Radiotherapy for advanced prostate cancer

Radiotherapy uses high-energy rays to treat cancer. It destroys cancer cells in the area where it is given. It can be given in different situations to treat advanced (metastatic) prostate cancer.

You have external beam radiotherapy for advanced prostate cancer. This means it is given from a machine outside the body (externally).

If you are having radiotherapy, you will see a clinical oncologist and a specialist therapeutic radiographer. A clinical oncologist is a cancer doctor who specialises in radiotherapy, chemotherapy and other drugs to treat cancer. Therapeutic radiographers are experts in radiotherapy and are specially trained in cancer treatment. They can also give you support, advice and information about your radiotherapy.

We have separate information about having radioisotope therapy for advanced prostate cancer.

If you have been newly diagnosed with advanced prostate cancer, your cancer team might talk to you about radiotherapy to the prostate gland. Research has shown that treating the prostate can help with symptoms, even when the cancer has spread to other areas. It can also help some people live longer. But radiotherapy to the prostate is not suitable for everyone.

You usually have radiotherapy once a day, Monday to Friday, over 4 weeks. Sometimes you have it once a week for 5 to 6 weeks.

Your cancer doctor plans your radiotherapy carefully. This is to make sure it is as effective as possible, while causing as few side effects as possible.

You will have a hospital appointment to plan your treatment. During the planning visit, you will have a CT scan. The scan is to help your radiotherapy team decide on the dose and area to treat. The hospital will send you information if you need to prepare for your scan.

During the scan, you need to lie still in the same position you will be in for your radiotherapy.

The person who gives you radiotherapy is called a therapeutic radiographer. They may make some permanent marks (tattoos) the size of a pinpoint on your skin. These are used to make sure you are in the correct position for your treatment. They also show where the radiotherapy machine will direct its rays. The marks are only made with your permission. It may be a little uncomfortable. If you are worried about this, talk to the radiographer.

Before your CT scan, you may need to have a special diet or take medicine to empty your bowel. You may also need to drink water to fill your bladder. At some hospitals, you may be asked to go to the toilet so your bladder is empty. Doing these things helps get very clear CT scan pictures to help plan your treatment.

You may have a small amount of liquid passed into your rectum. This is called an enema. It helps you empty your bowel fully when you go to the toilet. You can usually do this yourself. If you need help, speak to your radiotherapy team.

You may be advised to start pelvic floor exercises. Doing these exercises before, during and after your radiotherapy can help with bladder side effects.

Side effects usually build up slowly after you start treatment. They may continue to get worse for a couple of weeks after treatment. But after this, most side effects improve gradually over the next few weeks.

Your radiotherapy tea, will talk to you about side effects. They will explain what to expect and give you advice on what you can do to manage them.

Always tell them about your side effects rather than trying to treat them yourself. There are usually things they can do to help.

We have more detailed information about side effects of external beam radiotherapy to the prostate and pelvic radiotherapy.

The side effects of palliative radiotherapy are usually mild. They will depend on the area being treated. Always tell your cancer team about any side effects. There are usually ways to treat or manage them.

Feeling very tired is a common side effect. This should gradually improve a few weeks after treatment finishes. Try to pace yourself and plan your day so you have time to rest. Gentle exercise, like short walks, can give you more energy.

You may feel sick if the area treated is close to your tummy – for example, the ribs or spine. Your doctor can give you anti-sickness drugs to help prevent or control sickness. If you only have 1 or 2 treatment sessions, you may have flu-like symptoms for a few days afterwards.