Like all treatments, radiotherapy can cause side effects. These will affect each man differently, and you might not get all of the possible side effects.
Side effects happen when the healthy tissue near the prostate is damaged by radiotherapy. Most healthy cells recover so side effects usually only last a few weeks or months. But some side effects can start months or years after treatment. These may be similar to the side effects you had during or soon after radiotherapy and can last a long time.
If you have hormone therapy as well as radiotherapy, you may also get side effects from the hormone therapy.
Radiotherapy can irritate the lining of the bladder and the urethra (the tube men urinate through) and cause urinary problems. These can include needing to urinate urgently and more often and, sometimes, blood in the urine.
Radiotherapy can irritate the lining of the bowel (called proctitis) and cause bowel problems. Symptoms vary from man to man. Some will notice a slight change in their bowel habits rather than a problem.
Bowel problems often improve once treatment has finished, but some men will find that their bowel habits change permanently. Bowel problems can develop months or years after treatment.
Bowel problems and anal sex
If you’re gay, bisexual or a man who has sex with men, and are the receptive partner (‘bottom’) during anal sex, then bowel problems after radiotherapy may be a particular issue. Read our information for gay and bisexual men.
Tiredness and fatigue
The effects of radiation on your body can leave you feeling very tired, especially towards the end of your treatment.
Fatigue is extreme tiredness or exhaustion that can affect your everyday life. It might improve after your treatment but some men find it lasts longer.
There are things you can do to help manage fatigue. Our Get back on track service is designed to help you deal with fatigue. If you’re still working, read about managing fatigue at work.
You might get erection problems. It can take up to two years for erection problems to fully appear.
You may not produce any semen after radiotherapy. You may have a dry orgasm where you feel the sensation of orgasm but don’t ejaculate. This may feel different to the orgasms you were used to. If you might want to have children in the future, you might want to store your sperm before you start radiotherapy, so that you can use it later for fertility treatment. Ask your doctor, nurse or radiographer about sperm storage.
There is a very small chance that radiotherapy could affect any children you might conceive during treatment. You may wish to use contraception during and after treatment if there is a chance of your partner becoming pregnant. Ask your doctor, nurse or radiographer for advice.
You may get other problems during or many years after your treatment. These can include the following.
- Skin irritation – during treatment, the skin between your legs may become sore but this is rare.
- Hair loss – some of your pubic hair might fall out but this usually grows back after radiotherapy.
- Lymphoedema– if your lymph nodes are treated, there is a slight chance that fluid might build up in your tissues. It usually affects the legs, but it can affect other areas, including the penis or testicles. It can happen months or even years after radiotherapy.
- Hip and bone problems – radiotherapy can damage the bone cells and the blood supply to the bones near the prostate. This can cause pain, and hip and bone problems later in life.
- Other cancers – radiotherapy could increase your risk of bladder or bowel cancer. This is very rare. It would take at least 5 to 15 years for a second cancer to appear.
Talk to your doctor or nurse about your own risk of long term side effects. You might be more likely to get them if:
- you’re older
- you have diabetes
- you’ve had bowel or prostate surgery in the past
- you’ve had bladder, bowel or erection problems in the past.