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So, you’re considering IMRT? You’re making a great choice with Dr. Rich Bevan-Thomas! He will guide you through the uncertainty and confusion of diagnosis and treatment planning and make sure you have a clear understanding of all of it.
Let’s begin at the beginning, shall we?
IMRT stands for intensity-modulated radiation therapy. But don’t worry — you won’t need to memorize that! We’ll just call it IMRT.
IMRT is a high-precision form of external-beam radiation. It works from a 3D CT-scan image that makes it possible for the radiation oncologist to see precisely where to aim the beams. Complicated computer algorithms then control the radiation doses.
This precision means that you will get higher doses exactly where they’re needed with less risk of damaging healthy tissue you’d like to keep, like the rectum or bladder. (You’re welcome!)
As an added buffer to minimize radiation irritation to the rectum, Dr. Rich Bevan-Thomas recommends and places SpaceOAR gel in the office. SpaceOAR is a hydrogel that creates a temporary space between the prostate and rectum and is a 10-minute procedure done in the office. The space gel will slowly dissolve over three to six months.
Another important component of IMRT is image-guided radiotherapy (IGRT). IGRT allows your treatment team to see daily changes to your prostate and make appropriate dosing or positioning adjustments in real time.
External-beam radiation therapy has a high cure rate for prostate cancer, but this always depends on the Gleason grade and stage of the cancer. Dr. Rich Bevan-Thomas partners with radiation oncologist Dr. Jerry Barker of Urology Partners of North Texas. Dr. Jerry Barker is not only the director of the Texas Cancer Specialists Center but also a partner at Urology Partners of North Texas. Dr. Barker has the experience to get patients excellent results.
Your treatment will be done by a team led by Dr. Barker at our partner center, Texas Cancer Specialists. Dr. B-T recommends an in-depth discussion with Dr. Barker about the duration and protocol of your treatment.
Receiving IMRT is more of a process than a procedure. You will have treatment five days a week, for anywhere between five and nine weeks. The duration depends on your cancer grade and stage and your PSA.
At each visit, you will lie down on the procedure table, then be guided into the machine. (Good news here — the equipment resembles an MRI, but it’s open on both ends. If you have claustrophobia, no worries!)
Now for the fascinating part. As you are lying still on the machine, instead of being adjusted for different views as you would for ordinary X-rays, the machine moves around you as it controls the location, size, direction, and shape of the beams.
The procedure is painless and routinely takes less than 10 minutes from start to finish.
Erectile dysfunction is always possible with prostate procedures, but IMRT has less risk for ED than earlier radiation techniques. The amount and extent of your radiation plan will depend upon the volume of your cancer and where it is located in your prostate. There is always the risk of ED.
Much of that will depend upon how the nerves respond to the inflammation and irritation caused by the radiation.
That will depend on the side effects you have. Many men can work, cook, and enjoy whatever they do for fun. Others are tired and need to rest more than usual. You can have sex if you want to, but you may feel too tired at first. Don’t be alarmed if you do — your sex drive should improve when your treatment is over and after the hormone deprivation therapy you were given wears off.