Advanced techniques

The standard external delivery method is called external beam radiation therapy (EBRT), in which beams of radiation are aimed at the tumor from outside the body. Because radiation to the prostate can damage the nearby rectum, bowel, and bladder, researchers have refined and developed alternatives to standard EBRT. Three-dimensional conformal radiation therapy (3DCRT) is the most popular refinement; intensity-modulated radiation therapy (IMRT) is a further refinement. The newest technique is proton beam radiation.

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• 3DCRT: In 3DCRT, the radiation oncologist uses dozens of computed tomography (CT) scans to "conform" the radiation beams to the precise shape of the tumor. Custom shaping of the beams permits higher dosing of radiation to the tumor while avoiding healthy tissue and nearby organs.
• IMRT: A further refinement of 3DCRT is intensity-modulated radiation therapy (IMRT), in which the intensity of each beam is raised or lowered to meet the needs of the patient. Unlike 3DCRT, in which the radiation oncologist must arrange the beams by hand and determine the total dose of radiation to give, IMRT software determines the number, orientation, and intensity of the beams.
• Proton beam radiation therapy: This employs the specialized targeting of 3DCRT, but it uses proton beams instead of X-rays. Protons, which are positively charged subatomic particles, are effective at killing cells at the end of their path while causing minimal damage to the tissues they pass through. The theory is that these particles can allow for higher radiation doses with fewer side effects.