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radioterapia en cáncer de próstata

Radiotherapy and prostate cancer

radioterapia_marbella In Spain, prostate cancer is the most frequent tumor diagnosed in men according to the cancer figures for the previous year. In Europe, it is estimated that prostate cancer causes up to 7% of cancer deaths in men.

 

Localized prostate cancer is radically treated with local therapy, generally surgery and / or radiation therapy, while advanced / metastatic prostate cancer is treated with hormone therapy, chemotherapy, and / or targeted therapies, requiring radiation therapy in some cases to alleviate symptoms or improve. local control.

Radiation therapy is an essential treatment for the multidisciplinary management of this tumor.

This treatment has been gaining importance over the years as it presents excellent disease control figures, comparable to surgical treatment1, with the advantage of being a non-invasive treatment.

The prevalence of prostate cancer reaches almost 60% in men> 80 years. In this more fragile population of patients, the ideal is to be able to count on a treatment that avoids the patient having to undergo surgery with the risks that this may entail.

 

 

Radiation therapy is given with curative intent:

  • In patients with localized tumor, either low, intermediate or high risk.
  • In higher risk patients. Association with hormonal treatment is required for not only local control but also systemic control of the disease.
  • In patients who after surgery have micro-disease or certain risk factors. The trend now in some of these patients is to actively monitor the possible recurrence / relapse of the disease, and if it occurs, treat the patient with early rescue radiotherapy 2,3

 

Radiation therapy to alleviate the symptoms of the disease

  • In those patients in whom the disease is more advanced, radiotherapy can improve the symptoms derived from the disease, such as pain.
  • Prostate cancer tends to have a predilection for bones, which is why metastases are usually located at the level of the bones of the spine and pelvis. Radiotherapy achieves an improvement in pain of up to 70%  4.
  • When dissemination is limited, radical intention treatment can also be performed at the affected site / locations.

 

In summary, radiotherapy treatment is a fundamental part that can be offered in the different stages of the disease and always with a high level of evidence.

 

HC radiation therapy in prostate cancer:

radioterapia_prostata

Improve survival figures:

  • The treatment of prostate cancer with tomotherapy achieves excellent control of the disease, reaching 5-year relapse-free survival rates of up to 98.9% without associating severe acute toxicity 5.
  • In patients at higher risk (high or very high risk) after treatment with tomotherapy together with hormonal therapy, a relapse-free survival at 5 years is observed between 91-99%. Furthermore, tolerance to treatment was good, with 10% or less of the patients presenting long-term moderate-severe genitourinary or gastrointestinal side effects  6.

 

Radiotherapy that follows the tumor

  • The prostate moves up to 12-15mm due to changes in the volume of the bladder or rectum (the organs next to it). Other more conventional radiotherapy systems do not detect this movement, with the risk of not treating the entire area well or of having to widen margins and therefore increase the volume that will receive radiotherapy.
  • Our radiotherapy has a tracking system known as Synchrony, capable of following the movement of the tumor in real time during each radiation session.
  • This is achieved after the placement of fiducials inside the prostate, which the system is capable of tracking and thus administering the treatment with high precision.
  • This precision is ideal for those extreme hypofractionation treatments (SBRT) that manage to eliminate the disease with less treatment sessions7,8.

 

Reference:

