Use of Radiation in Treating Prostate Cancer
In this episode. Dr. Issra Rashed leads a discussion focusing on prostate cancer, and the treatment options available.
Featured Speaker:
Issra Rashed, MD
Dr. Rashed is a radiation oncologist at the Riverside Cancer Institute. She completed her doctor of medicine and radiation oncology residency at Loyola University in Chicago. Transcription:
Use of Radiation in Treating Prostate Cancer
Gabby: Welcome back to Conversations on Cancer, brought to you by the Riverside Cancer Institute. Today I'm joined by Dr. Issra Rashed, the radiation oncologist here at the Riverside Cancer Institute to talk about prostate cancer and available treatment options at the Riverside Cancer Institute. Thanks so much for coming on the podcast today, Dr. Rashed.
Dr. Issra Rashed: Oh, I'm very happy to Thank you so much, Gabby, for having.
Gabby: So my first question is, what is prostate cancer?
Dr. Issra Rashed: So the prostate itself is a gland, that's only in men. it's involved in semen production and storage. Sometimes this gland can develop cells within it that grow uncontrollably, which can become cancerous. Those cells can then leave the prostate gland and go to other parts of the body, which is what makes it cancer.
Gabby: Are there any risks, risk factors associated with prostate cancer that might make someone more likely, to get prostate cancer than someone else?
Dr. Issra Rashed: There are definitely some risk factors, but I think a lot of patients who come in with cancer don't always have these risk factors. The ones that we do look out for is increasing age. As men get older, they're more likely to get a prostate cancer. genetics also plays a role because we know that having a family history of prostate cancer is also associated with a higher risk of getting it. There's very rare but sometimes seen mutations in germline cells that lead patients to get cancers as well. These are sometimes passed from mom and dad down to kids, and in families as well, between aunts, cousins and that kind of thing. and so those are some also risk factors that we can see.
Gabby: So unfortunately, it sounds like a lot of things are out of the person's control as far as risk factor.
Dr. Issra Rashed: I think with our current understanding of cancer, especially prostate cancer I think the vast majority is that we just don't
Gabby: Yeah, yeah. No, that makes sense. Are there any symptoms or early warning signs? I know here you guys really emphasize screening and, being on the lookout for early warning signs. So, hopefully the cancer is more treatable. Are there any of those symptoms associated with prostate cancer?
Dr. Issra Rashed: Prostate cancer is actually kind of unique in that it starts usually on the outer part of the prostate gland and usually it's asymptomatic until it gets into more advanced stages. Usually you get symptoms when it grows too big and starts to grow into bladder or rectum or too deep by the urethra, and that's when patients can sometimes have symptoms like rectal bleeding or changes in urination, difficulty with urination, blood in the urine, and that kind of thing. But the best way to find cancer is always to find it when it's small, when it's early, and that's where the screening comes in. Because even when the cancer is very small, the PSA usually starts to rise. And so we can catch it before symptoms develop, and thus can treat it more curably.
Gabby: How is, prostate cancer treated?
Dr. Issra Rashed: There's three main treatment options for most cancers, and prostate is one of them. There's surgery, there's radiation, and there's systemic therapy. And systemic therapy kind of covers everything from chemotherapy, which is the one a lot of people hear about, as well as some of the newer treatment options like immunotherapy and other targeted or biologic agents. Radiation has two different types of forms to it. And I'll focus a little bit on that since I'm a radiation doctor. the most common one is external beam radiation.
Usually this is a patient, this is an option for all patients. there's also something called brachytherapy therapy. a lot of people know this is the seeds. And this is an option for also some patients, especially earlier stage patients. So those are the kind of two main options.
Gabby: What types of treatment do you guys offer here at the Riverside Cancer Institute? Is it all the ones you just mentioned, or, certain ones are offered here?
Dr. Issra Rashed: So we do the external beam here. External beam has pretty much two main forms, a photon, which is what I do here. There's also something called proton, which is done at only, a number of centers across America. But in general, photons is the way to go with prostate cancer, except in kind of more unique select cases. We are soon to be having some more brachytherapy technology here, but that's not yet been installed. But as soon as it is, I think we'll be definitely offering some of those kinds of services in the near future for our prostate patients.
