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External-Beam Radiation Therapy (EBRT) For Prostate Cancer

Side Effects From External Radiation: During Treatment

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While radiation therapy is safe, there are few possible short and long term side effects of EBRT. Side effects vary from patient to patient and according to the exact location of the radiation. Most side effects are due to the fact that the radiation beam affects normal tissues around the tumor area.

Normal daily activities can usually be continued during treatment. 

Common side effects include:

  • Fatigue (the most common symptom of radiation therapy)
    • Generally there is no fatigue during the first weeks of treatment.
    • Whether fatigue appears after that, and to what degree, depends on the individual.
    • If fatigue does appear, it generally plateaus around week 5.
    • Techniques are available for decreasing the effects of fatigue. 
    • Fatigue generally goes away within a week to a week and a half after end of treatment.
    • Fatigue does not generally keep people from working during treatment.
    • For tips on how to deal with fatigue, see the document in To Learn More.
  • Bladder irritability which shows up as a need to urinate more frequently than normally.  If this symptom shows up, it can continue for a while after end of treatment.
    • There is generally no need for a catheter (a tube through the penis to the bladder to ease urination).
    • Men who have severe urinary problems before starting EBRT are at risk for needing a catheter during EBRT.
  • Bowel irritation with may progress to diarrhea toward the end of treatment.
    • If diarrhea appears, it may continue for a week or two after the end of treatment.
    • Drink plenty of clear liquids to make up for the fluids being lost due to diarrhea.
    • For tips on how to deal with diarrhea, click here.
  • Erectile dysfunction.
    • Whether you experience erectile dysfunction after EBRT depends on:
      • Your potency level prior to the start of treatment. 
      • Your age
      • Other medical conditions which could effect erectile function such as diabetes, hypertension or cardio vascular disease.
    • If erectile dysfunction occurs, there is assistance available.See the Survivorship A to Z document about erectile dysfunction.
    • There are ways to be intimate other than by having sex. Plus there is plenty of stimulation you can get and receive that doesn't involve an erection. Speak with your doctor for more information or for a referral to an expert in the area.
    • If your medical condition is interfering wit h your sexual relations with your significant other, tell your significant other about your feelings and what you would like to change. Ask for your significant other's point of view. Listen to it rather than prepare your response. If the two of you can't work it out, speak with your doctor or seek counseling.
  • Temporary pain upon ejaculation and a permanent decrease in semen volume.
  • Incontinence (in the sense that urine leaks out of the penis unintentionally). For some men, incontinence happens when doing activities such as sitting. For some men it only happens when there is increased abdominal pressure – such as from laughing, coughing, sneezing or exercise.
    • EBRT rarely causes incontinence.
    • If a man is already incontinent before EBRT, incontinence tends to remain.
    • Sometimes, urinary frequency can feel like incontinence because the bladder sits on the prostate.  As noted above, this goes away over time when caused by EBRT.
    • There are tips for dealing with incontinence. See the document in “To Learn More.”
  • Your white blood cell counts may drop during radiation treatment. White blood cells fight infection and prevent bleeding. If blood tests show this problem, you may have to put treatments on hold for a week or two to allow your blood counts to come back up. 

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