At Home Christian Jessen 2014 - 214

pROSTATE
CANCER
GUIdE

RAdIOThERApy

This treatment involves the use of very high
energy rays directed at the prostate gland.
Radiotherapy does not require anaesthesia.
The patient has an initial period of around three
months where they take medicines to deprive the
prostate tumour of the male hormones feeding it.
This plays an important role; it's been proven that
external beam radiotherapy following a course
of medical treatment achieves a much higher
successful outcome than radiotherapy alone.
This is now an internationally accepted practice.
Patients might find that their prostate moves
position due to respiration, and they may
experience varying degrees of bladder and
bowel fill. A scatter of radiation can cause
radiation toxicity to the bladder and rectum.
However, in order to safeguard against this, an
insertion of markers into the prostate can target
the treatment and focus the radiation beam.
Markers are now used routinely to achieve
a reduction in the incidence of radiation proctitis
(inflammation of the rectum lining) and cystitis
(inflammation of the bladder). Different types of
radiotherapy techniques include the following:
External beam therapy (IGRT with
IMRT): The patient is treated daily, five days

a week over a seven week period as an
out-patient attendance. No anaesthesia
is needed for this radiotherapy treatment.
CyberKnife: Patients with low risk prostate
cancer can be treated with a highly focused
beam of radiation using extreme accuracy
over a period of one week as an out-patient
attendance. No anaesthesia is needed for this.
Brachytherapy: Tiny radioactive seeds are
implanted directly into the prostate gland under
ultrasound control to irradiate and destroy
cancer cells. A single session as a day case
or a one-night hospital stay under general
or regional anaesthesia is needed for this.
high-Intensity Focused Ultrasound
(hIFU): Computer-guided, HIFU waves travel
from a rectal probe through the rectal wall
and are subsequently focused in the prostate.
This focusing beam of ultrasound emission
produces the intense heat and destroys the
tissue inside the targeted zone. A urethral
catheter is then inserted after the procedure
in order to aid urinary drainage during the
time the necrotic debris (dead tissue and cell
debris) is expelled. Treatment is carried out
under a spinal or general anaesthetic as
either a day case or a one-night stay.

'a caring team helped me to be relaxed'
Frank Kettle, 65, Buckinghamshire, chose to have brachytherapy
'I underwent a routine PSA test early 2013.
The results were at a level, which in itself,
would have been considered acceptable.
However, as there was a history of prostate
cancer within the family, consultant urological
surgeon, Mr Kaisary, recommended that
I have a biopsy. The biopsy was carried out
at the Platinum Medical Centre at Wellington
Hospital, north
west London.
'I was
counselled
in full with all
details of the
technique.
A caring team
helped me
to be very
relaxed and
comfortable
throughout.
Brachytherapy:
There were
Seeds in the
no side effects
prostate gland
and I was back

in work that afternoon. The results of the
biopsy proved positive. Mr Kaisary met
with myself and my family on no less than
three occasions, during which he explained
in great detail the next options available.
I did not feel any pressure to accept
a particular course of treatment.
'We then met Dr Katharine Pigott,
a consultant radiotherapist, who advised
us further on the process and options in
relation to the brachytherapy (pictured,
left). I proceeded with the brachytherapy
in June 2013 at Wellington Hospital. I was
admitted on a Friday morning, I underwent
brachytherapy at 9am, and was back in
my room for breakfast at 10:30am. I was
taken care of during my overnight stay at
the hospital and left the next morning.
'The post follow-up checks - initially every
three months with my specialists - were
reassuring, and I am well on the road to a
full recovery. Although I have experienced
certain side effects, on the whole these were
less severe than those I was advised about.'

'i requested to have
a prostate biopsy'
Stanley Roberts, 82, St John'
s
Wood, London chose to have
hIFU radiotherapy

'I'd had resection of the prostate
gland a few years back in 1994 and
the prostate chippings examined were
benign. I carried on with having my
PSA measured annually. By 2008, I
was 75 years old, fit and well but my
PSA reading went up so I went to see a
consultant urologist, who discovered
a tumour in my enlarging prostate.
'I requested to have prostate biopsy
and was diagnosed with a cancer
which was an active grade on the
Gleason scale (this tells you how
aggressive the cancer is).
'I debated the issue and was given
full information with regards to my
various options. HIFU treatment
appealed to me and I proceeded to
have it under general anaesthesia and
stayed in hospital for two days.
'I must admit that my various lifestyle
activities continued with no trouble
whatsoever. Today, I am 84 years old;
I lead an active life and travel with no
restrictions. I have my PSA regularly
checked by my family doctor every six
months and it continues to be on the
lower end of the scale. I am very
pleased with the choice I made.'

MEET ThE ExpERT

Mr Amir Kaisary is a consultant urological surgeon
at Wellington Hospital, north west London.
He created the one-stop prostate evaluation
clinic called the 'Prostate Laboratory', where
a full assessment of the prostate is conducted.
Mr Kaisary and Dr Katharine Pigott,
consultant oncologist, are an experienced
team offering management of prostate cancer
from diagnosis right up to delivery of various
treatment, and follow-up patient care.

FOR MORE INFORMATION
Contact Mr Amir Kaisary
on 020 7483 5262, email
amir.kaisary@btinternet.com or visit
www.thewellingtonhospital.com


http://www.thewellingtonhospital.com

Table of Contents for the Digital Edition of At Home Christian Jessen 2014

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