Gabby: That's very exciting. As far as, the options that Riverside offers here, how is Riverside set apart from organizations close to us as far as the treatments that we're able to offer to patients with a prostate cancer diagnosis?
Dr. Issra Rashed: So Riverside is a really big hospital system and it recruits some of the best employees, doctors included. Okay. And so we're able to offer patients pretty much everything under one roof. They can choose what treatment they want in many situations, and there's a doctor here and the technology to do it. So we offer external beam, full ton radiation. We offer surgical options for prostate cancer. There's even within surgery, lots of different smaller procedures, as opposed to some of the bigger surgeries people know about that we can do here.
And we have numerous different systemic therapy agents with our medical oncologists out here. And like I said, that includes not only chemotherapy or hormone therapy in the setting of prostate cancer, but there's also other targeted and other biologic agents that sometimes, we can offer depending on the stage and the type of cancer and all of that's available here at Riverside.
Gabby: Awesome. Awesome. It's great to have that in our community because, I mean, it's not a huge community, but people definitely need this care. So it's great that we offer it here.
Dr. Issra Rashed: It's common prostate cancer. Obviously people are living longer and the longer you live it's great, but it also means you live long enough to see cancers that maybe we didn't see when you didn't live as long, many, many decades ago, better blood pressure control, better diabetes control, better heart control, and all that stuff. So we're seeing a lot more cancer. so yeah, it's important to be able to get that kind of treatment closer to home. You know, you don't wanna be driving hours out to the city or to another state to get, the best treatment. We bring that closer to home, and that's what our facility, and our institution does.
Gabby: Yeah, that's great. Are there any, side effects associated with radiation treatment? Well, I focus on that since you're our radiation oncologist. Is there anything patients can expect as far as the side effects go?
Dr. Issra Rashed: So, radiation has come a very long way over the last few decades. So here at Riverside we have some of the newest technology, which we combine with not only the ability to deliver radiation, but also to target our radiation very, very precisely. As a result of this, we can Treat prostate cancer very effectively, while also minimizing the radiation dose to other organs that can cause side effects, and especially minimize their risk of a complication. So most patients, during radiation will have. Temporary side effects, irritation of the bladder, the rectum.
Sometimes the bowels, and the urethra are all very close to the prostate, so they get mild irritation during treatment that patients can feel. Vast majority of patients this completely resolves after treatment. Some patients might have some mild lingering side effects, but we typically do not see complications in this era. It can happen, sometimes you do everything you can and a problem can arise, but they're definitely, the exception, not the rule.
Gabby: Yeah, that's good. How has treatment for prostate cancer evolved over the years? You've talked about some exciting things coming to Riverside soon but has there any changes that have happened in the last 10, 15 years to how prostate cancer is treated?
Dr. Issra Rashed: I think what's, I think very key, in kind of improving. Prostate cancer outcomes over the last, few years is tightly linked to the advancements we have in imaging and in screening. Okay. So because we can image with better technology, better imaging, we can find cancers when they're smaller, when they're earlier, and they can be treated with, less morbid, less side effects from their surgical radiation or other types of treatment. Also because we can be way more precise with our surgeries and our radiation.
We can increase the amount of treatment, we can give the prostate and still protect the bladder and the rectum would sit right next to it. So we have better cancer outcomes, and still have really good low toxicities.
Gabby: Is there anything else you would like to add before we go?
Dr. Issra Rashed: I'm a cancer doctor, but I think the best thing we can do is find a cancer before it becomes a cancer or. Very, very small, and the cure rate is the highest, and the side effects are usually the least. So I can't tell you enough to go ahead and get screened, talk to your primary care doctor or whoever you see kind of manages your general health about screening. See if you're a candidate and what it takes for prostate. It's usually a simple blood test they can add on when they're doing a CBC or a BMP. With your annual well checks, and we can monitor that and assess if we need to screen you more aggressively.
Gabby: I think that's a great place to end off. Thank you so much for coming on the podcast today, Dr. Rashed.
Dr. Issra Rashed: Thank you so much for having me, Gabby.
