Having external radiotherapy for prostate cancer
Radiotherapy uses high energy x-rays to treat cancer cells. It is a common treatment for prostate cancer.
You have external radiotherapy in a hospital radiotherapy department. You usually have it as an outpatient each weekday over 4 to 8 weeks. Some hospitals have rooms near the hospital you can stay in if you have a long way to travel.
When you might have it
You might have external radiotherapy with the aim to cure prostate cancer. This is called radical radiotherapy. You might have radical radiotherapy for prostate cancer that:
- hasn’t spread outside the prostate gland. This is localised prostate cancer
- has spread into the tissues around the prostate gland. This is locally advanced prostate cancer
Doctors in the UK recommend the best treatment for you depending on your risk group. They use a system called the Cambridge Prognostic Group (CPG).
Your doctor might recommend you have radical radiotherapy in combination with hormone therapy if you have a CPG 2, 3, 4 or 5 prostate cancer.
Your doctor may also recommend you have external radiotherapy in combination with brachytherapy. This is to try to stop prostate cancer from spreading beyond the prostate.
Brachytherapy is a type of internal radiotherapy. This means that a radioactive source is put inside the prostate. The radioactive source releases radiation to destroy the prostate cancer cells.
Radiotherapy if prostate cancer has spread (metastatic prostate cancer)
You may have radiotherapy treatment to the prostate or to other parts of the body where the prostate cancer has spread to. This can help to reduce symptoms and help you feel better.
The radiotherapy room
Radiotherapy machines are very big and could make you feel nervous when you see them for the first time. The machine might be fixed in one position. Or it might rotate around your body to give treatment from different directions. The machine doesn't touch you at any point.
Before your first treatment, your 
will explain what you will see and hear. In some departments, the treatment rooms have docks for you to plug in music players. So you can listen to your own music while you have treatment.
Before each treatment session
You might need to drink a certain amount of water before each treatment so that your bladder is full. This can help to reduce the movement of the prostate between treatments and reduce the radiation dose to the bladder. You have to drink the same amount of water each time so that your bladder is the same size.
The radiographers help you to get into position on the treatment couch. They line up the radiotherapy machine using the marks on your skin.
Then the radiographers leave you alone in the room for up to 25 minutes.
This video is about having radiotherapy it lasts for 2 minutes and 17 seconds.
Dan (radiographer): Before your treatment starts your doctor will need to work out exactly where the treatment needs to go and also which parts need to be avoided by the treatment. To have radiotherapy you lie in the same position as you did for your planning scans. We then line up the machine based on your tattoo marks. It is really important that you stay very, very still when you are having treatment it is also important to let the radiographers know right at the beginning if you are not comfortable so they can adjust your position
Radiographer: Ok all done, we’ll be back in a couple of minutes
Dan (radiographer): We leave the room and control the room from a separate room This is so we aren’t exposed to radiation. Treatment takes a few minutes and you will be able to talk to us using an intercom. We can see and hear you while you are having your treatment and will check that you are ok. When your treatment starts you won’t feel anything; you may hear the machine as it moves around you giving the treatment from different angles. Because we are aiming to give the same treatment to the same part of the body everyday then the treatment process is exactly the same everyday so you shouldn’t notice any difference. You’ll see someone from the team caring for you once a week while you are having treatment they’ll ask how you are and about any side effects.
Patient: They get you from one sitting area to another and then take you into the room where you undress to the waist and then lie down and line you up by either moving you or asking you to shuffle a little and they check the dimensions and they talk to one another and they say I am fine this side how are you ...yes fine...ok, stay where you are Jeff and that was it. There were a few little clicks and lights go on and off and you can see a green laser beam which line sup with certain things on your body uh so no, no real noise and no discomfort.
During the treatment
You need to lie very still. Your radiographers might take images (x-rays or scans) before your treatment to make sure that you're in the right position. The machine makes whirring and beeping sounds. You won’t feel anything when you have the treatment.
Your radiographers can see and hear you on a CCTV screen in the next room. They can talk to you over an intercom and might ask you to hold your breath or take shallow breaths at times. You can also talk to them through the intercom or raise your hand if you need to stop or if you're uncomfortable.
You won't be radioactive
This type of radiotherapy won't make you radioactive. It's safe to be around other people, including pregnant women and children.
Travelling to radiotherapy appointments
You might have to travel a long way each day for your radiotherapy. This depends on where your nearest cancer centre is. This can make you very tired, especially if you have side effects from the treatment.
You can ask your radiographers for an appointment time to suit you. They will do their best, but some departments might be very busy. Some radiotherapy departments are open from 7 am till 9 pm.
Car parking can be difficult at hospitals. Ask the radiotherapy staff if you are able to get free parking or discounted parking. They may be able to give you tips on free places to park nearby.
Hospital transport may be available if you have no other way to get to the hospital. But it might not always be at convenient times. It is usually for people who struggle to use public transport or have any other illnesses or disabilities. You might need to arrange hospital transport yourself.
Some people are able to claim back a refund for healthcare travel costs. This is based on the type of appointment and whether you claim certain benefits. Ask the radiotherapy staff for more information about this and hospital transport.
Some hospitals have their own drivers and local charities might offer hospital transport. So do ask if any help is available in your area.
Side effects of treatment
Radiotherapy to the prostate can affect your bladder and bowels. This can mean you might have to pass urine and empty your bowel more often than normal.
Treatment choices
Your doctor might offer you a choice of treatments, such as monitoring the cancer or having surgery or radiotherapy. These treatment choices have different benefits and side effects.
