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External beam radiation therapy (radiotherapy) and side effects

With external beam radiation therapy (also known as
external beam
radiotherapy), high energy x-rays are directed at the entire prostate to treat cancer. If cancer has spread to the lymph nodes just outside the prostate, this area around the prostate is sometimes also targeted.

Common side effects
of external beam radiation therapy

Radiation therapy affects each man differently and comes with some side effects. Usually, the issues don’t last forever and many men are able to keep up a good quality of life. As you work through recovery, try to stay hopeful about the journey ahead.

Typically, you might experience:

  • urinary problems

    • needing to urinate (wee) often - 'urinary frequency'

    • suddenly feeling you have to urinate - 'urinary urgency'

    • burning when you urinate

    • having a hard time urinating or feeling like you need to push it out

    • blood in your urine (could take several years before this appears)

  • bowel issues

    • diarrhoea

    • passing wind (or farting), more than usual

    • needing to go to the toilet more often

    • leaking a clear, jelly-like mucus from your bottom

    • bleeding from your bottom

    • a feeling that you haven’t fully emptied your bowels, and there’s more that needs to come out

  • fatigue, or feeling extremely tired

  • sexual issues

    • uncomfortable or dry orgasms

    • painful ejaculation (may last for a short or long time)

    • rusty-coloured semen (for a short time)

    • erection problems (can appear up to 2 years after treatment)

    Although some men experience problems immediately after receiving radiation therapy, loss of erections becomes more of an issue over time.

Loss of fertility (not being able to father children)

Radiation therapy can greatly affect your fertility. If you’d like to father children in the future, speak to your doctor or care team about sperm banking before you have treatment. The sooner you have this conversation, the better. 

If you’re having any trouble with these body changes, speak to your doctor or care team right away. They can guide you towards helpful solutions and relief.

How long does
treatment last?

The radiation oncologist will make a plan with you to determine how many treatments you need and how often you'll need them.

  • For some men, the radiation therapy plan is given 5 days per week, usually Monday to Friday, with weekends/holidays off to rest. Each treatment is non-invasive (the machine doesn’t touch you) and is typically scheduled for 15 to 20 minutes (the beam is usually on 5 or fewer minutes). This schedule can go on for 4 to 8 weeks.

  • A newer type of external beam treatment, called stereotactic body radiation therapy (SBRT), can be even shorter (2 to 5 treatments) and is given every other day or once a week. SBRT is available at a growing number (but not all) cancer centres.

Who's a good candidate?

External beam radiotherapy can be used to treat localised or locally advanced prostate cancer, and sometimes in advanced (metastatic) prostate cancer (where the cancer has spread outside the prostate and surrounding areas).

Looking ahead

After external beam radiotherapy, you’ll have regular check-ups with your doctor to monitor your progress. Speaking up about what you’re going through will become very important. Let your doctor or care team know what side effects you’re experiencing right away, so you don’t have to handle it alone.

What's next?

Now that you've read up on External beam radiation therapy (radiotherapy) and side effects , here are some related articles to explore as you continue to build your knowledge and understanding of this topic.
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