Treatment Techniques

Only the latest treatment techniques and verification are offered at our treatment centres. A/Prof Andrew Kneebone and A/Prof Tom Eade are happy to discuss the appropriate treatment regime with patients, as treatments are tailored to each patient to ensure the best possible outcome.

Intensity Modulated Radiation Therapy / Intensity Modulated Arc Therapy

Intensity Modulated Radiation Therapy (IMRT) and Intensity Modulated Arc Therapy (IMAT) are advanced methods of radiation delivery available for prostate cancer and both are available at our four treatment centres.

IMRT and IMAT utilise advanced computer technology to create a varying strength (modulated) beam that is delivered using multi-direction beams or continuous arcs. This technique enables radiation dose to be conformed precisely to the prostate cancer treatment area, reducing the dose received by surrounding healthy tissue.

Intensity Modulated Arc Therapy (IMAT) results in a quicker daily treatment time for patients by using arcs to deliver dose rather, than conventional radiation therapy beams. These advanced treatment techniques treat significantly less healthy tissue than conventional Radiation Therapy techniques ( a highly important factor when so many sensitive organs are located in close proximity to the prostate).

Image Guided Radiation Therapy (IGRT)

There are several techniques that A/Prof Andrew Kneebone and A/Prof Tom Eade can use to pinpoint your treatment, ensuring that the Radiation Therapy treatment is targeting the cancerous cells, whilst avoiding healthy tissue.

Cone-Beam Computed Tomography

Cone-Beam Computed Tomography (CBCT) involves taking a CT scan whilst you are setup and awaiting treatment. The Radiation Oncology team will review the scan in real time, checking that soft tissues of the prostate cancer region match appropriately. Your prostate planning volume can be overlayed onto the CBCT to show where the dose will be delivered, ensuring that the Prostate cancer area is treated as intended in the initial plan. Once the Radiation Oncology team is happy with the CBCT setup they will make any necessary adjustments to within 1mm and proceed with treatment. This technique is advantageous in showing both internal tissues and external contour changes that may have occurred, and can potentially impact on treatment accuracy.

Cone beam scan

Cone beam scans reveal whether your bladder and rectum are the right size throughout treatment.

 

Fiducial Markers

Fiducial Markers are small gold pellets, highly visible on a CBCT or X-Ray which are inserted directly into the Prostate prior to the planning process. Three markers are typically inserted using ultrasound guidance to place and adequately space each marker within the prostate. These markers are then used to align the planned treatment area to the prostate cancer on a daily basis. Being directly in the prostate these markers can be used to easily track any movement that may occur within the treatment area more accurately.

Hydrogel

Hydrogel is a highly advanced treatment aid consisting of a specialised compound that is inserted between the prostate and the rectum prior to simulation and planning. It is inserted using ultrasonic guidance to appropriately place the Hydrogel between the prostate and rectum.

This additional compound spacer between the prostate and rectum limits the Radiation Dose that is received to the rectum whilst allowing maximum dose to the prostate cancer. Hydrogel is viewable on MRI and is clearly different from regular tissue for the planning process. Notable dose reductions have been achieved by staff whilst using Hydrogel.

Once treatment is completed, the compound will break down naturally over a period of months within the body and ‘dissolve’ into surrounding tissues.

Hydrogel insertion image

Hydrogel insertion

Stereotactic Body Radiotherapy (SBRT)

A/Prof’s Eade and Kneebone are among the first physicians in Australia to pioneer the use of stereotactic radiosurgery techniques for the treatment of prostate cancer and as such, they remain two of the most experienced doctors in the country.

SBRT consists of a much shorter course of radiotherapy than the standard form of radiation therapy (called EBRT). It’s only 5 treatment sessions compared to 40 for EBRT, which is achieved because it is much more targeted. Greater targeting (and accuracy) therefore means that higher doses can be delivered over a shorter period of time.

To ensure such accurate targeting, a technique called real time image-guidance is available on the TrueBeam where 3 implanted gold seed markers in the prostate are monitored continuously during treatment. This image-guidance is used alongside an ‘intensity modulated beam’ that is shaped to fit around the prostate gland as the machine rotates around the patient. The continual motion of the radiation beam is called RapidArc.

It’s the combination of the state-of-the art image-guidance and RapidArc movement that allows the delivery of higher radiotherapy doses.

This increased accuracy not only means better cure rates, but less normal tissue is damaged resulting in fewer side effects.

Click here for more information about treating Prostate Cancer using SBRT SBRT for Prostate