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Radiation therapy uses a beam of high-energy rays or particles
to destroy cancer cells.
There are several ways to apply radiation therapy. The most
common way is to deliver a carefully focused beam of radiation from a
machine outside the body. This is known as external beam radiation.
External beam radiation therapy usually involves having treatments 5
days a week for a period of 6 weeks or so.
Another way to deliver radiation is called brachytherapy. In
this method, hollow needles are first placed into the penis in the
operating room. Then tiny pellets of radioactive materials are put into
the needles to treat the tumor (this is known as internal radiation or
interstitial radiation). The pellets are kept in place for 2 to 4 days
while they release their radiation. After the treatment is over, the
needles are removed. Another type of brachytherapy involves putting the
radiation source close to the tumor. This is called plesiobrachytherapy.
In this method, a plastic cylinder is placed around the penis and then
another cylinder with radiation source is placed on top of the first
cylinder. Another way to do this puts the radioactive material into
catheters attached to a plastic mold of the penis.
The main drawback of radiation therapy is that it can destroy
or damage nearby healthy tissue along with the cancerous cells. Many
people experience side effects such as swelling, redness, and
sensitivity. The skin in the treated area may have patches that are
oozing and tender. For some, the skin may even peel. For a while, you
may feel a burning sensation when you urinate. Patients treated with
brachytherapy will find their side effects to be at their worst 1 to 2
weeks after the treatment is finished. If external beam radiation is
used, the side effects occur during treatment and then improve after
radiation is stopped. Most symptoms go away in 1 to 2 months. Over
time, men treated with radiation may notice the skin of the penis has
become darker or less elastic. Tiny web-like blood vessels (called telangiectasia) may
be visible. Some more serious side effects that can occur include:
- destroying some of the skin or tissue at the end of the
penis (necrosis)
- problems urinating due to narrowing of the urethra
(stenosis) from scar tissue
- abnormal healing resulting in a fistula (abnormal
connection) between the urethra and skin
In many cases, the function and appearance of the penis
gradually return to normal in the months and years after radiation
therapy. In cases where the tumor has not penetrated beyond the glans,
radiation is directed only at the tip of the organ, so the ability to
achieve erections should not be affected.
As an alternative to surgery, groin and pelvic lymph nodes may
be treated with radiation. Possible side effects of pelvic area and
groin lymph node radiation include tiredness, nausea, or diarrhea.
Radiation therapy to the groin and pelvis may be done after lymph node
removal to reduce the risk of penile cancer coming back
Radiation therapy may be used as an alternative to surgery to
treat some penile cancers. Circumcision often needs to be done before
radiation starts. This treatment can help some men avoid partial or
total penectomy.
Last Medical Review: 07/11/2008
Last Revised: 05/13/2009
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