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 to significantly interfere with daily life.
Incontinence as a Potential Side Effect of Radiation
Severe incontinence occurs in fewer than two percent of men who undergo external radiation therapy. Temporary incontinence or urinary leakage, frequency, burning during urination, and difficulty urinating 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 Potential Side Effect of Radiation
Impotence as a side effect varies greatly, from 25 to 50 percent in men who are under 60 years of age. 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 of 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 or 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.
Additional side effects of radiation therapy include itchiness or discomfort in the perineal skin (or the skin between the anus and scrotum); darkening of the skin in the anal area; abdominal discomfort, diarrhea, and excessive gas and cramping; fatigue; and loss of pubic hair. If you’re concerned about any of the side effects aforementioned, or would simply like to discuss them in greater detail, speak with your primary care physician or radiation oncologist.