatment outcomes by targeting both the local tumor environment and systemic micrometastases.
When used together, radiotherapy and hormonotherapy complement each other through their different mechanisms of action. Radiotherapy induces DNA damage in cancer cells, leading to cell death, while hormonotherapy suppresses the hormonal signals that drive the growth of hormone-receptor-positive breast cancers. This combination has been shown to be particularly effective in reducing the risk of local recurrence in hormone-receptor-positive patients, with studies demonstrating improved disease-free survival and overall survival compared to either treatment alone.
However, radiotherapy remains a vital option for patients with hormone-receptor-negative tumors or those who cannot tolerate hormonotherapy due to contraindications or side effects. In these cases, radiotherapy alone is crucial for local disease control, preventing recurrence and improving survival outcomes.
For hormone-receptor-negative patients, radiotherapy remains effective in controlling local disease and reducing the risk of recurrence.
The decision to use radiotherapy with or without hormonotherapy should be individualized based on tumor biology, hormone receptor status, and the patient’s overall health and preferences. Personalized treatment plans that consider these factors are essential for optimizing outcomes and minimizing unnecessary treatment-related toxicities.
In summary, the process of diagnosing and treating prostate cancer patients receiving radiotherapy is complex and involves various aspects. As healthcare providers, it is important to focus on patient-centered care by addressing both physical and emotional needs. Continued research in diagnostic tools, treatments, and supportive care will enhance outcomes for prostate cancer patients. Patients should remain informed, actively involved in their medical care, and supported by a strong support system while facing the challenges of surviving cancer. As we advance in understanding and treating prostate cancer, we move closer to a future where survival is a real possibility for all who have battled this challenging disease.
Declarations
Acknowledgement
Special thanks to Dr. Nasrin Hosseinzad Manie for her insightful manuscript which this letter is merely on that manuscript.
Funding
None.
Conflict of interest
The author has no competing interests or conflicts to declare.
Authors’ contributions
RGS is the sole author of the manuscript.