External beam radiation therapy and side effects

With external beam radiation therapy, 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.
Most side effects start midway through treatment. They can persist for around two weeks and then tend to get better over a 6-week period.
As you work through recovery, try to stay hopeful about the journey ahead.

Typically, you might experience:

  • urinary problems

    • needing to urinate (pee) 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

    • diarrhea

    • passing gas (or farting), more than usual

    • needing to go to the bathroom more often

    • leaking a clear, jelly-like mucus from your butt or anus

    • bleeding from your butt or anus

    • 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-colored 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 saving (banking) your sperm 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 often you’ll need treatment. For some men, the daily radiation therapy plan could be:

  • 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.

  • You should be able to go home after each session. You will usually have up to 20 sessions, so the schedule is around 4 weeks but it can go for up to 8 weeks. During treatment you will regularly be reviewed by your treatment team.

  • 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 of (but not all) cancer centres. Speak to your doctor to find out more on this.

Who's a good candidate?

External beam radiation therapy can be used to treat localised or advanced prostate cancer. 

Looking ahead

After external beam radiation therapy, 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 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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