Prostate Cancer RT Late Effects Flashcards
1
Q
What are acute urinary toxicities associated with prostate treatment?
A
- Frequency
- Urgency
- Dysuria
- Reduced flow
- Nocturia
(above are obstructive and impact the urethra through the prostate) - Rarer = urinary retention, incontinence and haematuria
2
Q
What is tamsulosin used for?
A
- Used for obstructive symptoms
- Alpha blocker, relaxes smooth muscle at the prostate.
- One per day, works for 12 hours
- Not for people with low blood pressure or on medication for low blood pressure
3
Q
What is solifenacin?
A
- Calm bladder down
- Treat irritative symptoms
- Must be certain that patient is experiencing retention
- Not for people with glaucoma
4
Q
What are typical bowel symptoms?
A
- Frequency
- Urgency
- Loose stools/diarrhoea
- Passing mucous
- Bleeding/inflamed piles
- Tenesmus
- Increased flatulence
5
Q
How to manage bowel symptoms?
A
- Dietary advice, dependent on symptoms
- Water intake, should always be high
- Fybogel = bowel regulator
- Loperamide if diarrhoea gets very severe
- Gas, slow eating, no fizzy drinks
- Bleeding/pain/piles: proctosedyl ointment
6
Q
What are some other acute symptoms?
A
- Pubic hair loss
- Fatigue: lifestyle, exercise, sleep, holistic care
- Change in sexual experience, erection or libido, dry ejaculation
- Skin soreness, hydrocortisone
7
Q
What are some late effects of radiotherapy to the prostate?
A
- Pelvic radiation disease (PRDA)
- Occur months or years after radiotherapy
- As acute
- Bladder shrinkage = more frequent urination
- Urethral stricture
- Rectal pain
- Intolerance or sensitivity to food or drink
- In small numbers, perforation, fistula, bowel obstruction
- Erectile dysfuntion
- Infertility
- Hip bone problems (rare)
- Development of other cancers, around a decade later
8
Q
What are preventions of late effects?
A
- Prehabilitation, lifestyle changes, smoking etc
- Evolving techniqes, VMAT, IMRT, IGRT
- Bowel and bladder protocols
- Spacers
- Optimisation of urinary function prior to XRT
- Future biological markers
