Stereotactic Prostate Radiosurgery: Side Effects & Managing Them

One treatment option for prostate cancer is stereotactic radiosurgery (SRS). 

In this article, we will explore what stereotactic prostate radiosurgery is, the side effects of SRS treatment, how long it takes to work, and what to expect during the procedure.

Possible Side Effects of Stereotactic Radiosurgery

Like with any medical procedure, it’s possible to experience side effects and adverse reactions during SRS treatment.

Here are some common side effects and risks associated with undergoing stereotactic radiosurgery:

1) Urinary Symptoms

Some patients may experience a temporary increase in the frequency of urination following SRS treatment. This is often due to irritation of the urinary tract caused by radiation. 

SRS can also lead to a sense of urgency, where patients feel the need to urinate more urgently than usual. 

These symptoms are typically transient and tend to improve as the body adjusts to the treatment.

2) Rectal Symptoms

Prostate radiosurgery may cause temporary rectal discomfort, which can manifest as mild to moderate diarrhea or rectal bleeding in some cases. 

These symptoms often resolve as the body heals after stopping SRS treatment.

3) Erectile Dysfunction

SRS can impact erectile function to some extent. However, the degree of impact can vary significantly from person to person. 

Some patients may experience minimal changes after prostate radiosurgery, while others may notice more pronounced effects. 

4) Bowel Changes

While it is rare, some patients may experience long-term changes in bowel habits after stereotactic body radiosurgery. 

These changes can include increased bowel urgency or, in extreme cases, incontinence. 

It’s important to note that such side effects of stereotactic radiosurgery are not typical and occur infrequently.

5) Fatigue

Fatigue is a common side effect of prostate radiosurgery, especially during and immediately after the treatment sessions. 

However, this fatigue is usually temporary and tends to improve gradually in the weeks following treatment. 

Adequate rest and hydration can help reduce SRS-related tiredness.

6) Skin Reactions

Some patients may notice skin reactions at the treatment site, such as redness or mild irritation. 

These skin changes are typically temporary and resolve on their own without the need for specific treatment.

7) Radiation Toxicity

While modern SRS techniques aim to minimize radiation exposure to healthy tissues, there remains a small risk of radiation toxicity. 

This risk is associated with the possibility of radiation affecting nearby organs or tissues, leading to side effects specific to those areas. 

It’s important to note that this risk is generally low, and treatment planning focuses on minimizing it as much as possible.

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When You Might Have Stereotactic Radiosurgery

Early Stage Prostate Cancer

SRS is often the preferred treatment for those diagnosed with early-stage prostate cancer. 

Stereotactic radiosurgery allows for the targeted delivery of radiation directly to the tumor, minimizing damage to healthy tissues. 

For patients who are not surgical candidates due to age, preexisting health conditions, or personal preferences, SRS offers an alternative.

Localized Tumors

When prostate cancer is localized, meaning it remains within the prostate gland without spreading to nearby structures or distant sites, SRS is a possible treatment option. 

The ability to precisely focus radiation beams ensures that the tumor receives a concentrated dose while sparing adjacent organs and tissues. 

This localized approach has a lower risk of side effects and complications than broader radiation therapy.

High-Risk Patients

Some prostate cancer patients may fall into the category of high-risk people who are more prone to experiencing complications from traditional surgical interventions. 

This includes: 

  • patients with underlying health conditions
  • advanced age
  • those who are not deemed suitable candidates for surgery due to other factors

For these patients, SRS can be a safer and more manageable treatment option.

Previous Radiation Therapy

In cases where patients have previously undergone radiation therapy for prostate cancer but require additional treatment due to disease recurrence or persistence, SRS remains a viable option. This is known as reirradiation or salvage therapy

What to Expect During Stereotactic Radiosurgery

Before undergoing stereotactic radiosurgery for prostate cancer, you’ll have a comprehensive evaluation, which may include imaging scans like CT or MRI. 

Here’s what you can generally expect during stereotactic radiosurgery for prostate cancer:


During the simulation, you’ll be positioned precisely on the treatment table. Immobilization devices, such as a custom-fitted mask or body mold, may be used to ensure you remain in the correct position throughout the treatment.

SRS Treatment Planning

Your medical team will develop a personalized treatment plan, determining the optimal radiation dose and target area to maximize effectiveness while minimizing damage to surrounding healthy tissue.

Radiation Delivery

The actual SRS procedure is painless, and you’ll remain awake throughout. The linear accelerator (linac) or other specialized machines will deliver highly focused radiation beams to the prostate. Treatments are typically given in several sessions, known as fractions, over a span of days or weeks.


During the treatment, your healthcare team will closely monitor you to ensure the accurate delivery of radiation.

Recovery from SRS Treatment

After completing your SRS treatment sessions, you can generally resume your normal activities. 

You may experience some of the side effects mentioned earlier, but they are usually temporary.

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How Long Does It Take For Stereotactic Radiation To Work?

It takes a few days to weeks for stereotactic radiation to begin to work, and the cancer cells may continue to die for several weeks or months after you finish your SRS treatment.

What Is The Success Rate Of Stereotactic Radiosurgery?

The success rate of SRS for prostate cancer varies depending on factors such as the stage of cancer and the patient’s overall health. It has been shown to have excellent outcomes in terms of tumor control and minimizing side effects, especially for early-stage prostate cancer.

What Is The Difference Between Stereotactic Radiation vs Radiosurgery?

Stereotactic radiosurgery (SRS) and stereotactic body radiation therapy (SBRT) both involve highly precise radiation delivery. However, SRS typically delivers a higher radiation dose in a single session or a few sessions, while SRT uses multiple lower-dose treatments over a more extended period.


Stereotactic radiosurgery is an advanced treatment option for prostate cancer, offering precise tumor targeting. 

It is particularly beneficial for early-stage, localized tumors and patients who are not candidates for surgery. 

If you or a loved one is considering stereotactic radiosurgery for prostate cancer, it’s essential to consult with a healthcare provider who specializes in this treatment. 

They can provide personalized guidance and help you make an informed decision about the best course of action for your specific situation. 

Remember that early detection and timely treatment can greatly improve the prognosis for prostate cancer patients.

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  1. Nieder, Carsten, Anca L. Grosu, and Laurie E. Gaspar. “Stereotactic radiosurgery (SRS) for brain metastases: a systematic review.” Radiation Oncology 9 (2014): 1-9.
  2. Freeman, Debra, Gregg Dickerson, and Mark Perman. “Multi-institutional registry for prostate cancer radiosurgery: a prospective observational clinical trial.” Frontiers in Oncology 4 (2015): 369.
  3. Boehmer, Dirk, et al. “Guidelines for primary radiotherapy of patients with prostate cancer.” Radiotherapy and oncology 79.3 (2006): 259-269.

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