Radiotherapy for Prostate Cancer

The aim of this leaflet is to support you during your treatment and remind you of the information given by your consultant and the radiographers.

What is Radiotherapy

Radiotherapy is the controlled and precise use of radiation to treat cancer and some non-cancerous conditions.

  • External Beam Radiotherapy is delivered using a machine called a Linear Accelerator (Linac) (pictured below). The radiation is given through the skin to the area affected, often from multiple directions. This is completely painless and treatment takes minutes.
  • Brachytherapy is where radiotherapy is given internally.

You may have one or both of these types of radiotherapy. Your doctor will discuss the type and length of treatment with you, as each person has their treatment planned individually.

(Picture:  Radiographers from the department with linac 2)

Important Information

If you have a pacemaker or ICD (Implantable Cardioverter Defibrillator) please let staff know as this is important information when planning your treatment.

Treatment Preparation

Bowel Preparation

It is important not to be constipated (trouble opening your bowels daily). If you are constipated please see your GP for some laxatives, or contact the department for advice if you are unsure.

We will also ask you to use a daily enema before your CT scan and each treatment. This helps to make your treatment as reproducible as possible by clearing the lower part of the bowel.

Eating and drinking well is important and you do not need a completely empty bowel for your treatment. If you are having any problems with your appetite please speak to a member of staff about this.

Bladder Preparation

We need you to have a full bladder for your scan and treatment each day. This is very important in helping to minimise any side effects.  A large bladder will help push healthy tissue out of the way of the radiation as well as reduce the dose the bladder itself will receive.

You will need to attend the department 1 hour before your CT scan and treatment each day to allow time for you to fill your bladder. We will ask you to empty your bladder and then drink 750ml of water/squash over 30mins. We will then ask you to sit and allow this to fill your bladder for a further 30mins.

We keep the process the same to try and ensure that your bladder is the same size for treatment every day.

It is also very important to drink plenty of fluids throughout your treatment limiting caffeine and alcohol) to be well hydrated.

We may telephone you before your CT appointment to check you are following this preparation. This is because it is so important and helps to make sure your treatment is planned and treated accurately each day.


If you currently smoke, then stopping smoking before you start your radiotherapy is one of the best things you can do to help yourself. Smoking can worsen side effects from radiotherapy and also limit the effectiveness of treatment.

Services to help you stop smoking are provided by ONE YOU.

Please ring 01522 705162 or visit One You Lincolnshire for further advice and support about quitting smoking, or to refer yourself to the service.

If you are unable to stop smoking completely then we advise stopping for 2 hours before and 2 hours after your treatment.

Staying active

Staying as active as possible is also very important. The benefits of exercise are not just physical. Exercise can help lift your mood and help to alleviate fatigue. A gentle walk, gardening or house work can help to keep you more active, but it is important to listen to your body.

Treatment Planning

Your first appointment will be a planning session. This will be in our CT scanner (pictured opposite). This scan allows us to plan exactly where you will have your treatment and the best position for you to lie in.  We will ask to make some permanent skin marks (little ink dots) to help position you accurately for each treatment.

We may use contrast (a special dye that gives us better pictures) with your scan. This will be given through a cannula into a vein in your arm. This will involve a sharp scratch but should be relatively painless. It is important to drink well in the days before your appointment so that you are well hydrated. This is also important for a few days after your scan to help your body flush out the contrast.

If you are a diabetic, taking Metformin, you will need to contact the department please, to check whether you need to stop taking this, before or after the scan.

The staff will explain the procedure fully when you attend for your appointment but if you have any queries please contact the department before your appointment.

If it is difficult to find a vein and staff are unable to place the cannula or you are unable to have contrast, for medical reasons, we can still scan and plan your treatment without the contrast injection.


There will be a number of weeks between your planning appointment and starting treatment. It takes time to plan your radiotherapy treatment. This is a complicated process that involves a number of staff but ensures the best treatment for you.


The number of treatments, sometimes called fractions, varies and will be discussed with you by your consultant. Radiotherapy is usually given as an out-patient with daily treatments from Monday to Friday each week.

You may have had gold seeds placed in your prostate and we will use these to target the radiotherapy each day.

Treatment is painless and very quick (minutes) and although the radiographers leave the room to treat you, they can see you on closed circuit cameras at all times.

It is important that you keep as still as possible and breathe normally but if you need the radiographers during your treatment, please raise your hand and they will come straight to you.

You will not be radioactive during this treatment and it is safe for you to be with other people, including children.

Possible Side Effects

Radiotherapy affects people in different ways and you may experience different side effects to someone having similar treatment to you. Radiotherapy is a localised treatment, which means only the area having treatment will be affected.

Radiotherapy has a build-up effect and often people do not notice any side effects until about 10 days into a course but this also means that side effects will continue for a couple of weeks after treatment too. If you are having chemotherapy as well as radiotherapy you are likely to have more side effects but this will be discussed with you. Some patients may have some permanent side effects from treatment but this will also be discussed with you.


Most people will have a skin reaction, but this will vary from mild redness to feeling quite sore with some skin peeling. We tend to see worse reactions where there are natural skin folds or friction for example, in the groins, around the back passage and between the buttocks.

It is fine to wash as normal and for you to continue with your usual soap, shower gel, deodorant and body lotions. We do ask that you avoid talcum powder, medicated/antibiotic creams and extremes of temperature (hot water bottles/ice packs) in the area we are treating.

You will be seen during your treatment by a Review Radiographer, who will advise you about any other care for your skin. The review team is available each day between 8.30am and 4.30pm and you can request to speak to them if you have any concerns regarding side effects from the treatment.


