Harvard Perspectives on Prostate Disease

Radiation therapy in the spotlight (Part 1 of 2)

What is it? Why so many variations?

Just saying the word "radiation" conjures up fears of cancer-causing agents and images of Hiroshima at the end of World War II. Adding the word "therapy" after "radiation" often fails to ease concerns. The fact that we can't see it, feel it, smell it, or taste it simply adds to its mystique. But radiation therapy has proven its ability to trump cancer and prolong the lives of millions of patients. And thanks to technological innovations in the last several years, radiation therapy more accurately targets — and more effectively treats — tumors than in decades past.

When physicians talk about radiation, they're referring to ionizing radiation, which is in the same part of the electromagnetic spectrum as x-rays and gamma rays. Radiation therapy devices deliver targeted doses of radiation to specific spots. It kills its "prey" by damaging the DNA in cancer cells. When the DNA is damaged, the cells can't replicate successfully and the cancer is halted.

Among the challenges for physicians and prostate cancer patients considering radiation therapy: which type is best? There are two broad categories of radiation therapy — external beam and brachytherapy. Within each category, there are various methods and devices to deliver the radiation. Many physicians have trouble sorting out the pros and cons of each; for an anxious patient with little medical knowledge, the task proves even more daunting.

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