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Radiation therapy may be recommended instead of prostatectomy in certain situations.

If you do have surgery, and prostate-specific antigen, or PSA test, results indicate a rise in PSA levels after surgery or if the cancer has spread beyond the prostate, salvage radiation therapy may be used to eliminate remaining cancer cells. It is also used if cancer returns after treatments.

Our radiation oncologists use image-guided radiation therapy to treat men with prostate cancer. This type of therapy uses daily CT scans to target tumors with precise doses of radiation in less than two minutes—much faster than traditional types of radiation therapy.

As a result, the risk of damage to surrounding tissue is minimized. This is especially important in the treatment of the prostate, which shifts each day as the bladder, located next to the prostate, fills and empties.

Your urologist, working with your radiation oncologist, may inject a gel between the prostate and rectum. This gel protects the rectum from radiation injury. This procedure is performed with intravenous sedation or general anesthesia.

Your urologist may also place a pinhead-sized radiofrequency marker in the prostate. This allows your radiation oncologist to track your prostate throughout radiation treatment to ensure all treatments are precisely targeted. Side effects of image-guided radiation therapy tend to be minimal and may include mild fatigue and an increase in urination or bowel movements. Your doctors can help you manage these effects if they happen.

Your doctors may also determine that implanting radioactive seeds, or brachytherapy, offers the highest chance of success. This procedure is often combined with other forms of radiation and is performed by your radiation oncologist together with your urologist in a dedicated operating suite at Tisch Hospital.

We also offer stereotactic body radiation therapy, or SBRT, to treat prostate cancer. This minimally invasive treatment precisely delivers radiation beams that destroy cancer cells while sparing surrounding healthy tissue. SBRT requires far fewer treatments—7 on average—than other forms of radiation therapy, which may require more than 40.

Our doctors use multiple types of radiation equipment to deliver SBRT, including the technically sophisticated Varian Edge linear accelerator with Calypso radiofrequency guidance, at Tisch Hospital, and the CyberKnife system, at our CyberKnife Center locations in Mineola and Manhattan.

We have also added an MRI-linear accelerator (MR-LINAC) machine to our Department of Radiation Oncology. MR-LINAC combines high-resolution MRI and a photon linear accelerator to treat tumors more precisely than currently available radiograph-based techniques and provides real-time images that allow for stronger, more targeted therapy while preserving the surrounding tissue.

experienced fewer treatment sessions and faster recovery times.

For some men, doctors may recommend hormone therapy, such as androgen deprivation therapy, for 6 to 24 months after radiation therapy, depending on how aggressive the primary cancer is.