RADIOTHERAPY PROSTATE CANCER

ANATOMY

By: Don Concordio Bauzon

PHYSIOLOGY

&

ANATOMY & PHYSIOLOGY• A donut shaped gland about the size of a golf ball which is inferior to the urinary bladder and surrounds the prostatic urethra.

• The fluid from the prostate is clear and slightly acidic (pH level of 7.2-7.9).

ANATOMY & PHYSIOLOGY

LOBES OF PROSTATE:• Anterior lobe or Isthmus - corresponds to transition zone• Median lobe - corresponds to central zone• Posterior lobe - corresponds to peripheral zone• Lateral lobe - spans all zones

ANATOMY & PHYSIOLOGY

ANATOMY & PHYSIOLOGY

ZONES OF

PROSTATE

CANCER INCIDENC

E

TRANSITION ZONE

10–20%

CENTRAL ZONE

2.5%

PERIPHERAL ZONE

70–80%

ANATOMY & PHYSIOLOGY

GEMPESAW

CAUSES SYMPTO

MSINCIDENCE RISK

FACTORS

,,

&

•Frequent urination•Urgent feeling of urination•Difficulty in starting or stopping the urine flow •Anuria

•Bladder retention•dysuria•Hematuria•Painful ejaculation

SIGNS & SYMPTOMS

• is the most common cause of cancer death in men > 75 yrs. old

PROSTATE CANCER

rarely found in men < 40 yrs. old

People who are at higher risk include the following:

1. African- American men2. Men > 60 yrs. old3. Men who have a father or brother

with prostate cancer.

Excessive alcohol intake

OTHER PEOPLE AT RISK INCLUDES:

Farmers

High fat diet (especially animal fat)

Tire plant workers

Painters

Men who have been around cadmium.

• is less common with vegetarians

PROSTATE CANCER

Benign Prostatic Hyperplasia (BPH)- a common problem

- enlarged prostate as men ages.

Year: 2012 Males

Cases 26,500

Incidence Rate (per 100,000) 121

Incidence RankDeaths

1st

4,000

Death rate (per 100,000) 19

Death rank 3rd

5- year relative survival (2004-2006) 96%

PROSTATE CANCER STATISTICS AT A GLANCE (CANADA)

1.Digital rectal examination (DRE)2. Transrectal ultrasound (TRUS)+/-3. Pelvic CT scan and MR4. Nuclear Medicine5. Contrast Enhanced Ultrasound6. Computer- Aided Ultrasonography

OUTLINE THE MODALITIES USED:

1. Serum level of PSA

2. Biopsy:• Indications:

A. Palpable mass on DRE

B. Elevated PSAC. Both high PSA

& Palpable mass

OTHER PROCEDURES TO BE DONE FOR DIAGNOSIS:

Elastography

OTHER PROCEDURES TO BE DONE FOR DIAGNOSIS:

Bauson

DIAGNOSTICEXAMINATIONS

OTHER

• HORMONE THERAPY

help some type of cancer cell to grow such as: prostate cancer

as a cancer TX may involve taking medication.

may involve surgically removing the gland that is producing the hormones

DIAGNOSTIC EXAMINATION

• CHEMOTHERAPY may be used in combination with other treatment such as:

Radiation surgery

DIAGNOSTIC EXAMINATIONS

• RADICAL PROSTATECTOMYthe entire prostate gland and

some tissue around it are removed.

DIAGNOSTIC EXAMINATIONS

• LAPAROSCOPIC RADICAL PROSTATECTOMYuses a

laparoscope and special long, thin surgical tools.

DIAGNOSTIC EXAMINATIONS

• LAPAROSCOPIC RADICAL PROSTATECTOMY

DIAGNOSTIC EXAMINATIONS

• TURP TRANSURETHRAL RESECTION OF THE

PROSTATE

DIAGNOSTIC EXAMINATIONS

• CRYOSURGERY

DIAGNOSTIC EXAMINATION

STAGINGMag-aso, Zhernan Dave

•Stage I- very small ,inside the prostate

gland

• Inside the prostate gland, larger

•Cancer has broken, grown into the tubes which carry semen

•Metastases (bones,liver

or lungs)

• LYMPHATIC METASTASIS

TREATMENT

Noveno, Bianca Lorriane D.

Biancz :)

PLANNING

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Pre-techniques and Procedures

Post-techniques and Procedures

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Pre-techniques and Procedures

Tumor localization through:

1.Ultrasonography

2. Urethrogram

3. Lymphangiography

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Biancz :)

SimulationNote:•Color Red (target) – Prostate Gland•Color Light Blue – Urinary Bladder•Color Dark Blue – Rectum

Pre-techniques and Procedures

Biancz :)

Biancz :)

Biancz :)

Biancz :)

Biancz :)

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Materials and Aids in Treatment

•Orfit

•Styrofoam Mold

Lead Blocks

Biancz :)

TREATMENT

SENCIO, KREZA

FOUR FIELD TECHNIQUE

PORTALS AND FIELDS

•Superiorly, the fields extends from the acetabulum and •Laterally to include the two thirds of the obturator foramen•100% Isodose line

• Lateral borders in AP and PA fields are 1.5- 1.2 cm lateral to the pelvic brim

When regional lymph nodes are included:

Superior border level of midsacroiliac joints

Inferior border is usually 1-1.5cm inferior to the junction of membranous prostathic urethra

Posterior border of the lateral field

is commonly placed

at the S2-S3 interspace

DOSE

•A cumulative dose of 45-50 Gy is delivered over 5 to 5.5 weeks. •Total dose of 72 – 86 Gy •Approximately 20-30 Gy for boost field

•Typical prescribed dose: 50.40 Gy in 28 fractions•Boost field: 28. 80 Gy in 16 fractions•Total dose delivered: 70.20 Gy in 44 fractions

PROSTATE CANCERTREATMENT

AFTER

EFFECTS

Bladder inflammationDiarrheaSore skin in the genital areaLoss of pubic hair

Long term side effectsincontinenceImpotenceInfertility

Short term side effects