For all the survival rate success taking place with prostate cancer treatment, quality of life hindrances — such as increased sexual dysfunction — leave something to be desired.
New research from the University of Michigan provides evidence that radiation therapy outcomes for these patients can be significantly improved if undertaken with the assistance of MR imaging.
The team, led by Dr. Patrick McLaughlin, professor of radiation oncology, treated 49 patients with aggressive prostate cancer using a combination of MR imaging, implanted radiated seeds and external beam radiation. The results, published in Lancet Oncology, show that after a minimum of five years since treatment, 92 percent of the patients reported they were still sexually active.
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Unlike other imaging modalities, MR can precisely image the borders of the prostate, said the researchers, making it a vital tool for outlining the individual patient's anatomy and planning radiation therapy. “On CT scans, the prostate merges with other tissues nearby and when physicians circle the ‘prostate’ on CT, it is commonly overestimated and treated to high dose,” McLaughlin told HCB News.
Sexual function isn't the only quality of life concern, there is also a need to reduce the possibility of bladder or rectal irritation — symptoms which can take different forms and plague many cured prostate cancer patients.
Avoiding sensitive areas such as nerves, vessels and sphincters that control bladder function, erectile function and rectal function, is the objective in improving quality of life outcomes. The researchers said oncologists can better target treatment using an MR guided technique called vessel-sparing radiation.
In the following video, Dr. McLaughlin highlights vessel-sparing radiation and how the procedure works.
For patients who have slow-growing, non-aggressive cancers, MR can confirm that there are no aggressive cancer cells present, said McLaughlin, and sometimes that means avoiding radiation exposure altogether.
Radiation oncologists and surgeons are continually conducting research to improve their understanding of the functional anatomy of the prostate so that one day patients will be able to finish treatment good-as-new.
“In the past, cure came at a steep price in lost quality of life,” said McLaughlin, “but with modern refinements it is increasingly possible to meet the new standard of successful prostate cancer treatment: cure with quality of life.”
