Day Two of radiation treatment. Questions about diet, gas, exercise.

In terms of diet, I suggest listening to your body. It's good to know in advance what foods might cause you pain and bloating, but not every food affects everyone the same way.

There's also a off-the-shelf supplement called "Beano" in Canada (not sure if it has a different name in the U.S.) that helps people who have trouble digesting things like beans, vegetables, and whole grains. It might be worth asking if it's safe for you to take it with certain meals to prevent gas and bloating.

I was given a list of specific foods to avoid during treatment and told to take Gas-X every day.

I continued to exercise every day and forced myself to do it sometimes. I needed a nap for about 1-2 hours every afternoon.

ADT hasn’t made me tired like radiation but has caused depression which I finally realized needs treatment so am seeing a therapist and taking Wellbutrin. It also has made all my gains at the gym disappear but I still go because it helps me feel a bit better and is important. ADT will also make sex challenging, to say the least.

I was never advised to change my diet while having 35+ radiation treatments. I was also never told to change or limit my exercise. Walking a couple of miles a day shouldn’t hurt you, but can help keep the weight down. I have done that twice daily and never had a fatigue problem.

Never had any side effects from the radiation, it was as if I never had it done. As far as my body was concerned, though it did stop my cancer from coming back for 2 1/2 years, without ADT. I was a 4+3 Gleason and started with surgery.

A few years later, when I got on ADT, I based how much I ate by what I weighed every morning. While I did get a small belly from ADT my weight hasn’t changed more than a couple of pounds in 10 years.

A diet without red meat is recommended on many prostate cancer diet webinars I have attended. Broccoli is highly recommended. In Australia they grow a super broccoli from which they make a soup for prostate cancer survivors. Test show it stops DNA from changing, which helps a lot with prostate cancer.

I eat a big salad for lunch every day and never noticed having a gas problem from it. Lettuce, kale, tomatoes. Avocados, green onions, some shredded chicken and marinated artichoke hearts. Keeps my A1C down as well, something you have to worry about when on ADT, it can cause diabetic issues.

My radiation was salvage radiation so likely a little less of a blast each time..my RO's advice was the same as @jeffmarc 's no excercise advice and no diet changes. I eat fairly healthy though anyway.

I would go to the treatment at 9, eat breakfast in the parking lot after treatement, then go to the gym right from there for a couple hours. I'd go home and have lunch (usually a salad with some protein on it) then take a nap for a half hour to an hour. I like a routine, once I established this routine, it made everything easier. Dinner is usually some sort of veggie stir fry with chicken or fish.

I may have been a little gassy, but, other than that, only felt fatigue from the treatment. Most of that was in the last two weeks. I just kind of pushed through. What's the movie line? "you don't gotta like it, you just gotta do it" That was kind of my mantra....
Best of luck to you!

My radiologist did give me a list of foods that could cause gas, so I experimented and eliminated any that actually did. Broccoli was not a problem for me.

As for exercise, I was encouraged to do as much as I could. Weightlifting, jogging, etc. The only limitation given was bicycle riding during the 35 sessions and for one month after, since the pelvic floor muscle was irritated from the radiation treatments. There was no problem with bicycle riding after this period of time.

37 Salvage Radiation Treatments:
Trepidation over "mostly full bladder" and "mostly empty rectum" was with me for 8 wks.
Diet: I usually eat a LOT of vegetables. Cut back, but did not eliminate. Was advised that "yes", I had some gas, but was never "kicked off the table". Not hydrated sufficiently one time.
Joked with a radiation buddy that the perfect radiation diet was a double whopper with cheese, hold the pickle and lettuce, and fries. All 3 meals 🤪
I did take a GasX each night when I thought that I might have pushed the veggie/fruit limit.
Exercise: I continued my 50 minute walk and 3x weekly light upper body lifting.
Honestly, I think that you can do as much as tolerable; but be kind to yourself.
Good luck; this too shall pass.

The reason for the "low fart" diet is that gas in the rectum can push the wall closer to the prostate and so be more exposed to radiation.

Same reason for filling the bladder - protect the organs at risk.

In the bowels it can also cause movement and so things can move around after the initial CT scan, (less of an issue with an MR Linac).

The "bowel prep" enema before treatment also helps.

At the hospital I went too, they took it fairly seriously.

One time they stopped after the initial CT scan due to gas and when I could not pass it myself they used a catheter (something to avoid 😉) and restarted from scratch with a new scan.

I also had a meeting with a dietician before treatment where all the evil (healthy!) foods were listed.

After talking with the dietician I came to the conclusion that healthy food is banned☹️!

Avoid:
▪️fodmaps (onions, garlic, artichokes etc)
▪️any sort of beans (very thin string beans without seeds are ok)
▪️whole grains are out but processed cereals are ok!
▪️most leaf vegetables and salads are out especially cruciferous vegetables (no broccoli, cauliflower etc), no mushrooms, root vegetales OK
▪️many fruits are out (bananas, cooked apples without skin OK)
▪️fatty meat out (slows transit), lean meat OK
▪️white rice and bread without seeds are OK
▪️Anything else that impacts you personally. I also stopped most dairy since I am slightly intolerant (lactase supplements did not help)
▪️Carbonated drinks are out, including beer.

