NCCN Guidelines for Patients
Prostate Cancer, Version 1.2016
Overview of cancer treatments Cryosurgery
HDR brachytherapy uses seeds made of iridium-194
that are contained inside soft catheters. The catheters
are removed after radiation has been given. This
treatment requires staying in the hospital for 1 to 2
days. HDR brachytherapy may be given along with
Side effects of radiation therapy
Similar to surgical treatment, a common side effect
of EBRT and brachytherapy is erectile dysfunction.
Unlike surgery, erectile dysfunction may develop
several years after radiation therapy. Although not
as common as erectile dysfunction, other sexual
changes may include difficulty achieving orgasm,
thicker semen, dry orgasm, discolored semen, and
a decreased sperm count. These less common side
effects often stop after a short period of time.
You may develop urinary problems. Urinary problems
right after EBRT may include frequent urination,
a burning feeling while urinating, blood in urine
(hematuria), and feeling the need to rush to a
bathroom or you’ll leak urine (urge incontinence).
After brachytherapy, you may have burning with
urination, a slow or weak urinary stream, urinary
retention, overflow incontinence, and hematuria.
These side effects go away. Several years later,
radiation injury to the bladder can cause urinary
incontinence, although this isn’t common for either
EBRT or brachytherapy. However, your risk after
brachytherapy is higher if you have had a TURP.
Despite the best treatment planning and delivery,
your rectum will be exposed to some radiation
during EBRT or brachytherapy. You may have rectal
pain, diarrhea, blood in the stool, and inflammation
of the colon. These side effects will go away over
several months. Several years later, radiation injury to
the rectum can cause rectal bleeding and irritation but
these symptoms are rare.
EBRT may cause changes in your skin. Your treated
skin will look and feel as if it has been sunburned. It
will likely become red and may also become dry and
sore and feel painful when touched. You may also feel
extremely tired despite sleep (fatigue) and not feel
hungry. Exercise may help reduce fatigue.
Not all side effects of radiation therapy are listed here.
Please ask your treatment team for a complete list of
common and rare side effects. If a side effect bothers
you, tell your treatment team. There may be ways to
help you feel better.
Cryosurgery is a treatment option if radiation therapy
fails. Cryosurgery treats prostate tumors by freezing
them. This treatment is often done as an outpatient
Very thin needles will be inserted through your
perineum into your prostate. Imaging tests will be
used to place the needles. Argon gas will flow through
the needles and freeze your prostate to below-zero
temperatures. Freezing kills the cancer cells. Your
urethra will be spared by use of a catheter filled with
The full range of side effects from cryotherapy is
unknown. More research is needed. Known short-
term side effects include urinary retention, painful
swelling, and “pins and needles” feeling in the penis
(penile paresthesia). Long-term side effects include
erectile dysfunction, stress incontinence, fistulas, and
blockage of the urethra with rectal scar tissue.