Prostate cancer treatment: Could two radiation sessions be enough?

Radical shift in prostate cancer treatment?

Prostate cancer, one of the most common cancers among men in India, could soon see a dramatic change in how it is treated. Researchers are now asking a provocative question: can the disease be managed with just two sessions of radiation therapy?

Current standard treatment often involves daily radiation doses spread over several weeks. This new approach, called ultra-hypofractionated radiation therapy, aims to deliver a much higher dose of radiation in fewer sessions.

How the two-session approach works

In conventional radiation therapy, patients typically undergo 20 to 40 sessions over four to eight weeks. The two-session method uses advanced imaging and precise targeting to deliver a concentrated dose of radiation directly to the tumour.

The technique relies on stereotactic body radiation therapy (SBRT) technology, which allows doctors to map the prostate in three dimensions and aim beams with sub-millimetre accuracy. Each session lasts about 30 to 45 minutes.

Early studies from centres in the United States and Europe have shown that this could be as effective as longer regimens for certain patients, particularly those with low- or intermediate-risk prostate cancer.

What the data says so far

Clinical trials have reported that five-year cancer control rates for ultra-hypofractionated therapy are comparable to standard radiation. Side effects, including urinary and rectal issues, appear to be similar in frequency and severity.

However, experts caution that the two-session schedule is not yet standard practice. Most published studies have looked at five-session or three-session regimens. The leap to two sessions is still being tested.

One ongoing trial in the UK is recruiting men with localised prostate cancer to compare two sessions of high-dose radiation against the standard course. Results are expected in the next two to three years.

Implications for Indian patients

If proven effective, a two-session protocol could be a game-changer for Indian men. Many patients in smaller towns and cities find it difficult to travel to a cancer centre every day for weeks. A treatment that requires just two visits would cut costs and logistical hurdles significantly.

Hospitals in metros such as Tata Memorial Centre in Mumbai and AIIMS in Delhi already have the advanced linear accelerators needed for SBRT. Scaling up would require investment in training and equipment at district-level facilities.

Doctors also stress that patient selection is critical. Men with aggressive or advanced prostate cancer are unlikely to benefit from such a short course. Only those with localised, low-risk disease may be candidates.

What comes next

Larger multi-centre trials are needed before any guidelines change. Until then, the two-session method remains experimental. Patients interested in this option should discuss it with their oncologist and consider enrolling in a clinical trial.

For now, the standard of care in India remains conventional fractionated radiation. But the possibility of reducing treatment from weeks to just two appointments is a prospect worth watching closely.