Friday/Saturday you can eat 🍔 and drink 🥂what you want! 🎉
While it's a pretty unhealthy diet it is only for a short time and it is in you best interests.

If you are not already into exercise, just do moderate stuff, walks etc, or start very slowly, beginning RT (especially on ADT ) is not really a great time to start.

A lot of people get fatigue (fairly common after week 3) but I was lucky and had none but I am also used to exercise (>40 years with weights) and continued training 3x a week without issue.
If you have a large number of sessions and need to drive, just the logistics can be tiring.

If you look online there is much contradicting info but this was pretty similar to the advice given at my hospital (mine was a bit more lenient on some foods to avoid constipation)
https://www.nutrition.va.gov/docs/Oncology/RadiationTherapyforProstateCancerNutritionFeb2022.pdf
I weigh myself the same time every morning like @jeffmarc (wifi scale connected to an app) and actually had a hard job eating enough of the crap food to keep my weight stable.
Daily weighing is a great way to manage the weight (it fluctuates daily and you need to ignore that but you also see trends quickly so can correct them)

Good luck with the treatment, how many sessions will you have?
I recently had 28, 3 high dose on MR Linac (1 hr) and 25 on traditional IGRT (20 mins).

If you want any advice on bladder prep just say so, it took me a while to get it right.

Agree with everything said here. I live to eat foods that cause gas - corn, beans, cauliflower, etc - and was told to stop that before radiation. I did and my GI tract stopped as well! But gas can cause your intestines to bloat and swell, putting them closer to the radiation field and in harm’s way - this is what causes proctitis down the road.
So I Got ‘Healthy Fiber’ on Amazon and take it 3X per day - gives almost 20gms of non-fermentable, non- bloating fiber. Regular once again!
Have not started radiation yet - on Orgovyx for past 2 months. Working out, walking, incline stepping, ripping out stumps on property. Tired afterwards but who cares?
Working your muscles is the ONLY antidote to the effects of ADT. You don’t have to kill yourself - which is probably what your RO was trying to say - but please exercise at whatever level you are comfortable with. Even curling a 5 lb dumbbell while watching TV is beneficial. Best!

I started a lawn service company after my retirement and went through a radical prostatectomy after a couple of years. I survived that fine and 11 years later I had a recurrence. I had 36 treatments of radiation and I worked during it all. You'll have to take it a bit easier than I did though. By the end of each week, I was so exhausted that it took the weekend to recover to begin the next week. There was no mention of a special diet to follow but a suggestion to not overdo the sugar. My recommendation would be to do a little bit of exercise as you feel fine with. I did what I did with the idea of maintaining some body maintenance and to help keep depression at bay.

Thanks to all for the input. Very helpful.
There's the diet to minimize/eliminate gas for the actual radiation treatment. But also to minimize most fiber rich fruits and veggies that might make diarrhea more likely/problematic? At least that's what the doc said. I'm not very "regular" as it is. But it seems constipation is better than regularity during prostate radiation treatment. But that doesn't help with the "empty your bowels before treatment" request. No enemas requested/mandated before my treatments though I have heard that some are asked to do that every time. Not sure if that's for a different form of radiation.

Ironically. I used to work for the company that makes the radiation machine that I'm being treated with (Varian). But I moved from the Oncology division of the company to the semiconductor division very early on so haven't seen them for over 25 years. Immediately started thinking about the people I saw building, testing, calibrating those machines. The quality of the technician that comes to calibrate and certify them at the hospital. The quality of the technicians that are in charge of aligning the machine and my body and their due diligence with making sure my body and the machine are ready for treatment. At the end of the day, it's in God's hands. But I will do some research on how critical the accuracy is on the success of treatment when it comes to how well the machine is calibrated and how well the techs align you and do their thing.
Will they stop and do something when gas, bladder, or full rectum may be an issue and do what's needed or do they just move forward because they're having a bad day, ready for lunch, or whatever? Just saying, these are the thoughts going through my head as someone that has managed employees who's responsibility it was to perform high precision work. Not paranoid. Just the thoughts that crossed my mind when I noticed the "Varian" label on the machine.

Regarding the exercise:
I'm glad that I maybe don't need to minimize my exercise/resistance training too much. I have worked out my whole life but only in the last few years have I stopped. Long days at work, long commute, and I moved my parents in to my house 7 years ago to help with their care. Didn't have a lot of motivation to work out at the end of the day. But now that I'm home and not working (53, laid off after 30 years in the semiconductor industry, and not sure if I'm going to return to work or try to retire), this seemed like a good time to get back to a regular exercise routine and stave off any weight gain/muscle loss from the treatment.

Interested to hear others thoughts.