Constant need to urinate with radiation therapy for prostate cancer

I'm sorry to hear about that. I had very similar symptoms, except that they emerged a year after the radiation therapy. They started with a nasty UTI that wouldn't respond to antibiotics, and a big bout of hematuria (my urine was blood red at one point). I was sometimes going to the bathroom every 30 minutes at night.

A cystoscopy showed some mild radiation damage to the bottom of my bladder adjacent to the prostate, but before that, my oncology urologist and I brought the dysuria under control through a series of measures.

Diet: significantly reduce caffeine (maximum one small cup of tea a day) and limit other irritants like spicy food and alcohol.

Hydration: drink a lot of water (at least 48oz/day), but not within 2–3 hours of bedtime of course.

Mindfulness: learn to relax and calm the urge through breathing exercises, visualisation, etc.

Exercises: kegels. lots.

Medication: Myrbetriq (Mirabegron) to relax the detrusor muscle that pushes on the bladder, starting at 25 mg and then going to 50 mg per day.

Even with all of this, it took 7 months before I started sleeping for a significant amount of the night without rushing to the bathroom and I felt safe going out without wearing a heavy-duty bladder-leak pad. Your mileage may vary. But definitely talk to your medical team about Myrbetriq, because it did make a big difference for me.

p.s. I'm able to drink lots of tea and eat spicy food again now, a year later, I sleep through most of the night, I don't have to plan long trips around bathroom stops, and I even wear light-coloured pants sometimes. 🙂

(Flomax didn't help me, either. And while drinking lots of water may sound counterintuitive when you're constantly running for the bathroom, it actually, flushes the irritants out of the urinary tract; dehydration is often the beginning of a urinary tract infection or other bladder problem.)

I have had 14 (of 40) IMRT sessions to date and am having similar issues to what you describe. At its worst, I was peeing every two hours at night. Based on what I've read here and elsewhere, I'm glad I didn't get a prescription for Flomax. Instead, I requested Cialis but I have to say it is not very effective but maybe better than nothing. I have noticed that when I take ibuprofen before bed, though I don't like to take it, it reduces the number of times I need to pee.

I also have bowel problems from the radiation but it has greatly improved since I started a regime of a tablespoon of psyllium mixed in water in the morning. I also take retinol (Vitamin A) in the form of a teaspoon of cod liver oil every morning as well. This has resulted in a big improvement in bowel function.

I also try to get a workout in each day on a rowing machine. It tones the muscles in the pelvic region as well as elsewhere.

I had similar urination issues during my ADT and radiation. I would stop drinking any liquids after my dinner and could go from 8 to 11 PM without urinating. But then, as soon as I got into bed, I would be up a half hour later to urinate and then it could be a half hour after that I needed to urinate again. I did the double void technique to try to empty my bladder, but I still would be urinating 3 to 4 times a night. My urologist said that Eligard was a diuretic, and that was what was causing the nocturia. I stopped drinking coffee and cut back on alcohol in order to avoid irritating my bladder. The radiation affects on my bladder I believe were secondary to that of the Eligard. Once the Eligard left my system, I went from urinating 20 times a day to about 10.

Thank you all for your insight and suggestions. I know everyone's body reacts differently to the treatments . I reached out here because it seems at least in my area there's very little support system during the treatments themselves. Lots of good information that is greatly appreciated!

Suggest looking into ‘bladder neuromodulation’. Placement of this device significantly improved my hyperactive bladder symptoms, allowing decent sleep.

One more non-medical suggestion. Because my metastasis had left me paraplegic for a while, I'd gotten used to using urinal bottles like these during my months in the hospital:
https://www.amazon.com/Urinals-Spill-Proof-PerfectMed-Pack/dp/B07YMHR8SJ/
When my dysuria started and I needed to go every 30 min sometimes at night, I found that keeping one of these beside the bed make a big difference: I didn't need to wake all the way up to use it (no walking to the bathroom, etc), and because I knew it was so close, I ended up needing it less, because I didn't feel as worried about making it (stress can cause the detrusor muscle to contract — search for "urge incontinence"). So my sleep starting improving.

You can keep hand sanitizer on the bedside table to clean your hands, and in the morning, just empty the urinal bottle into the toilet, then shake it up with some water and squirt of hand soap or shampoo to keep it clean and fresh-smelling.

Dave1957: do you know the type of radiation machine that was used on you?

You sound almost exactly like me. 21 sessions of proton beam therapy and urinary issues from about session 7 or so. Nurses said it was too early but all I knew was that is was very real. Received flomax which helped a little. Also had hemorrhoids which was a first for me and probably a direct result of not drinking enough water (due to painful urination). Unfortunately, the only thing that helped was time. By about session 16, the symptoms were manageable somewhat. Seems counterintuitive but stay hydrated.

Very good suggestion that I hadn't thought of. I'm surprised I haven't worn a path through my carpet with all the trips.