post radiotherapy

• This sounds completely normal and very like my situation, down to the same Gleason score and ‘Locally Advanced’ diagnosis. Following HDR Brachytherapy and 23 sessions of EBRT in 2024 my toilet habits were all over the place for months. I finished my two years of hormone therapy (Prostap and Abiraterone) in February of this year and things have settled down completely in terms of number 1 and 2 habits, flow and so on. All the best, Mike

Hello Michael (Michael1953 ) 

I am a T3a - Gleason 9 (5+4) but my initial PSA was 182.

No issues apart from increased urination after 20 fractions of Radiotherapy and have had 3.75 years of Hormone Therapy and mastered all the side effects. Yes I can only walk 2/3 miles without a break now but I put that down to old age as well. (full story if you click on mt name or avatar).

Stay positive, keep going and you will get there.

Best wishes - Brian.

Thanks for that Mike, can I ask are you still on any medication at all?

Thanks for your reply Brian. My understanding is that the RT kills the cancer cells and the HT stops them from spreading beyond the prostate. If the RT has worked why is the 2 years of HT necessary, and can the follow-up PSA test be accurate if still on HT. Would a further MRI scan clarify this? I'm a bit confused and will bring this up at my next review.

Thanks again 

Hello Michael, 

I can't comment on your radiotherapy as I'm starting mine in 4 weeks which I'm not looking forward to, however I can identify with you about the hormone therapy and it's unwelcome side effects which I've had plenty of and some of the ones that fall into the "frequency unknown category "

Like you I've been told that I will be on hormone therapy for 2 years which doesn't help my mindset. 

I have T3b and Gleason score 4+ 3.

It's reassuring that you haven't had too many side effects from radiotherapy. 

Hello Michael (Michael1953 ) 

You are correct HT removes your testosterone and stops the cancer from growing, then the Radiotherapy kill the cells off BUT

* The longer courses of HT improve survival rates and prevent recurrence for aggressive cancers.

* 2/3 years will normally mop up any microscopic cancer cells already broken off the main tumor and potentially setting up shop somewhere else in your body.

Radiotherapy keeps on working long after your 20 fractions and you can expect your lowest or nadir PSA some 18 months after RT ends.

The PSA test is the main test used to review your progress - an MRI scan is about 90% accurate but the ultimate in detection is a PSMA-PET scan.

Best wishes - Brian

Hi, yes I found the radiotherapy sessions straight forward but the main problem is preparing your body prior to the treatment. Full bladder, empty bowels and no wind! It's an art that takes a bit of mastering but the most important thing is to be well hydrated during the day (about 2 litres). You will then be asked to empty your bladder 45 minutes before treatment and then drink 500ml to fill it again, but you must be able to last until the treatment is finished, timing is everything!

Good luck! 

Thank you 

Hello Vmc 

Whilst most prostate radiotherapy is empty bowel full bladder - some is empty bowel /empty bladder - mine at The Christie Oldham was the latter. You will find out what you need to do at your radiotherapy planning scan.

Here's a link to a thread you may find of use:

 What you wish you had known before starting Radiotherapy? 

I wish you well with your radiotherapy.

Best wishes - Brian.

Thanks again