Long-term side effects of brachytherapy for prostate cancer:
Brachytherapy for prostate cancer can lead to long-term side effects like increased frequency of urination and challenges with erectile function.
The testicles
The testicles are two small, oval-shaped organs located below the penis, enclosed in a skin pouch called the scrotum.
Image of the testicles (cruk)
Starting from puberty, the testicles begin producing sperm. Inside the testicle, small tubes come together to form the epididymis, a single tube that becomes wider as it exits the testicle. This wider tube is known as the spermatic cord.
The spermatic cord leads to a short passage called the ejaculatory duct, which opens into the urethra, the tube that carries urine and semen out of the body through the penis.
Testosterone:
The testicles produce the hormone testosterone, which is responsible for developing male characteristics such as:- A deeper voice
- Facial hair growth
- Increased muscle mass
- The ability to achieve an erection
- Male sexual drive (libido)
Where does testicular cancer start:
The testicles consist of various cell types, and the kind of cancer you have depends on the specific cell where it begins. Most testicular cancers arise from germ cells, which are responsible for producing sperm. Doctors classify germ cell cancers into two main types:- Seminoma
- Non-seminoma
Long-term side effects of brachytherapy for prostate cancer:
Brachytherapy for prostate cancer can lead to long-term side effects like increased frequency of urination and challenges with erectile function.
These effects vary from person to person, so not everyone experiences them all. If you encounter any of these issues, it’s important to inform your doctor or nurse. They can provide guidance and support to manage these effects effectively.
About side effects:
Before beginning treatment, your doctor will outline the potential risks of experiencing certain side effects, but they cannot guarantee which ones will affect you. Some individuals may be more prone to specific side effects.
If you undergo both brachytherapy and external radiotherapy, the likelihood of experiencing side effects may increase.
Problems passing Urine:
After completing radiotherapy, you may encounter difficulties with urination. Initially, it could be challenging to urinate, improving gradually over months or even years. This is often caused by the treatment narrowing the passage from the bladder to the penis, known as a urethral stricture.
Tell you doctor if you find it harder to pass the urine
You may undergo a procedure known as urethral dilatation to address urethral stricture following radiotherapy. This involves inserting instruments like a thin rod or a flexible tube with a camera and tools to widen the narrowed area under local or general anesthesia.
In cases where the urethra narrows again, you might need repeat procedures. In rare instances, some men experience urine retention, characterized by swelling and discomfort in the abdomen without being able to pass urine, necessitating immediate medical attention at the local emergency department where a catheter can be inserted to drain the bladder.
Leakage of urine:
You might experience urinary leakage following brachytherapy treatment.
If urine leakage persists long-term, your doctor or nurse can arrange a referral to a specialized incontinence clinic. There, healthcare professionals can assist you with exercises to strengthen muscles, bladder training techniques, and medications.
In rare cases, some men may experience complete loss of urinary control. If this occurs, a catheter may be necessary to drain urine directly into a bag attached to your bladder.
Erection problems:
Radiotherapy can affect the nerves responsible for erectile function.
The likelihood of experiencing difficulties with getting and maintaining an erection depends on factors such as your age (typically less common if under 65), existing health conditions, pre-existing erectile issues, and whether hormone therapy is used before or after radiotherapy.
If you encounter erection problems, it’s crucial to notify your doctor or specialist nurse promptly. They can then refer you to a specialist who can provide appropriate support.
Early intervention with medications like sildenafil (Viagra) may assist in achieving and sustaining erections.
Frequent or loose motions:
Your bowel movements may become more frequent or loose after treatment.
To manage this, your healthcare provider might recommend anti-diarrhea medications like loperamide (Imodium) or bulking agents such as Fybogel, which can help regulate your bowel movements. It’s important to consult your doctor before starting any new medications.
Maintaining a balanced diet with small, regular meals is usually advisable. If needed, your healthcare team can offer guidance on dietary adjustments. Some individuals find it beneficial to limit high-fiber foods like beans, nuts, seeds, dried fruits, bran, and raw vegetables.
Stay hydrated by drinking plenty of fluids—aim for 8 to 10 glasses per day to replace lost fluids.
Inform your doctor if you experience persistent issues like frequent bowel movements or bleeding. They can refer you to a specialized team that includes oncologists, gastroenterologists, surgeons, dietitians, and nurses for further management and support.
Inflammation of the back passage (Proctitis):
Long-term side effects of radiotherapy can include inflammation of the rectum, known as proctitis. This condition can cause a sensation of needing to strain, even when there is no need to pass stool. It may also lead to bleeding from the rectum or a discharge of mucus.
Bleeding associated with proctitis is typically mild, though some individuals may experience more severe symptoms. If you develop proctitis, it’s important to discuss it with your radiographer or nurse. They may recommend treatments like steroid suppositories for a temporary period to help reduce inflammation and alleviate symptoms.
Cancer of the bladder or lower bowel:
Some men may develop bladder cancer or rectal cancer years after undergoing radiotherapy for prostate cancer.
It’s crucial to consult your GP if you observe any signs such as blood in your urine or stool, or if you notice changes in your bowel habits. Early detection and medical attention can be essential in managing any potential long-term effects of radiotherapy.
Daignosis
If you have any symptoms, your first step is usually to visit your GP. They will discuss your symptoms with you and conduct an examination. Based on their findings,
Treatment options
A team of healthcare professionals (multidisciplinary team) will determine your treatment plan. Most people undergo surgery to remove the affected