Options on radiotherapy and the side effects

Clyde21 said:

I am told this procedure in still under review and its value not yet fully understood

That sounds a bit like brachytherapy boost.  It is completely understood and very effective.  As your consultant what the name of your treatment is.  If it is Brachytherapy boost, have a read of my bio (click on the snow scene next to my name).   AW

Clyde21 said:

ed a more aggressive form of radiotherapy which will target not only the prostate but the area immediately surrounding the prostate.

The brachytherapy tackles the prostate internally, and external beam radiotherapy deals with the inside as well, plus outside and surrounding areas.  AW

Hello Clyde21 . My husband had whole pelvic radiotherapy in 2020. The side effects can be divided into acute (short term) and chronic (long term). During the procedure and for a few weeks after he found that he needed to wear a Tena 3 pad at night and a Tena 2 during the day, mainly for confidence but he did have occasional accidents. He then went for another 3 years when nothing was needed. Recently he has had to start wearing a Tena 2 pad at night as he was finding that if he slept through then it was damp in the morning. For security he also wears one if we go out for the day, again more for security. During radiotherapy he did experience slight abdominal pain but this was sorted out with a bladder relaxant tablet and paracetamol. He has had no problems since. Bowel wise everything is fine although with a tendency towards constipation but that is more due to the hormone therapy and something we deal with by diet and the occasional dose of a gentle laxative.

There is a procedure which injects a gel between the rectum and the prostate which can help protect the rectum from the radiotherapy called Spaceoar, although it is not freely offered so maybe something you could ask about. Radiotherapy to the pelvic area whether it is just to the prostate or the wider area does increase the risk of gastrointestinal problems such as rectal bleeding, diarrhea, fistulas or strictures with the incidence increasing over time which might need intervention. I have been on the forum for almost 2 years now and in that time I can only remember a couple of times when this has been reported as a side effect. Radiotherapy techniques have improved over recent years to produce a more targeted dose, especially with things like Brachytherapy, with less collateral damage to surrounding organs so a lot of the data available is retrospective based on older types of machine or techniques and when looking at the figures the comparative studies do cite this as a limitation.

I hope that others who have had pelvic radiotherapy a while ago can give you their experiences as well.

It is difficult having to make decisions on treatment routes when we are not experts. We just have to go with the one which feels right for us and then live with the consequences. I wish you all the best.

Hello Clyde21 

Let me throw my hat into the ring!!

I have had a TURP operation followed by 20 fractions of Radiotherapy to both my prostate and my pelvic lymph nodes. (Click on my name or avatar for details).

During the radiotherapy there was a slight change to both my bowel/urine movements, but as we say in the North "nowt to write home about". The side effect that built up was fatigue and at the end of the 20 fractions I was fatigued, but I put this down to the travelling, waiting around etc and I managed to walk it off with the dog!!

That was over 2 years ago and as far as I am aware there are no lasting side effects.

I hope this helps, I am more than happy to answer any specific questions.

Best wishes - Brian.

One thing I forgot to say was that doing pelvic floor exercises can help to strengthen the muscles which control the bladder and help with ED.

Hi Clyde21 ,

I have just finished what was described by my oncologist as "radical radiotherapy" and might be close to what you are discussing.

I had 37 fractions (daily doses) of 2 Greys, totalling 74 grays. This targeted my prostate and 2 areas of lymph nodes (only one was suspicious - the other was "just in case".

This finished just on 2 months ago, and so most of the immediate side effects have receded now.

These are the ones I encountered:

• Blood in the poo - but only twice. Probably not caused by other problems, but by a lone haemorrhoid aggravated by the radiation.
• Some bladder symptoms - mainly occurring at night, and involving feeling that I wanted to go and having to wait for production. Highest I got to was seven times in one night, but usually around 4.
• Tiredness - added to the existing minor fatigue from hormone therapy. Towards the end of the therapy, I also encountered a slipped disc, which meant walking it off was not going to happen, so I decided i would have a daily afternoon nap (even if I didn't need one, but don't tell anyone).
• Already encountering ED as a result of the HT, so no change.

That was about it. Not enough time has passed to encounter any long term effects, but all of these were within my ability to cope. Only the bladder symptoms caused any real change, but that only got to the mild swearing level.

The cumulative level of radiation I received was quite aggressive, so I think that this experience was similar to what you might have.

Nothing to worry about, but a number of things to keep an eye on.

I have to say that if I hadn't hurt my back (nothing at all to do with the treatment), this would have been a breeze.

My last PSA test was 0.05, so I am hoping that it achieved the desired effect.