Radiotherapy to the pelvis can make you feel sick. If you do notice this, it can be helpful to try foods with ginger in them for example; ginger biscuits, ginger beer or stem ginger. Peppermint products can also help but we can also arrange anti-sickness medication if needed. Please speak to the staff.

Bladder Symptoms

You may want to pass urine more often and more urgently.  You are also likely to need to get up more frequently at night to pass water.

Radiotherapy can cause burning and discomfort on passing urine which people can mistake for an infection or cystitis. This is called radiation cystitis and antibiotics will not help. It is important not to take antibiotics until your urine has been tested (this can take a few days). Drinking plenty and regular pain relief can help.

If you start to find it difficult to pass urine and/or feel you are not able to empty your bladder, please speak to the staff. If you develop these symptoms over the weekend please seek medical attention urgently.

Bowel Symptoms

After the first couple of weeks of treatment your bowel habits may change, for example, your stools may become loose or you may develop diarrhoea.  If this happens tell your radiographer and medication can be prescribed for you.

During treatment you may suffer from lower abdominal pain or discomfort.  Again please tell your radiographer or doctor who may prescribe some pain relief or specialist medication to ease this.

After three or four weeks of treatment you may notice some discomfort on opening your bowels. This is called proctitis and is caused by inflammation in the back passage. Sometimes you may feel the urge to pass a motion but are unable to pass anything.

This is called tenesmus and some gentlemen mistake this for constipation. You may also notice you are passing some mucus (clear jelly-like substance) and a little blood. This is normal during radiotherapy but please speak to staff as there is medication to ease this.


You may feel tired or lethargic during your radiotherapy treatment and for a number of weeks after your treatment has finished.  Keeping active can help but it is important to listen to your body and if you feel unwell, to rest. Your normal activities at home will help to keep you active and if you feel able, a daily walk can be beneficial. This lethargy can also affect your mood and emotions. This is normal but please speak to staff for support.

Potential Late Side Effects

Long term side effects can occur months or years after radiotherapy treatment. There is no way to predict who might be affected, but these would be permanent changes. We plan the treatment to avoid surrounding areas as much as possible to minimise the risk of these side effects.

Bowel Changes

Radiotherapy can cause scarring in the bowel which can lead to looser stools and frequency.

As the tissues heal small scars or adhesions (areas of tissue that have become connected) can form. This can mean the bowel is slower and in rare cases the bowel can become blocked.  Please speak to your doctor if you notice any of these changes or are concerned.

Bladder Changes

After radiotherapy some people will notice that they have to pass urine more frequently and a small number, (4%) of patients, develop urinary incontinence as a result of radiotherapy.

Some gentlemen find they have difficulty passing urine. This is because the tube carrying the urine from the bladder to the penis (urethra) becomes narrower (stricture). Please speak to your doctor if you notice any changes.

You can notice a little blood in your urine or your motions. This is because radiotherapy can cause the development of small blood vessels in the area treated and these blood vessels can bleed more easily.

Sexual Function

After radiotherapy, 40 to 60% of gentlemen report significant changes to their sex life. This includes problems getting and maintaining an erection and lack of sex drive (libido).

Please try not to be embarrassed and talk to your doctor. They can tell you about different ways to help, such as medication, practical solutions and counselling.


You will be seen by your consultant 4 to 8 weeks after completing your treatment. This appointment will be where you were originally seen (i.e. not always in Lincoln) and you will need to have a blood test a week before this appointment. You will also be given a finishing letter from the department with information and contact numbers for once you are finished.

Getting to the Department

The Radiotherapy & Oncology department is the large building to the left of Main Reception, opposite the staff car park.

Operational hours of the department are between 7.15am and 5.30pm. There is a coffee/snack shop open from 9:00am until 3.00pm. There are toilets and water available in the main waiting area.


When you first arrive you will need to book into reception.  On your first visit a radiographer will come and explain what will happen and answer any questions and our receptionists are always happy to assist you.


There is free parking for all people having Radiotherapy and Chemotherapy.  Please use the Parking Eye machine on the oncology reception desk to enter your registration number every time you attend to ensure no charges are made.

If you park in the disabled car park, you will also need to enter your vehicle registration number at the machine on the reception desk to ensure no charges are made.

Arranging Transport

If you are able to get to the hospital, either by car or by public transport, this is the preferred option. This is perfectly acceptable unless your doctor has advised you otherwise.

There are regular buses that come in to the hospital site, please see the Stagecoach website for details.

Please see the information below about various community transport services that can serve the hospital, please note there may be a charge for some services.

Lincolnshire Dial-a-Ride

Phone: 01522 544983

Call Connect

Phone: 0345 234 33 44

For advice or more information, please contact the Lincolnshire Transport Helpline on: 0345 456 4474

If you have problems travelling from home each day we may be able to offer help with transport. Please note that there are criteria for ambulance bookings and you may not be eligible. If you use the ambulance service you should be aware that you will be away from home for at least half a day. Transport is for the benefit of patients only and escorts may only be booked in certain circumstances; please discuss this with the staff.

If you are at home feeling unwell and feel unable to attend for any of your appointments, please contact the department as soon as possible so we can arrange for you to be reviewed by a radiographer or a ward doctor. Please phone 01522 572268 or 572236.

Final Note

The staff in the Oncology Department are here to help you. If you have any problems or worries, please seek our help and advice.

Useful Contacts:


01522 572268 (Weekdays 9am to 5pm)

Clinical Nurse Specialists (Urology)

Lincoln:          01522 573821

Louth:             01507 631473

Boston:          01205 446082

Out of Hours/Bank Holidays

Waddington Unit: 01522 572255/01522 572257

Macmillan Cancer Support

Macmillan Cancer Information and Support Centre
01522 573799 (Mon to Thurs 9.00am to 4.00pm)

Cancer Research UK