Side Effects of Radiation Treatment for Prostate Cancer

Surgery and radiation therapy are the two main treatment options for prostate cancer. Modern radiation therapy can be highly effective in treating localized cancers, but the dose and delivery are crucial in maximizing your chances of eradicating the disease and in minimizing the risks. If you choose radiation treatment, be sure you are aware of the short- and long-term side effects.

Bowel Function in Early Stage of Treatment

• Radiation therapy requires treatment five days a week for a minimum of six weeks. Unfortunately, the rectal wall is far more susceptible to the damaging effects of radiation than the cancer-ridden prostate, and problems become cumulative. While treatment for prostate cancer requires a radiation dose of 70 grays or higher, it takes only 50 grays to cause damage to the nearby rectum. Hence, 6 to 8 percent of radiation patients will develop inflammation of the rectum in the early stages of the treatment. This may cause diarrhea, frequent stools, passing of mucus and enough rectal bleeding to require a tampon or pad.

Bowel Function in Later Stage of Treatment

• More damage occurs as radiation treatment progresses, which may lead to ulceration of the anal canal, resulting in painful bowel movements and bleeding. According to Dr. Peter T. Scardino, chairman of the Urology Department at Memorial Sloan-Kettering Cancer Center, 26 percent of patients suffer intestinal cramps, 17 percent chronic diarrhea, 38 percent flatulence, 12 percent rectal bleeding or mucus discharge, and 30 percent had rectal pain. In addition, side effects which occur a year to two years after the therapy include bowel urgency, diarrhea and bleeding. Ten to 15 percent of men will have issues with urine or bowel soiling that require the wearing of adult diapers.

Urinary Side Effects

• The six- to nine-week treatment can cause damage to the urethra resulting in bleeding, irritation and pain. Inflammation of the urethra may cause 10 to 20 percent of patients to develop urinary frequency, urgency and burning. Usually these symptoms start four to six weeks into the therapy, continue to worsen for up to three months and then disappear. Long-term side effects include bleeding and pain.

Erectile Dysfunction

• Erectile nerves are located about 1/10 of an inch from the prostate, so it is impossible to kill the gland's cancer cells without injuring those nerves. Erectile dysfunction and pubic hair loss may not become evident until years after radiation therapy. A gradual loss usually occurs in 30 to 50 percent of patients.

Infertility

• Radiation mutates sperm cells, so fathering a child after therapy is highly unlikely. While it is not a 100 percent certainty, doctors do advise men who might want children in the future to bank sperm before treatment. Six to eight deposits are recommended.