- Bowel problems: Radiation can irritate the large intestine and rectum and lead to a condition called radiation proctitis. This can lead to diarrhea, sometimes with blood in the stool, and rectal leakage. Most of these problems go away over time, but in rare cases normal bowel function does not return after treatment ends. In the past, about 10% to 20% of men reported bowel problems after radiation therapy, but the newer conformal radiation techniques may be less likely to cause these problems.
- Bladder problems: Radiation can irritate the bladder and lead to a condition called radiation cystitis. You might need to urinate more often, have a burning sensation while you urinate, and/or find blood in your urine. Bladder problems usually improve over time, but in some men they never go away. About 1 man out of 3 continues to need to urinate more often.
- Urinary incontinence: Overall, this side effect is less common than after surgery. The risk is low at first, but it goes up each year for several years after treatment.
- Erection problems, including impotence: After a few years, the impotence rate after radiation is about the same as that after surgery. It usually does not occur right after radiation therapy but slowly develops over a year or more. This is different from surgery, where impotence occurs immediately and may improve over time.
- Feeling tired: Radiation therapy may cause fatigue that may not go away until a few months after treatment stops.
- Lymphedema: Fluid buildup in the legs or genitals (described in the surgery section) is possible if the lymph nodes receive radiation.
- Urethral stricture: The tube that carries urine from the bladder out of the body may, rarely, be scarred and narrowed by radiation. This can cause problems with urination, and may require further treatment to open it up again.
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