Prostate cancer treatments can be highly effective, often resulting in excellent long-term outcomes, especially when caught early. However, like any significant medical intervention, they are not without side effects. Whether you are preparing for treatment or navigating recovery, understanding how to manage these side effects is vital. Effective symptom control not only enhances quality of life but also supports better physical and emotional wellbeing.
This guide outlines practical strategies for managing prostate cancer treatment side effects, with particular attention to recovery after surgery, while also covering radiotherapy and advanced prostate cancer treatments.
Managing common side effects of prostate cancer treatments
Surgery (Radical prostatectomy)
While we explore surgery only briefly here (you can find our full guide here), it remains a common and highly effective option for localised prostate cancer. Understanding how to manage prostate cancer surgery side effects helps ensure a smoother recovery.
1. Incontinence
Temporary stress urinary incontinence (such as leakage when you cough, sneeze, laugh or stand up quickly) is common in the weeks following surgery. After that, it will gradually improve during the first year. Patients who undergo a Retzius-sparing prostatectomy will have, on average, three times better urinary continence during the first 6 months compared to those who do not. Most, but not all, men are suitable for this surgical approach, and eligibility largely depends on the location of the cancer. Pelvic floor physiotherapy (I recommend using the NHS Squeezy app) helps to accelerate the rate of improvement of continence, and exercises should ideally begin before surgery. Continence pads, fluid management (such as spacing out fluid intake), and limiting caffeine and alcohol all support recovery. If leakage persists beyond a year (which occurs in around 1-2% of men), corrective surgery in the form of a urethral sling or artificial urinary sphincter will be discussed.
2. Erectile dysfunction (ED)
Surgery can impact the nerves responsible for erections, even in nerve-sparing procedures. ED recovery varies depending on patient age, pre-existing erectile function, comorbidities such as diabetes, and medications—such as those used to lower the blood pressure. In most cases, erectile function reaches its recovery plateau around three years after surgery.. Supportive strategies include oral medications like Viagra, Cialis or Levitra, a vacuum device, a urethral prostaglandin pellet or cream, penile self-injection, or surgery. Psychological support and couples counselling can also play a role in restoring intimacy and confidence.
3. Fatigue and loss of energy
Fatigue after prostate cancer treatment is common, especially in the afternoon during the first few weeks. Having a nap in the afternoon, maintaining hydration, and slowly reintroducing light exercise such as walking rebuilds stamina. A nutrient-rich diet supports recovery.
4. Pain or discomfort
Pain is usually short-term and well-managed with paracetamol and/or ibuprofen tablets. Discomfort in the perineum during the first few weeks can be eased by sitting on a cushion.
It is worth noting that recovery speed can vary depending on individual health factors, age, and the extent of cancer. Patience and proactive care are key to regaining normal function after surgery.
Radiotherapy
Radiotherapy is a targeted treatment that effectively destroys cancer cells, often used in localised or locally advanced prostate cancer. Its side effects typically accumulate over time and can linger post-treatment. It may be combined with hormonal therapy, which lowers the testosterone level.
1. Fatigue
Fatigue often builds during the course of radiotherapy. It’s important to pace activities, rest when needed, and maintain a basic level of physical activity, like gentle walks, to reduce deconditioning. Some men find mindfulness practices, breathing exercises, or even short naps helpful for energy management.
2. Urinary urgency and frequency
Radiotherapy can irritate the bladder, leading to more frequent or urgent urination. Avoiding bladder irritants such as caffeine, alcohol, spicy foods, and citrus may help. Bladder training exercises and adequate hydration (not overhydration) are also beneficial.
3. Bowel irritation
Some men experience changes in bowel habits, such as loose stools, cramping, or rectal discomfort. A low-fibre diet and avoiding gas-producing foods can help. If symptoms persist, consulting a dietitian or gastroenterologist is advised.
Skin changes around the treatment area may also occur, such as redness or irritation, which typically resolves with time. Using gentle skincare products and wearing loose-fitting clothing can ease discomfort.
Advanced/Metastatic Treatments
In advanced prostate cancer, where the disease has spread beyond the prostate, treatments are aimed at prolonging life, managing symptoms, and preserving quality of life. Side effects depend on the type of systemic therapy used, including hormone therapy, chemotherapy, or newer targeted drugs.
