Prostate cancer

Radiation therapy

Prostate cancer

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Radiation therapy is a way of treating cancers using X-rays or other types of radiation. It is also known as radiotherapy.

The two main types of radiation therapy are external beam radiation therapy and brachytherapy. Some people will have one of these treatments and others will have both.

If you have a prostate cancer that is localised to the prostate or the immediate area around the prostate, you may have a few treatment options.

It is recommended that you see a radiation oncologist as well as a urologist to fully understand these treatment options.

What you need to know

Radiation therapy for prostate cancer

Radiation therapy can be used to treat prostate cancer in different ways, including:

  • as an alternative to surgery for men whose cancer is in the early stages
  • to get rid of any cancer cells left behind after surgery
  • in combination with hormonal therapy to control cancer that has spread to the tissue around the prostate.
  • to relieve pain and control symptoms in men with advanced cancer.

Both external beam radiation therapy (EBRT) and brachytherapy can be used to treat prostate cancer.

External beam radiation therapy (EBRT)

External beam radiation therapy (EBRT) uses beams of X-rays or other radiation to treat cancer from outside the body. The beams are produced by a large machine called a linear accelerator.

There are several different types of EBRT. Most involve having treatment 5 days a week for a number of weeks. Others only need a small number of treatments.

Before starting radiation therapy you will go to a simulation or planning session to work out how you will be positioned for treatment.

When you go for each treatment, most of the time is used to set you up in the right position. The actual radiation beam is only on for a few minutes.

EBRT is not painful and you won’t feel anything during the treatment. You will hear some buzzing noises and the machine will move around you but it won’t touch you. The radiation therapist can see and hear you throughout the treatment.


Brachytherapy treats cancers by using small radiation sources inside the body, or on or near the skin. Each source is slightly smaller than a grain of rice. When brachytherapy is used inside the body, it is sometimes called internal radiation therapy.

For some patients, the radiation source is put in place for a short time and then removed. For others, the radiation sources are put in the body and left there permanently. These patients can go home once the sources are in position. 

Radionuclide therapy for prostate cancer

Radionuclide therapy is a way of delivering high levels of radiation directly to cancer cells. It can be used to treat some cancers which have receptors for a particular protein or molecule.

The protein or molecule is labelled with a radioactive substance, called a radionuclide or radioisotope, and injected into the patient’s bloodstream. When it reaches the cancer cell, it attaches to the receptor and radiation from the radionuclide damages the cancer cell.

Radionuclide therapy is being used in clinical trials for some advanced prostate cancers. It uses the radionuclide Lutetium-177 and targets prostate-specific membrane antigen (PSMA) which occurs on the surface of many prostate cancer cells. The treatment is called Lutetium-177 PSMA (LuPSMA).

The radiation oncology team

Health professionals who work as part of the radiation oncology team include:

  • radiation oncologist
  • radiation therapist
  • radiation oncology nurse
  • medical physicist.

What to ask or talk about

Side effects of radiation therapy for prostate cancer

Most people get some side effects with radiation therapy for prostate cancer.

These can include:

  • redness and other skin changes in the treatment area
  • hair loss in the treatment area
  • pain and swelling
  • tiredness (fatigue)
  • impotence (erection problems)
  • bladder problems, e.g. needing to go to the toilet more often and not being able to wait
  • bowel changes, e.g. diarrhoea
  • lymphoedema (swelling in the legs and scrotum)
  • infertility.

Will I be radioactive?

External beam radiation therapy (EBRT) does not make patients radioactive.

Brachytherapy patients can be radioactive while they are receiving treatment. Those who go home with radioactive sources in their body will give out a very small amount of radiation which reduces over time.

Some other types of radiation therapy can also make patients radioactive for a time after treatment.

Radiation can be a risk to pregnant women, babies and small children. If you are having a treatment where you may be radioactive, your doctor or nurse will tell you what safety precautions to take.

checklist Checklists

Use our checklists to find helpful tips or questions to ask.

Next steps

Preparing for radiation therapy

Before radiation therapy, you will need to sign a consent form. It is important you understand what you are consenting to and the possible side effects. 

Some things you should know are:

  • whether you need any tests before starting radiation therapy
  • if you need to change your diet or medications
  • when you have to be there
  • if you need to have time off work
  • if you will be able to drive after radiation therapy.
If you smoke, you should stop before starting treatment as your risk of complications is higher.

Where to get help

There are people you can talk to for more information or support.

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