[약손+] Diagnosis and treatment of prostate cancer, which threatens men’s health ⑪Advantages and disadvantages of external radiation therapy for prostate cancer ::::: Article

Men and women differ not only in their body structures but also in the hormones they secrete and lifestyle habits, which results in differences in the high incidence of cancer. For men, there are representative male cancers that reduce the quality of life. It is ‘prostate cancer.’ Prostate cancer is known to be a common cancer in the West, but its incidence rate in Korea has been increasing recently. We will learn about how to treat and manage prostate cancer, which threatens men’s health, with Professor Kim Byeong-hoon, a urology specialist.

[윤윤선 MC]
Earlier, in addition to surgery, you also mentioned radiation therapy. These days, when looking at radiation therapy, there are various issues such as proton therapy and baryon therapy. Are they the same?

[김병훈 비뇨의학과 교수]
Both protons and baryons, which are hot issues these days, can be used in prostate cancer. However, you can think of this as an extension of existing external radiation therapy rather than a special new treatment.

First of all, radiation therapy can be used to treat localized prostate cancer when surgery is difficult due to advanced age or complications. It can also be performed as a treatment for residual cancer tissue after prostate surgery or in cases of locally advanced prostate cancer. It is also widely used in the treatment of prostate cancer in various situations to reduce pain when the cancer has spread throughout the body or when pain occurs.

When used as a local treatment, the advantages of radiation therapy are that it can be performed as an outpatient procedure without the need for hospitalization like surgery, there are no acute side effects related to surgery, and radiation can be administered in a slightly wider range than surgery.

However, there is a disadvantage of having to go back and forth to the hospital every day for a long time, about 6 to 8 weeks. There are no immediate side effects, but since normal tissues are exposed to radiation, various side effects such as cystitis, blood flow, proctitis, and bloody stool appear late over time.

The recent proton therapy and baryon therapy have been developed to overcome these shortcomings. Proton therapy uses protons that make up the nucleus of a hydrogen atom, and baryon therapy uses carbon.

X-rays, a conventional radiation therapy, can cause side effects elsewhere by irradiating all tissues through which the radiation first hits depending on the depth of the body, whereas protons and baryons do not have a significant effect on intermediate tissues, called Bragg peaks, and only affect the target area. Because it has physical properties that allow it to deliver high levels of radiation, its biggest advantage is that it only sends radiation to cancer and reduces side effects on normal tissue.

However, the downside is that it is expensive and there is a lack of clinical data. Especially in prostate cancer, the current guidelines do not say that proton and baryon therapy can replace existing radiation therapy.

(Composition Kim Jae-yoon)