The irradiation procedure

After comprehensive preparation, the actual radiation treatment can begin. In percutaneous irradiation, the patient lies down on a couch which is located below the linear accelerator. The device rotates around the couch and emits the radiation.

The radiation that is emitted is about 1.8- 2.0 Gray. At the end of the treatment 74- 80 Gray should have been emitted. This means that the total dose is distributed, as a single exposure to the total dose would cause too much damage to the surrounding tissue.

In brachytherapy, radiation is provided by implanted radioactive sources. To introduce the sources into the tissue, an anaesthetic or local anaesthetic is necessary. For LDR brachytherapy, a catheter is first inserted into the bladder.

A contrast medium is then introduced so that the urethra can be seen on the ultrasound or X-ray image. This ensures that the urethra is not injured during the procedure. Tiny radioactive metal particles are then inserted into the prostate via fine hollow needles.

The hollow needles are then removed and after about a month a follow-up check is carried out. The procedure of HDR brachytherapy is similar. In this case, however, the radiation sources are not left in the tissue, but are removed immediately after radiation. In addition, the radiation source is much stronger than in LDR brachytherapy.

The duration of the irradiation

Depending on the stage of the tumour, you will be irradiated for seven to nine weeks. Irradiation takes place on weekdays, the weekend is used for tissue regeneration. The treatment plan can, however, be designed differently for each individual. The irradiation itself is very short, it lasts a few minutes.

How often do I have to go for irradiation?

Most patients are irradiated for seven to nine weeks and have to undergo radiation every day during the week. One can therefore expect 35 to 45 appointments for radiation. However, the dates of treatment can vary considerably from person to person, so it is advisable to discuss the details with your doctor.

Can you do it as an outpatient?

In the case of percutaneous radiotherapy and LDR brachytherapy, you can go home immediately after the treatment. HDR brachytherapy, on the other hand, requires a hospital stay of several days. Whether the treatment with radionuclides can be carried out on an outpatient basis depends on the medication. It is best to discuss this with your treating physician. .

The side effects of irradiation

The side effects caused by radiation can be divided into two categories: acute and long-term side effects. The acute side effects include skin irritation, which can lead to rashes and itching. Furthermore, the urethra or even the bladder can become inflamed.

The symptoms resemble an inflammation of the bladder. In addition, the intestinal mucosa can become inflamed, which can lead to diarrhoea. Long-term side effects of irradiation are incontinence, diarrhoea and impotence.

The urge to urinate is a known side effect of radiation. Irradiation causes the mucous membrane of the urethra and bladder to become inflamed. This inflammation is usually acute, but can become chronic and lead to a narrowing of the urethra.

In addition to the urge to urinate, symptoms such as pain and possibly blood in the urine can occur. Incontinence is also possible. Painkillers and in some cases antibiotics are used for treatment to prevent infection.

In addition, it is recommended to drink a lot in this case. Diarrhoea is also one of the more common side effects. Irradiation leads to an inflammation of the mucous membrane.

Consequently, diarrhoea, pain and possibly slight bleeding occur. Various drugs can be used for treatment. .