Lanceford Chong: In general, the acute side effects from radiation therapy will involve the urinary tract system. This will include more frequent urination during the day and night, and how much more frequently a patient will urinate depends on a lot of different things. In general, the urinary frequency will be increased a mild amount to a moderate amount. Rarely do we see someone have significant increases in the frequency of urination.
The next thing is that they might develop a sense of urgency when the patient feels like they have to urinate. They’re going to go and urinate now because they really can't hold it well. Some patients develop burning when urination. This is usually mild, and only in the minority of patients. The second area of side effects deals with the rectal area. Patients may develop diarrhea, more frequent stools, loose stools, but generally this is not a major problem. The vast majority of patients do not have symptoms in this area. If they did develop it, it’s usually during the last couple of weeks of treatment, and if diarrhea were present, maybe once or twice a day.
In general, patients will not have any nausea or vomiting. They may develop some tiredness, but that would be towards the latter two to three weeks of treatment and it would not be debilitating. Blood counts are usually acceptable. The patients will not lose the hair on their head. In general, they do quite well. Now the treatment options in terms of fractionation for external beam radiation therapy are as follows. In general, intensity modulated radiation therapy is given one time per day five days per week, Monday through Friday, for upwards of 45 treatments. Another approach is stereotactic body radiation therapy. These patients are treated five times, one treatment essentially every other day, over a two week period of time. Now if i patient wishes to combine brachytherapy, so called internal radiation, with external beam radiation, we would generally give them intensity modulated radiation therapy for about a month, 25 fractions, one fraction per day, five days per week. And then after a couple of weeks, they would be brought into the hospital for the so called implantation of either live sources or catheters that will allow for internal radiation.