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For a long time, radical surgery of the prostate was considered the only successful treatment method for prostate cancer. In the meantime, however, there are ultramodern procedures from radiation therapy. The advantage is that radiotherapy is gentler on the tumor with the same cure rates; incontinence and impotence occur much less frequently than with surgery. As a pioneer in the field of brachytherapy (internal radiation), the West German Prostate Center (WPZ) has expanded its spectrum with one of the most modern radiation therapy facilities in Europe. On September 1, 2009, the radiation therapists of the WPZ, Dr. Gregor Spira and Dr. Carsten Weise opened a new large department in the oncological therapy center rechtsvomrhein in Cologne. On an area of 1000 sqm, in a new building flooded with light, patients are irradiated with the latest high-tech with pinpoint accuracy and safety.
Marksmanship in demand
"The more precisely the radiation hits the tumor in the prostate, the greater the success of the treatment," explains Dr. Spira. By optimizing the radiation dose to all parts of the prostate, the chance of cure can be optimized. At the same time, high radiation exposure of neighboring organs can be avoided, which leads to a reduction in undesirable side effects.
A prerequisite for high targeting accuracy of radiation therapy is therefore precise positioning of the patient under the radiation source. "Even if the patient is positioned very precisely every day, the position of the tumor can deviate by up to a few centimeters from the expected position due to internal movements," explains the radiation therapist. The prostate in particular can shift due to its position next to the colon and urinary bladder, depending on how full they are. Radiation can therefore only be optimally precise if the exact positioning of the tumor to be treated is checked again and again during treatment, says Dr. Spira.
Gold pins mark the tumor
The remedy is IGRT (image-guided radiotherapy), an image-guided radiotherapy. Before treatment begins, tiny gold marker seeds are implanted in the patient's prostate. Through the computed tomography scanner attached to the linear accelerator, it is then possible to use the marker seeds to visualize the prostate during radiation and track movements of the organ. "Positional deviations of the prostate are determined and immediately corrected. This ensures that the prostate and tumor are irradiated with millimeter precision," explains Dr. Weise.
However, the state-of-the-art linear accelerator of the new radiation therapy center can do even more: In the future, the facility will also enable irradiation with the innovative "Rapid Arc" technique, a further development of intensity-modulated radiation therapy (IMRT). The prostate is irradiated in a single 360-degree rotation of the irradiation head, which travels once around the patient in just two minutes. The shape of the irradiation field and the radiation dose constantly adjust to the shape and position of the tumor during treatment. "This enables an even more effective and at the same time gentle irradiation of our patients," Dr. Weise sums up.