Radiation therapy is a common and effective treatment for prostate cancer. This treatment uses high-energy rays to target and destroy cancer cells within the prostate gland. While beneficial, radiation can affect surrounding healthy tissues, leading to various side effects. Understanding these potential effects helps individuals anticipate and manage changes during treatment.
Acute Side Effects of Radiation
During or immediately following radiation therapy, individuals may experience several temporary effects. Fatigue is a common acute side effect, often beginning a few weeks into therapy and persisting for several months after treatment. This fatigue is a normal response as the body repairs cells and tissues affected by radiation.
Radiation near the prostate often impacts the urinary and bowel systems due to their close proximity. Urinary changes, such as increased frequency, urgency, and a burning sensation during urination, are common. These symptoms arise from irritation and inflammation of the bladder lining and the urethra. Some individuals may also experience mild pelvic discomfort.
Bowel issues, including diarrhea, rectal discomfort, and an urgent need for a bowel movement, can also occur. The rectum is susceptible to irritation because it lies close to the prostate, leading to radiation proctitis. Skin in the treated area may become irritated, appearing red, dry, or itchy, similar to a sunburn. Temporary hair loss in the treated region is also possible. These acute side effects typically improve within weeks or months after completing radiation therapy.
Potential Long-Term Side Effects
While many acute side effects resolve, some individuals experience effects that persist for months or years, or develop later. Persistent urinary issues can include ongoing incontinence or a narrowing of the urethra, known as a urethral stricture. The bladder may also remain irritated, leading to continued frequency, urgency, or blood in the urine, a condition called radiation cystitis.
Long-term bowel problems can manifest as chronic diarrhea, persistent rectal bleeding, or proctitis (inflammation of the rectum). Erectile dysfunction is another common long-term side effect, which typically develops gradually rather than immediately after treatment. This can be due to radiation’s effect on nerves and blood vessels in the area.
Lymphedema, a rare but possible complication, involves swelling in the legs or genital region due to fluid accumulation. This occurs if lymph nodes around the prostate are damaged by radiation, impairing the lymphatic system’s ability to drain fluid. A very rare risk is the development of secondary cancers, such as bladder or colorectal cancer, many years after therapy. The absolute rates for these secondary cancers are low.
Managing Radiation Side Effects
Managing radiation side effects involves a combination of self-care strategies and medical interventions, with open communication with the healthcare team being important. For urinary symptoms like frequency or urgency, drinking plenty of water helps dilute urine and can reduce irritation. Limiting caffeine, alcohol, and spicy foods can also alleviate bladder irritation. Pelvic floor exercises can strengthen muscles that control urination and bowel movements, which can help with incontinence.
For bowel-related issues such as diarrhea, dietary adjustments play a role. Increasing intake of soluble fiber, found in foods like oats, bananas, white bread, and skinless fruits, can help solidify stools. Conversely, temporarily limiting insoluble fiber from whole grains, nuts, and raw vegetables may be beneficial. Medications like anti-diarrheals (e.g., loperamide) or bulking agents may be prescribed. For radiation proctitis, treatments can include medications in pill, suppository, or enema form, such as sucralfate or mesalamine, to control inflammation and bleeding.
Fatigue can be managed by balancing rest with light activity and ensuring adequate nutrition, including protein in meals and snacks. For skin irritation, gentle washing with mild soap and warm water, followed by patting dry, is recommended. Avoiding perfumed lotions and using creams recommended by the care team can also help. Erectile dysfunction can often be addressed with medications like sildenafil, and a specialist referral may be beneficial. Consistent follow-up care allows the healthcare team to monitor side effects and adjust management strategies as needed.