Gabby: And thank you listeners for tuning into Conversations on Cancer brought to you by the Riverside Cancer Institute. Make sure to leave a review, like, and subscribe wherever you listen to our podcast.
Use of Radiation in Treating Prostate Cancer
Gabby: Welcome back to Conversations on Cancer, brought to you by the Riverside Cancer Institute. Today I'm joined by Dr. Issra Rashed, the radiation oncologist here at the Riverside Cancer Institute to talk about prostate cancer and available treatment options at the Riverside Cancer Institute. Thanks so much for coming on the podcast today, Dr. Rashed.
Dr. Issra Rashed: Oh, I'm very happy to Thank you so much, Gabby, for having.
Gabby: So my first question is, what is prostate cancer?
Dr. Issra Rashed: So the prostate itself is a gland, that's only in men. it's involved in semen production and storage. Sometimes this gland can develop cells within it that grow uncontrollably, which can become cancerous. Those cells can then leave the prostate gland and go to other parts of the body, which is what makes it cancer.
Gabby: Are there any risks, risk factors associated with prostate cancer that might make someone more likely, to get prostate cancer than someone else?
Dr. Issra Rashed: There are definitely some risk factors, but I think a lot of patients who come in with cancer don't always have these risk factors. The ones that we do look out for is increasing age. As men get older, they're more likely to get a prostate cancer. genetics also plays a role because we know that having a family history of prostate cancer is also associated with a higher risk of getting it. There's very rare but sometimes seen mutations in germline cells that lead patients to get cancers as well. These are sometimes passed from mom and dad down to kids, and in families as well, between aunts, cousins and that kind of thing. and so those are some also risk factors that we can see.
Gabby: So unfortunately, it sounds like a lot of things are out of the person's control as far as risk factor.
Dr. Issra Rashed: I think with our current understanding of cancer, especially prostate cancer I think the vast majority is that we just don't
Gabby: Yeah, yeah. No, that makes sense. Are there any symptoms or early warning signs? I know here you guys really emphasize screening and, being on the lookout for early warning signs. So, hopefully the cancer is more treatable. Are there any of those symptoms associated with prostate cancer?
Dr. Issra Rashed: Prostate cancer is actually kind of unique in that it starts usually on the outer part of the prostate gland and usually it's asymptomatic until it gets into more advanced stages. Usually you get symptoms when it grows too big and starts to grow into bladder or rectum or too deep by the urethra, and that's when patients can sometimes have symptoms like rectal bleeding or changes in urination, difficulty with urination, blood in the urine, and that kind of thing. But the best way to find cancer is always to find it when it's small, when it's early, and that's where the screening comes in. Because even when the cancer is very small, the PSA usually starts to rise. And so we can catch it before symptoms develop, and thus can treat it more curably.
Gabby: How is, prostate cancer treated?
Dr. Issra Rashed: There's three main treatment options for most cancers, and prostate is one of them. There's surgery, there's radiation, and there's systemic therapy. And systemic therapy kind of covers everything from chemotherapy, which is the one a lot of people hear about, as well as some of the newer treatment options like immunotherapy and other targeted or biologic agents. Radiation has two different types of forms to it. And I'll focus a little bit on that since I'm a radiation doctor. the most common one is external beam radiation.
Usually this is a patient, this is an option for all patients. there's also something called brachytherapy therapy. a lot of people know this is the seeds. And this is an option for also some patients, especially earlier stage patients. So those are the kind of two main options.
Gabby: What types of treatment do you guys offer here at the Riverside Cancer Institute? Is it all the ones you just mentioned, or, certain ones are offered here?
Dr. Issra Rashed: So we do the external beam here. External beam has pretty much two main forms, a photon, which is what I do here. There's also something called proton, which is done at only, a number of centers across America. But in general, photons is the way to go with prostate cancer, except in kind of more unique select cases. We are soon to be having some more brachytherapy technology here, but that's not yet been installed. But as soon as it is, I think we'll be definitely offering some of those kinds of services in the near future for our prostate patients.
Gabby: That's very exciting. As far as, the options that Riverside offers here, how is Riverside set apart from organizations close to us as far as the treatments that we're able to offer to patients with a prostate cancer diagnosis?
