Radiotherapy for advanced prostate cancer

You may be offered radiotherapy if the cancer causes symptoms such as pain in the prostate area, or if it has spread to other parts of the body such as the bones. In this situation, radiotherapy can’t get rid of all the cancer cells, but it can reduce symptoms. This is known as palliative radiotherapy.

It can take 7–10 days for the radiotherapy to start reducing the pain, and may take up to six weeks before the full effect is felt. Sometimes, the pain may get worse before it gets better.

Palliative radiotherapy

If cancer of the prostate has spread to the bones, radiotherapy can be given to relieve pain. Treatment is given to the affected bone or area. It may be given as a single treatment, or may be divided into a series of smaller treatments. Many men notice that the pain eases within a couple of days, while others may have to wait three or four weeks. Painkilling drugs can still be taken if necessary. The radiotherapy staff will explain your treatment and the possible side effects to you beforehand.


This treatment uses radioactive substances known as radioisotopes or radionuclides. Cancer cells absorb the radioisotope more than the normal cells do and so receive a higher dose of radiation.

Radioisotopes are particularly useful if several areas of bone are affected and are causing pain. The isotope is given as an injection into a vein in the arm. This can usually be done in the outpatients department.

Advanced prostate cancer in the bones can be treated using the radioisotopes:

  • radium-223
  • strontium-89.

After the injection, a small amount of radioactivity will be present in your urine, so you’ll be advised to use flush toilets instead of urinals to reduce the risk of anyone else being exposed to the radiation. The hospital staff will discuss any special precautions with you before you go home. The amount of radioactivity is very small and it is safe for you to be with other people, including children.

Most men feel some effect from the treatment within a few weeks, although, occasionally, the pain may get slightly worse before it gets better.

Advantages of radiotherapy

  • Radiotherapy can help to relieve bone pain and strengthen a weakened bone.
  • The aim is to make you feel more comfortable.
  • Usually there are only a few side effects, which are generally mild.

Disadvantages of radiotherapy

  • Pain may become slightly worse before it gets better.

I must admit, at first, the idea of radiotherapy was a little daunting. But, as each session passed, some with scans and some without, I began to feel more confident.

Terry, diagnosed with advanced prostate cancer

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Who might I meet?

You will meet many different specialists before, during and after radiotherapy treatment.