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The side effects of external beam
radiation therapy tend to be less severe than the side
effects of other prostate cancer treatments. Doctors
will often use external radiation therapy for prostate
cancer patients who want to avoid the risks of surgery.
Generally, no pain is associated with external radiation
therapy, and the associated side effects tend not interfere
with daily life. There is also a lower occurrence of
urinary side effects associated with external radiation
therapy.
Severe incontinence occurs in fewer
than 2 percent of men who undergo external radiation
therapy. Temporary incontinence or urinary leakage,
frequency, burning during urination, and difficulty
urinary or urinary retention are associated with external
radiation therapy. Patients may also see blood in their
urine, feces, or semen. These symptoms tend to go away
on their own within a few weeks. Some patients may also
experience acute urinary retention and may require a
Foley catheter for a few weeks.
Impotence as a side effect varies
greatly, from 25 to 50 percent in men who are under
60. Both impotence and incontinence can worsen over
a period of continued treatment because healthy cells
become less and less able to repair themselves. Penile
shrinkage is also a risk associated with external radiation
therapy. This shrinkage may also be called urethral
stricture, because penile shrinkage is caused by a shrinking
or the urethra. A physician, however, can “stretch”
the urethra back to its normal size during an outpatient
procedure.
Proctitis and prostatitis are also risks of external
radiation therapy. The beam may damage the rectum leading
to blood to mucus in the stool.
Proctitis can be treated with laser
surgery or suppositories and enemas. Prostatitis may
occur in about a third of patients who receive external
radiation treatment for prostate cancer. Prostatitis
may cause the PSA level to rise; patients, however,
should not be alarmed. A swollen prostate gland, not
prostate cancer, is the cause of the rising PSA level.
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