Side effects of prostate cancer radiotherapy
Radiotherapy to the prostate can cause some side effects. These include loose or watery poo (diarrhoea) and problems passing urine.
Side effects tend to start a week or 2 after the radiotherapy begins. They gradually get worse during the treatment and for a couple of weeks after the treatment ends. But they usually begin to improve after around 2 weeks or so after treatment finishes
Everyone is different and the side effects vary from person to person. You may not have all of the effects mentioned.
Tiredness and weakness
You might feel tired during your treatment. It tends to get worse as the treatment goes on. You might also feel weak and lack energy. Rest when you need to.
Tiredness can carry on for some weeks after the treatment has ended. But it usually improves gradually.
Various things can help you to reduce tiredness and cope with it, such as exercise. Some research has shown that taking gentle exercise can give you more energy. It's important to balance exercise with resting.
Sore skin in the treatment area
Your skin in the treatment area might get sore, or redden or darken. This can vary depending on your skin tone. Following these tips can help with this:
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Wear loose fitting underwear and clothes. Natural fibres can be more comfortable than man-made fibres.
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Gently wash the area each day. Use mild, unperfumed soap and warm or cool water. Try baby soap or liquid baby wash but check with the radiotherapy staff first.
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Gently pat the skin dry with a soft towel. Rubbing the skin can make it sore.
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Don't use perfumed lotions on the area. Use only creams or dressings recommended by your specialist or radiographer.
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Don't use talcum powder because it can contain tiny metal particles. The particles can make the soreness worse.
Tell the nurse or radiographer at your treatment centre if you notice reddening, soreness or other changes. They can prescribe creams to help.
Loss of pubic hair
Radiotherapy causes hair loss in the treatment area. Sometimes the hair loss is patchy, rather than complete. The hair can grow back, but not always fully. It might take several months.
Problems passing urine
You may feel:
- as if you want to pass urine all the time, but when you go, there isn't much there
- as if you need to pass urine as soon as possible (urgently)
- as if you have a bladder infection (cystitis)
- a burning pain when you do pass urine
- a weak flow of urine
- unable to pass urine
Try to drink plenty of water and avoid caffeine. Many people think that drinking cranberry juice can be helpful with bladder problems. But this isn't the case for bladder problems caused by radiation.
Your bladder inflammation should settle down a few weeks after your treatment is over.
Tell your doctor if you have any pain when passing urine. It could be a sign that you have an infection. They might arrange for you to do a urine test (Mid Stream Urine). You may need antibiotic treatment.
Your doctor may prescribe you some medicine if the flow of urine slows down too much. If you cannot pass urine then you may need to have a 
. This is temporary.
Loose or watery poo (diarrhoea)
Tell your doctor, nurse or radiographer if you have diarrhoea. They can prescribe medicine to help you.
Drink plenty of fluids. This helps to keep you hydrated.
Ask your nurse about soothing creams to apply around your back passage (rectum). The skin in that area can get very sore and even break if you have severe diarrhoea.
Voice over: Radiotherapy can cause many different side effects, such as tiredness. The side effects you get will depend on the area you're having treatment to.
This video is about the side effects you might have if you are a man having radiotherapy to the pelvis or abdomen.
Louise: The abdomen, the tummy, can be affected by radiotherapy, but it depends on which particular part of that we are treating as to what side effects you may experience. If we are treating the upper part of your abdomen and we are irritating your stomach, sometimes you can experience a little bit of nausea, potentially a little bit of vomiting.
This would normally start quite early on if it is going to be a problem and the doctor would prescribe you some medication to help with that.
If your bowels are being irritated by the radiotherapy, you may find you end up a little bit more gassy. Flatulence might be a bit of an issue and sometimes you can find you can end up with some diarrhoea.
Keith: Digestion seemed to be quicker and I was having to go to the loo more. Everything seemed weaker.
Louise: If you do find that you are having some issues with your bowels, always consult with the team before you take any action. It might be they recommend you make some small dietary changes to help with this, cutting out foods which are very high in fibre or very spicy foods.
If you're having issues with diarrhoea, they may also recommend some particular medication to help with that.
Keith: They gave me a course of Fybogel to take, which did help. I still have to take that now and again. Before the radiotherapy I was having problems anyway, but they became a bit more acute afterwards. If I needed to go to the toilet, I needed to go. We went on a holiday to Cornwall and it became the toilets of Cornwall tour.
Louise: Some radiation treatments to the pelvis may also cause some irritation to your bladder, so you might find you need to pass urine more regularly. It may also be more urgent with you passing smaller volumes. Sometimes you may find that there's a little pain or discomfort when you're urinating or you can't fully empty your bladder like you would do normally.
Keith: I don't drink coffee anywhere near as much. Alcohol, maybe I have 4 units a week. I was advised to drink cranberry juice. Tea as normal. I drink water through the day.
Louise: We would highly recommend during your radiotherapy that you stay well hydrated. We would recommend you drink up to 2 litres of water or squash a day to ensure that this happens. Drinks to avoid would include anything containing caffeine, so any kind of tea or coffee or decaffeinated drinks, fizzy drinks and alcohol as they all naturally aggravate your bladder.
Another symptom that some men might find as a result of the radiotherapy is that they have issues with erectile dysfunction. If this is the case, please do alert the radiotherapy team. There's a lot of support out there for gentlemen with this particular issue.
Keith: After the radiotherapy things were not the same. I was put on a course of a kind of a Viagra type of thing, but also on ejaculation I got a lot of pain.
Louise: Radiotherapy can cause infertility. If this is a concern for you and you would like to consider having children in the future, before you start a course of radiotherapy, it is best to discuss your options with the team. One of the options may be sperm banking.
It's always best to be open with partners when you're going through any kind of treatment, especially as this may have an impact on them too. It means that you can work through the problems together.
Voice over: If you're experiencing a side effect that hasn't been covered in this video, you can find more information on the Cancer Research UK website.
Possible long term side effects
Most side effects gradually go away in the weeks or months after treatment. But some side effects can continue or might start some months or years later. This includes problems getting an erection.
