1. External Beam Radiation Therapy (EBRT):

   External beam radiation therapy (EBRT) directs high-energy beams, such as X-rays or protons, to the patient from a machine from outside the body. Advancements in EBRT techniques focus the radiation more precisely on the tumor, allowing doctors to give higher doses of radiation while reducing the radiation exposure to nearby healthy tissue. The goal of EBRT is to kill the cancer cells while sparing the surrounding healthy tissue as much as a possible. Potential side effects after your treatment may include fatigue, skin irritation, urinary symptoms, and bowel changes.

2. Internal Radiation (Brachytherapy):

   Brachytherapy is a form of prostate radiation therapy where the radioactive source is placed inside the body, at or next to, the area requiring treatment. There are two methods of brachytherapy – low dose rate and high dose rate.

   Low dose rate (LDR) brachytherapy:

   • Radioactive seeds are placed in the prostate gland permanently
   • Slow release of radiation over several months

   High dose rate (HDR) brachytherapy:

   • Temporary
   • Catheters are placed in the prostate gland just before radiation is delivered, allowing the radiation source to travel temporarily into the prostate gland
   • Catheters are removed immediately after the radiation is delivered
   • May involve several sessions

   Potential side effects of prostate radiation may include urinary and bowel symptoms, but these are often temporary and manageable. Brachytherapy combined with EBRT can be an option for men with a higher risk of the cancer spreading outside of the prostate.

3. Proton Therapy:

   Proton therapy is an external form (EBRT) of prostate radiation that uses protons instead of X-rays to deliver radiation to the prostate. Once the proton beam reaches the tumor, it conforms to its shape and depth before releasing its energy, and then stops. This enables precise targeting, sparing surrounding healthy tissues from unnecessary radiation exposure. Side effects are generally mild, including temporary urinary and bowel symptoms.

4. Intensity Modulated Radiation Therapy (IMRT):

   IMRT is the most common form of EBRT and uses a computer-driven machine that moves around the patient as it delivers radiation. The beams can be shaped and adjusted to limit radiation exposure to surrounding tissue, allowing the radiation oncologist to deliver a higher dose of radiation to the tumor. A variation of IMRT is volumetric modulated arc therapy (or VMAT), which allows the radiation oncologist to deliver the radiation faster via a machine that rotates around the body in a few minutes.

5. Image-Guided Radiation Therapy (IGRT):

   IGRT is a form of EBRT that allows the radiation oncologist to take medical images of the prostate just before delivering the radiation to make minor adjustments in real time, improving targeting.

6. Stereotactic Body Radiation Therapy (SBRT):

   SBRT is a form of EBRT that delivers high doses of radiation in a few treatment sessions and utilizes advanced imaging and precise radiation delivery to target the prostate with accuracy. It is a well-tolerated therapy with limited side effects, typically involving urinary and bowel changes that improve over time.

Prostate radiation therapy offers effective and tailored approaches to prostate cancer treatment. It's important to understand all types of prostate cancer radiation therapies available to you and discuss them with your doctor to determine which is right for you.