1. Bone pain and chronic discomfort
Bone metastases can cause significant pain. Management may include radiotherapy to affected sites, radiopharmaceuticals (like Radium-223), or strong painkillers including opioids. Your care team may also recommend bone-strengthening drugs such as bisphosphonates.
2. Fatigue and frailty
Long-term hormone therapy can lead to ongoing fatigue, weight changes, and muscle loss. Nutritional support and a personalised exercise plan can help maintain strength and function. Working with a palliative care or supportive care team can optimise symptom control and wellbeing.
3. Hot flushes and mood changes
Hormonal therapy, which is also known as androgen deprivation therapy (ADT), can cause hot flushes, irritability, and mood swings. Lifestyle adjustments, relaxation techniques, and sometimes medications like antidepressants or low-dose oestrogens may be used to reduce symptoms.
4. Emotional strain
Living with advanced cancer can understandably take a toll on mental health. Common issues include anxiety, grief, and fear of disease progression. Accessing psychological services, support groups, or spiritual care can be deeply helpful. Some men benefit from antidepressants or talking therapies.
Understanding the management of advanced prostate cancer is crucial for maintaining dignity, independence, and comfort through each stage of the condition. Holistic support services can make a significant difference.
Emotional and psychological wellbeing
The emotional impact of prostate cancer and its treatment is often underestimated. Beyond physical recovery, men may struggle with identity changes, loss of independence, or fears about the future.
Support is available:
- Peer support groups and online communities (such as those hosted by Prostate Cancer UK) offer a safe space to connect.
- Counselling can help process feelings of loss, anxiety, or depression.
- Open conversations with partners, friends, and employers can ease social isolation and rebuild confidence.
Taking time to focus on mental health is just as important as managing physical side effects. The emotional impact of cancer and its treatment can be eased through structured therapy, regular check-ins with your healthcare provider, and setting achievable recovery goals.
Daily routines and self-care
A consistent, balanced routine can make a meaningful difference in recovery and resilience.
Adapting to body changes
Accepting and adapting to changes in sexual function, bladder control, or appearance (like weight fluctuations) takes time. Honest conversations with your partner and care team are essential. Confidence often returns gradually with support, education, and time.
Staying active
Regular movement can boost mood, improve circulation, and reduce fatigue. Our exercise guide recommends simple daily walks, stretching, and eventually progressing to strength exercises. Group classes or physical activity with others can also enhance motivation.
Rest and sleep
Prioritising good sleep hygiene, such as maintaining a routine bedtime, limiting screen time before bed, and managing night-time bathroom trips, supports healing.
Nutrition and hydration
Eating well can ease symptoms and promote tissue repair. Aim for a diet rich in whole foods, healthy fats, and protein. Stay hydrated, but monitor intake if urinary issues are present. Men recovering from advanced treatments may benefit from seeing a clinical nutritionist to manage weight, muscle mass, or dietary side effects.
Incorporating self-care strategies not only improves physical outcomes but also gives men a sense of control over their health.
Prostate cancer management guidelines
Ongoing monitoring is crucial after any prostate cancer treatment. Following recognised prostate cancer management guidelines ensures timely intervention if the cancer recurs.
PSA Monitoring
After treatment, PSA (Prostate-Specific Antigen) levels are regularly checked to detect signs of recurrence. Learn more about PSA testing here. A rising PSA may prompt further investigations or early intervention.
Follow-up appointments
NICE and EAU guidelines recommend structured follow-up protocols. These typically involve PSA checks every 3–6 months initially, then annually after 3 years. Imaging may be used if recurrence is suspected.
Red flags to watch for – symptoms to report promptly include:
- New or worsening bone pain
- Unexplained weight loss
- Changes in urinary or bowel habits
- Fatigue that disrupts daily life
- Shortness of breath or chest discomfort
If you’re ever uncertain, your care team at Santis Health is just a call away.
Managing the side effects of prostate cancer treatment can be challenging, but with the right support and self-care, recovery and quality of life can be significantly improved. Whether you’re coping with fatigue after prostate cancer treatment, urinary issues, or the emotional impact of cancer and its treatment, there are strategies and specialists to help.
For holistic support, read our main article on Prostate Cancer Diet and Lifestyle Tips. If you’re considering prostate surgery or have concerns about treatment, contact Santis Health to schedule a consultation with our expert team.
