Jefferson University Hospitals

Adam P. Dicker, MD, earned his undergraduate degree from Columbia College, New York, his PhD in molecular pharmacology from Weill Graduate School of Medical Sciences of Cornell University and his MD from Weill Medical College of Cornell University. He completed his residency in radiation oncology at Memorial Sloan-Kettering Cancer Center. Dr. Dicker has conducted extensive research on prostate cancer therapies, is the author of Basic and Advanced Techniques in Prostate Brachytherapy, and is the only radiation oncologist on the Investigational Drug Steering Committee of the National Cancer Institute’s Cancer Therapy Evaluation Program. Here, Dr. Dicker answers a patient’s question about treatment options for prostate cancer.

Question: I’m a 65-year-old male recently diagnosed with early prostate cancer. I’m considering various types of radiation therapy – internal or external, involving either photons or protons. Which is best for me?

Answer: The field of radiation oncology has had significant technological advances over the past decade. Today, photons (x-rays) can be targeted at cancerous tissues in the prostate either externally or internally (see box below). Your urologist and radiation oncologist can advise you about which approach is right for you and potential side effects.

A newer form of radiation therapy involves protons (subatomic particles) rather than photons. There is no evidence that proton therapy is more effective than photon therapy. Currently, proton therapy treatment delivery technology is not as advanced as that for photon therapy (IMRT). Whether protons will result in fewer side effects remains to be seen. Jefferson’s radiation therapy takes place through our Department of Radiation Oncology at Jefferson’s Kimmel Cancer Center and Jefferson Hospital for Neuroscience in Center City, the Radiation Oncology Pavilion at Jefferson’s Methodist Hospital in South Philadelphia, Jefferson-Frankford Hospital Radiation Oncology, and Jefferson Radiation Oncology Center at Riddle Memorial Hospital. The department has a state-of-the-art system of image-based planning and treatment delivery, and offers clinical research trial participation to many patients.

Two leading radiation therapy options for prostate cancer available at Jefferson are:

• Intensity-Modulated Radiation Therapy (IMRT) – an advanced type of of high-precision external delivery of photon radiation. IMRT maximizes the radiation delivered to the tumor and minimizes the amount that impacts surrounding normal tissue.
• Brachytherapy (radioactive seed implant) – places small radioactive seeds directly inside the prostate, effectively delivering high doses of radiation directly to the tumor “from the inside-out,” with little harm to the normal tissue around the prostate.