  1. Hamdy F.C, Donovan J.L, Lane J.A, et al. 10-Year Outcomes after Monitoring, Surgery, or Radiotherapy for Localized Prostate Cancer. N Engl J Med. 2016 Oct 13;375(15):1415-1424.
  2. Parker C.c, Clarke N.W, Cook A.D, et al.Timing of Radiotherapy after Radical Prostatectomy (RADICALS-RT): a randomized, controlled phase 3 trial. Lancet 2020.
  3. Kneebone a, Fraser-Browne C, Duchesne G, et al. Adjuvant radiotherapy versus early salvage radiotherapy following radical prostatectomy (TROG 08.03/ANZUP RAVES): a randomised, controlled, phase 3, non-inferiority trial. Lancet Oncol 2020; 21: 1331-40.
  4. Spencer K, Parrish R, Barton R, et al. Palliative Radiotherapy. BMJ 2018;360:k821
  5. Takakysagi Y, Kawamura H, Okamoto M. Long-term outcome of hypofractionated intensity-modulated radiotherapy using TomoTherapy for localized prostate cancer: A retrospective study. PLoS One. 2019 Feb 26;14(2):e 0211370.
  6. Tomita N, Soga N, Hayashi N, et al. High-dose radiotherapy with helical tomotherapy and long-term androgen deprivation therapy for prostate cancer: 5-year outcomes. J Cancer Res Clin Oncol. 2016 Jul;142(7):1609-19.
  7. Meier, R., Beckman, A., Henning, G., Mohideen, N., Woodhouse, S. A., Cotrutz, C. & Kaplan, I. D. (2016). Five-Year Outcomes From a Multicenter Trial of Stereotactic Body Radiation Therapy for Low- and Intermediate-Risk Prostate Cancer. Int J Radiat Oncol Biol Phys, 96(2), S33-S34.
  8. Kishan, A. U., Katz, A. J., Mantz, C., Chu, F.-I., Appelbaum, L., Loblaw, A., Cheung, P., Kaplan, I. D., Fuller, D. B., Pham, H. T., Meier, R., Buyyounouski, M. K., Shaverdian, N., Dang, A., Yuan, Y., Bagshaw, H., Prionas, N., Kupelian, P., Steinberg, M. L. & King, C. R. (2018). Long-term outcomes of stereotactic body radiotherapy for low- and intermediate-risk prostate adenocarcinoma: A multi-institutional consortium study. Journal of Clinical Oncology, 36(6_suppl), 84-84.

 
 
Dra. Paula Sedano
Dr. Paula Sedano Ferreras
Radiotherapy doctor
 

luxación hombro anterior

Shoulder dislocation

Shoulder anatomy and dislocation

The shoulder is the most mobile joint in our body. It consists of a ball known as the humeral head and a socket known as the glenoid. The high mobility of the shoulder requires a very shallow socket (glenoid). Around the socket there is a bumper (cartilage rim) called labrum which, together with a series of ligaments connecting the ball to the socket, prevent the ball slipping out of joint. These are called static stabilisers of the shoulder joint. On top of these structures there are four muscles called the rotator cuff connecting the scapula (shoulder blade) with the humerus (arm bone) and dynamically stabilising the shoulder when they contract. When the shoulder dislocates the traumatic force overcomes the blocking effect of the stabilisers and the labrum and ligaments can tear if the patient is young. Sometimes the rotator cuff muscles can tear if you are over 40 years of age. The shoulder can dislocate anteriorly (more common) or posteriorly. Shoulder dislocation is an emergency and requires urgent relocation under anaesthesia followed by a sling for 2 weeks and physiotherapy. A clinical examination by a specialised shoulder surgeon is recommended for active patients involved in sports activity.

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Inmunoterapia en HC Marbella

Oncology. #Genetic and Hereditary Cancer

 
 

Our genes may increase the risk of developing certain types of cancer, such as breast, ovary, colorectal, and prostate cancers. If you have any relatives who have been diagnosed with cancer, the oncologists at HC Marbella, experts in genetics, can help you learn more about the risk of developing a determined cancer. At HC we offer you a genetic assessment with specific genetic tests for different types of cancer, in order to help you make important decisions.

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Melanoma

ABCDE des Melanoms

Die frühzeitige Erkennung des Melanoms ist ausschlaggebend, um eine günstige Prognose sicherzustellen.

 

Die Identifizierung und Entfernung des Melanoms in frühen Stadien stellen eine gute Prognose des Patienten sicher, aber bedürfen einer regelmässigen Nachbehandlung und minuziöser Untersuchungen. Tatsache ist, dass die Überlebensrate im Falle von nicht-invasiven Melanomen bei 90-95% liegt. Bei infiltrierten Formen jedoch, liegt die Sterblichkeitsrate hoch und die Überlebensrate liegt unter 20%, wenn das Melanom sich auf andere Organe ausgebreitet hat.

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Tel.: +34 952 908 628

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