Reducing Complications With MRI-Guided Radiation in Prostate Cancer

“Prostate cancer is very curable with radiation,” radiation oncologist Dr. Matthew Solhjem, a radiation oncologist with Providence Cancer Institute and The Oregon Clinic, both in Portland, told CURE® as part of the “Speaking Out” video series.

Solhjem was speaking with CURE® about advancements in treating patients with prostate cancer by means of administering greater doses of radiation in fewer treatments via tactics such with MRI-guided stereotactic body radiation therapy (SBRT) and high dose rate (HDR) brachytherapy.

“[An] advancement that is at least very important with SBRT is the use of MRI-guided treatment,’ Solhjem said. “In terms of imaging the prostate gland, there’s MRI, there’s CT, there’s PET scan and ultrasound. And by far the best in terms of image quality and anatomical detail is MRI. Fortunately, Providence Cancer Institute purchased an MRI-guided treatment machine for our department so we can deliver this amazing treatment.

“Basically, patients come in every day [and] an MRI scan is taken. And we plan or replan the treatment every day to the unique anatomy on that day. The rectal wall is very visible, the bladder wall, the urethra. I think with the extreme accuracy of the MRI scan, we can deliver treatments much more accurately and spare the organs around the prostate gland better.”

That very detailed look at the patient’s anatomy, he explained, is advantage of MRI-guided SBRT over other forms of treatment.

“When we plan or replan the treatment every time ... how full the bladder is or how empty the bladder is can make a difference. Same with rectal contents. It’s a very customized treatment delivery for each treatment, so it takes a fair amount of time; patients are in the unit for an hour to an hour and a half or so,” he said. “But I think in the long run, the reduction in the radiation dose to the rectum and the bladder will lead to fewer complications and risks.”

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