Dr. Issra Rashed: So Riverside is a really big hospital system and it recruits some of the best employees, doctors included. Okay. And so we're able to offer patients pretty much everything under one roof. They can choose what treatment they want in many situations, and there's a doctor here and the technology to do it. So we offer external beam, full ton radiation. We offer surgical options for prostate cancer. There's even within surgery, lots of different smaller procedures, as opposed to some of the bigger surgeries people know about that we can do here.
And we have numerous different systemic therapy agents with our medical oncologists out here. And like I said, that includes not only chemotherapy or hormone therapy in the setting of prostate cancer, but there's also other targeted and other biologic agents that sometimes, we can offer depending on the stage and the type of cancer and all of that's available here at Riverside.
Gabby: Awesome. Awesome. It's great to have that in our community because, I mean, it's not a huge community, but people definitely need this care. So it's great that we offer it here.
Dr. Issra Rashed: It's common prostate cancer. Obviously people are living longer and the longer you live it's great, but it also means you live long enough to see cancers that maybe we didn't see when you didn't live as long, many, many decades ago, better blood pressure control, better diabetes control, better heart control, and all that stuff. So we're seeing a lot more cancer. so yeah, it's important to be able to get that kind of treatment closer to home. You know, you don't wanna be driving hours out to the city or to another state to get, the best treatment. We bring that closer to home, and that's what our facility, and our institution does.
Gabby: Yeah, that's great. Are there any, side effects associated with radiation treatment? Well, I focus on that since you're our radiation oncologist. Is there anything patients can expect as far as the side effects go?
Dr. Issra Rashed: So, radiation has come a very long way over the last few decades. So here at Riverside we have some of the newest technology, which we combine with not only the ability to deliver radiation, but also to target our radiation very, very precisely. As a result of this, we can Treat prostate cancer very effectively, while also minimizing the radiation dose to other organs that can cause side effects, and especially minimize their risk of a complication. So most patients, during radiation will have. Temporary side effects, irritation of the bladder, the rectum.
Sometimes the bowels, and the urethra are all very close to the prostate, so they get mild irritation during treatment that patients can feel. Vast majority of patients this completely resolves after treatment. Some patients might have some mild lingering side effects, but we typically do not see complications in this era. It can happen, sometimes you do everything you can and a problem can arise, but they're definitely, the exception, not the rule.
Gabby: Yeah, that's good. How has treatment for prostate cancer evolved over the years? You've talked about some exciting things coming to Riverside soon but has there any changes that have happened in the last 10, 15 years to how prostate cancer is treated?
Dr. Issra Rashed: I think what's, I think very key, in kind of improving. Prostate cancer outcomes over the last, few years is tightly linked to the advancements we have in imaging and in screening. Okay. So because we can image with better technology, better imaging, we can find cancers when they're smaller, when they're earlier, and they can be treated with, less morbid, less side effects from their surgical radiation or other types of treatment. Also because we can be way more precise with our surgeries and our radiation.
We can increase the amount of treatment, we can give the prostate and still protect the bladder and the rectum would sit right next to it. So we have better cancer outcomes, and still have really good low toxicities.
Gabby: Is there anything else you would like to add before we go?
Dr. Issra Rashed: I'm a cancer doctor, but I think the best thing we can do is find a cancer before it becomes a cancer or. Very, very small, and the cure rate is the highest, and the side effects are usually the least. So I can't tell you enough to go ahead and get screened, talk to your primary care doctor or whoever you see kind of manages your general health about screening. See if you're a candidate and what it takes for prostate. It's usually a simple blood test they can add on when they're doing a CBC or a BMP. With your annual well checks, and we can monitor that and assess if we need to screen you more aggressively.
Gabby: I think that's a great place to end off. Thank you so much for coming on the podcast today, Dr. Rashed.
Dr. Issra Rashed: Thank you so much for having me, Gabby.
Gabby: And thank you listeners for tuning into Conversations on Cancer brought to you by the Riverside Cancer Institute. Make sure to leave a review, like, and subscribe wherever you listen to our podcast.