The prostate is a tiny organ surrounded by critical structures. When
radiation treatments deliver dose to any of these structures, it can
sometimes lead to problems such as erectile dysfunction and bladder or
rectal irritation.
"We always have to keep cure as our first priority, but quality of
life is a major secondary concern for men with prostate cancer," says
Patrick W. McLaughlin, M.D., professor of radiation oncology at the
University of Michigan Medical School.
"In the past cure came at a steep price in lost quality of life, but
with modern refinements it is increasingly possible to meet the new
standard of successful prostate cancer treatment: cure with quality of
life."
McLaughlin is the senior author of a paper published in Lancet Oncology
that looks at how MRI and a clear understanding of the functional
anatomy, and its variations from patient to patient, can allow radiation
oncologists to plan a course of treatment that spares these critical
structures.
The team started by defining the critical functions and structures that
run through or near the prostate. These include the nerves, vessels and
sphincters that control bladder function, erectile function and rectal
function. They also found that MRI was a critical tool for accurately outlining the
prostate anatomy and planning radiation therapy. They could easily and
precisely see the borders of the prostate on MRI. Images from CT are
much less clear, and it's common to overestimate the area that needs to
be treated. With a clear outline of the prostate and other critical
structures on MRI, radiation oncologists can precisely target treatment
to the prostate while avoiding these critical erectile tissues. The
technique is called vessel-sparing radiation.
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