If you have received a prostate cancer diagnosis, you may be wondering which treatment options are available to you. Prostate cancer treatment options can include surgery, different types of radiation therapy and hormone therapy. Once your doctor identifies if your localized prostate cancer has a low risk, intermediate risk or high risk of the cancer spreading, they can determine the best treatment options for you. 

Stereotactic body radiation therapy (SBRT) is a radiation treatment that uses high doses of radiation with several beams of various intensities aimed at different angles to precisely target the tumor. This limits radiation exposure to healthy tissue and offers several benefits to patients undergoing prostate cancer treatment. To better understand SBRT, we spoke with radiation oncologist Karen Hoffman, M.D., who specializes in caring for patients with prostate cancer.

How is stereotactic body radiation therapy for prostate cancer different from other radiation therapies? 

Standard external beam radiation therapy for prostate cancer requires 20 to 28 treatments given over 4 to 6 weeks, whereas SBRT requires just five days of treatment. With fewer treatments, there is much less disruption to patients’ lives, especially for those who live far away.  

SBRT has been shown in clinical trials to be as effective in controlling prostate cancer as longer-duration radiation for patients with low- and intermediate-risk disease. Patients receiving SBRT for prostate cancer may initially experience more urinary symptoms, but long-term urinary and bowel function is similar to the function you would have after longer duration radiation treatment. 

With SBRT, we shorten the duration of treatment by giving larger amounts of radiation each day, using a more focused and precise radiation treatment. 

We are now treating patients with SBRT at several of MD Anderson’s Houston locations. This offers patients even more convenience during treatment.  

At our Texas Medical Center Campus, we treat patients with SBRT using MR-Linac radiation therapy. MR-Linac delivers precise high-dose radiation to patients inside an MRI machine. The machine constantly obtains images during treatment, providing high-resolution images of the tumor and control of the radiation beam in real time. 

This allows your care team to deliver high-dose radiation to tumors that can change shape or move during treatment. Our doctors can get information about not only the tumor but also normal surrounding tissue so they can modify and adapt your treatment plan daily if needed. This new technology keeps the radiation beam directly on target throughout treatment, providing even more precise treatment to protect normal tissues around it. 

What can prostate patients expect from a typical SBRT treatment plan? 

For prostate cancer, SBRT is an effective short course of radiation that can be given in just five treatments.  

Patients first meet with one of our physicians to verify they are a candidate for SBRT. Then, we do a planning appointment, a CT scan and an MRI scan to help map out where the radiation would go. You return one week later to start a typical SBRT treatment plan, which is five days of treatments delivered every other day.  

The most common early side effect is more frequent urination. Patients may also experience discomfort while urinating. These side effects can be managed with medication and typically go away after treatment. Most patients can maintain their usual activities during treatment.  

Many patients receive SBRT by itself. However, depending on your case, you might receive testosterone suppression with the radiation. You can eat and drink normally during treatment. When you undergo treatment, we typically ask you to have a full bladder and an empty rectum. 

What new research is being done for prostate cancer patients receiving SBRT?

As a leader in treating prostate cancers, MD Anderson has clinical trials for patients who have newly diagnosed, recurrent or progressive diseases. 

A recent prostate cancer randomized Phase III trial of stereotactic body radiotherapy in localized prostate cancer shows that five-fraction SBRT was non-inferior to control radiation therapy with respect to biochemical or clinical failure and is an effective treatment option for patients with low-to-intermediate-risk localized prostate cancer. Patients treated with SBRT reported more urinary side effects two years after treatment, but differences in urinary symptoms went away by five years.  

Given the convenience of SBRT for treating prostate cancer, ongoing clinical trials at MD Anderson are looking to expand patients eligible for this treatment. Hoffman is leading a national trial, the NRG GU013 trial, which is comparing prostate SBRT to traditional multi-week radiation for patients with high-risk prostate cancer.  

The PRORAD-5 clinical trial is testing SBRT for patients who need radiation treatment to the pelvic lymph nodes in addition to the prostate. The PRORAD-5 trial is led by Comron Hassanzadeh, M.D., and is only available at MD Anderson.  

What advice do you have for prostate cancer patients?

Patients with localized prostate cancer should discuss SBRT options with their care team to determine if they are a candidate for five-treatment radiation.

Choosing the right hospital may be the most important decision you make as a prostate cancer patient. At MD Anderson you will get care and support from the nation’s top-ranked cancer center. If you experience side effects, talk to your care team. We can help you come up with strategies to cope. From a dedicated prostate cancer support group to counseling to integrative medicine care, we have all the services needed to treat not just the disease, but the whole person.

Most importantly, look for a care team that makes you feel comfortable and is experienced to ensure you are getting the best treatment possible for the best possible outcome. 

Request an appointment at MD Anderson online or by calling 1-877-632-6789.