What To Expect After Radiation Treatment For Prostate Cancer

The term radiation alone raises some concerns. 

We have seen or heard of the effects of radiation in the media, and it may seem strange to learn that it is also used as a therapy.

So, if you are a prostate cancer patient close to starting your radiation treatment, you may wonder what to expect. 

After receiving radiation therapy, are there any tips to help you recover faster?

This blog post will provide you with an applicable answer to these and other common questions.

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What to expect after radiation treatment for prostate cancer

There are two types of radiation therapy. The first is known as external beam radiation therapy, or EBRT, and is the most basic of all, similar to receiving X-rays from a radiation oncologist. 

The second is brachytherapy, in which a seed with radiation is implanted into the prostate for a time to have a similar effect. 

The experience is somewhat different, depending on which one you have. However, regardless of the doctor’s method, you will not see or feel the radiation anytime. 

At the moment and right afterward, you may not feel anything in particular until about two to three weeks after prostate cancer radiation treatment.

Radiation therapy has adverse effects, like all cancer therapies. However, it differs from others because the treatment is localized, and so are the adverse effects.

You may experience some of these symptoms as side effects of prostate cancer radiation:

  • Urinary symptoms include increased frequency, difficulty initiating urination, urgency, and burning pain when voiding. In some cases, you might also experience urinary incontinence.
  • Stools that turn pasty and are smaller in volume, or occasional diarrhea.
  • Rectal irritation with slight bleeding, and a flare-up of hemorrhoid symptoms, if you have them.
  • Blood in the urine for a very short time, especially after a brachytherapy procedure
  • Pain, discomfort, or swelling in the perineal area or scrotum
  • Skin irritation or itching in the place where the radiation was applied
  • Tiredness or fatigue

Some of these radiation side effects improve with medications prescribed by your doctor. Others are brief and go away soon after your radiation sessions are completed. 

How long it takes for symptoms to improve will depend on the radiation dose and your symptoms before prostate cancer treatment. 

For example, if you already have problems with hemorrhoids in your rectum or a hyperactive bladder, the side effects of radiation for prostate cancer will take longer to go away. The same happens with those who require a higher level of radiation.

The recovery period usually lasts from 2 to 6 weeks. During this time, symptoms are expected to improve progressively.

In the case of prostate cancer, brachytherapy requires a surgical procedure to implant the seed, and sometimes patients may require catheterization. 

If so, you will go home with a Foley catheter and medications to reduce inflammation. 

Similarly, if you are unable to urinate after the procedure, it is recommended to wait a few hours and notify your physician to consider the option of placing a Foley catheter. It will be removed three to seven days later.

Other causes for concern have to do with testosterone and erection problems. Some men may experience erectile dysfunction or a reduction in erectile function. 

This is more common in men on hormone therapy, smokers, and those with underlying problems such as diabetes or hypertension. 

However, testosterone production is usually not affected by radiation therapy.

Further, follow-up visits with your physician after radiation therapy will help identify the effects on prostate cancer cells and tumor progression. 

Thus, in the first follow-up, it is imperative to discuss with your doctor any problems you are experiencing or have experienced during your recovery.

prostate health book

What happens to the prostate after radiation?

The prostate is a gland and, as such, is composed of cells with secretory capacity and ducts through which prostatic secretions circulate. 

In addition, it also has a network of nerves and blood vessels, like all body tissues.

The effects of radiation on all cells of the body are similar. It causes structural damage to the cell and its DNA, turning it into little more than a receptacle for organelles. Cellular functions are lost, as well as repair processes, and cell division, among others.

The process is similar in the prostate. In response to radiation therapy, prostate tissue regresses. 

In other words, the prostate shrinks as the glandular tissue dies or becomes atrophic. The cancer cells stop functioning as before and stop dividing, but also something similar happens with normal cells. 

Similarly, vascularization decreases significantly after therapy, providing a reduced proportion of nutrients to the remaining tissue.

Consequently, some changes will also be seen in ultrasound and other studies. Prostate cancer is characterized on an ultrasound as a hypoechoic area, i.e., darker in color. 

After treatment with radiation therapy, the prostate may shrink in size, but the hypoechoic areas almost always remain.

 If these areas are biopsied, it may be determined that some still contain cancer cells. 

However, these cells have an atrophic metabolic apparatus and usually do not progress to aggressive tumors. Thus, patients in the initial stage of prostate cancer will have an excellent prognosis, which is not true in patients with advanced prostate cancer. 

In the latter case, the tumor may not shrink enough, and the hypoechoic areas may continue growing with time.

Tips for recovery

During recovery, one of the most important steps is to know what to do in case of adverse effects. For example:

  • If fatigue sets in, we recommend taking frequent naps during the day. If you cannot get sick leave, consider at least reducing the number of hours you work daily. To counter fatigue, a good diet is also necessary, and although it may seem odd, exercise also helps because it favors energy generation.
  • For diarrhea, some dietary modifications can improve the problem. Avoid greasy, highly seasoned, or spicy foods. Eat more foods with insoluble fiber, especially fruits and vegetables.
  • If you experience increased urinary symptoms, you will receive treatment from your physician for these problems. You can also use herbal remedies for prostate health.
  • In case of irritation or swelling of the skin or scrotum, these symptoms usually improve with over-the-counter pain relievers. Avoid using hot tubs or jacuzzis for a few days, and refrain from bike riding until symptoms resolve. We also recommend that you avoid wearing tight-fitting clothing and topical lotions or creams containing alcohol.

In addition, you may also consider the following tips to prepare for and recover faster from prostate cancer radiation therapy:

  • Follow your doctor’s advice at all times
  • Report new symptoms or potential complications to your medical team.
  • If you have recurrent symptoms, don’t wait for them to appear before treating them. Stay ahead of the symptoms as much as possible.
  • Maintain a healthy lifestyle in every way. Avoid unhealthy habits such as smoking, and try to stay physically active with a balanced diet.


Radiation therapy is one of the most useful alternatives to treat prostate cancer in its early stages. 

It only works in cases of localized prostate cancer and causes regression of the gland, with atrophy of the tissue and its blood vessels.

This blog discussed what to expect after radiation treatment for prostate cancer.

Adverse effects of radiation therapy include urinary symptoms, fatigue, changes in bowel movement frequency, pain, swelling, and skin or perineal area irritation. 

These effects may begin a few weeks after treatment and continue for up to 6 weeks. As time passes, symptoms are expected to diminish gradually.

To speed recovery, maintain a healthy lifestyle by eating well, staying physically active, and reporting any unusual symptoms to your radiation team.

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10 Radiation Therapy Side Effects And How To Manage Them.


  1. University of California San Francisco Health (2023). FAQ: Radiation Therapy for Prostate Cancer. Accessed May 30th, 2023.
  2. Helpap, B., & Koch, V. (1991). Histological and immunohistochemical findings of prostatic carcinoma after external or interstitial radiotherapy. Journal of cancer research and clinical oncology117, 608-614.
  3. Egawa, S., Wheeler, T. M., & Scardino, P. T. (1991). The sonographic appearance of irradiated prostate cancer. British Journal of Urology68(2), 172-177.

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