How long do side effects from prostate radiation last?

From my reading, radiation side-effects usually end after a few weeks, but for an unlucky few they can last for a long time or even emerge years later.

My radiation cystitis and proctitis (both mild, fortunately) didn't emerge until a year or more after treatment. They cause me only mild discomfort now -- I got the incontinence from the cystitis under control -- but it also looks like they're permanent for me.

I'm not really complaining. When I was diagnosed with stage-4b prostate cancer at age 56, my radiation oncologist and I decided to "throw the kitchen sink" at it instead of just treating it palliatively, so I got a huge dose of radiation to my prostate in addition to other treatments. The treatments are still working, and I remain in full remission with undetectable PSA over 3 years after diagnosis.

I've shared this link in the forum before. It was one of the better resources I found for understanding radiation side-effects:
https://www.cancerresearchuk.org/about-cancer/prostate-cancer/treatment/radiotherapy/external-radiotherapy/side-effects-external-radiotherapy/

I had salvage radiation in 2016 I still have urine leakage and frequency.

I had 8 wks of radiation, 66.6 gy, as part of my salvage treatment.
About 2 - 3 weeks post treatment my radiation effects diminished greatly or went away.
Best wishes

@dwheels8
I know this is redundant but we are all different. What one will have side affects and how long the next will not. It is important you talk to your R/O and urologist about your side affects.

You did not mentioned if you had ADT or a hormone treatment. If you did your side affects are going to be very different from radiation including degree and how long lasting.

The incontinence is very common and I had it also. I don't think you saw previous posts but most including me talked about doing Kegel exercises. This again your urologist and or R/O can guide you how to do them as well as many videos that explain how to do them.

My incontinence was not full. It was just increased need and urgency and if not close to a bathroom would not be able to hold it. This got better with time but I also learned to go to bathroom when I felt I could rather that waiting for urgency to start.

The nausea you mentioned I am not familiar with. If you are on a hormone treatment it could come from that. Also be aware that most of us will have extreme anxiety and stress during the prognosis, treatment and recovery and we can all react differently to it which could be nausea as well. Really try to talk to your urologist and R/O about your side affects.

I knon when I was doing my radiation treatments I met with R/O once a week. He would go over dozens of questions and specifically asked about side affects. If I mentioned them he would give me advise on how to reduce them including medications.

My side affects started about half way in and continued afterward until about a year. After that year I was pretty well back to normal except dry orgasms. Both Mayo and UFHPTI have a portal system. You can send a message directly to your R/O or urologist or your PCP and get a reply. I used that all the time as well as my written down directions at my weekly visit which changed to 3 months visits, then once a year.

dwheel,

I finished my 5 treatments of radiation on October 4th, 2024. I had almost zero effects until October 5th. Now, 10 days later the only side effect left is the need to go often. 3 times per night if I'm hydrated properly. The urgency is still pretty strong to go as well. But, the pain while going number 1 and 2 is gone. I'm not back to my usual 'immediatly after breakfast' bowel movements but I can live with that. I will say for a few days I stayed near the toilet and regretted having to go but now that it's in the rear view mirror I am glad I went with radiation instead of removal. Hang in there and make sure your doctors know your side effects. ziggy

Everyone's side effects seem to be slightly different. I had nausea (though I never actually vomited) which is still occurring but I am also on ADT until the end of the month so it could be from that.

My radiation treatment ended in late June. The incredible tiredness went away about a month later. I had the opposite of incontinence--a very hard time peeing and being unable to fully empty my bladder. Flowmax helped and, after two months, I no longer needed it. Currently, the only side effects I can directly attribute to radiation rather than ADT is an occasional weird feeling my prostate and strange nerve feelings in my penis. These are not painful or unpleasant (or pleasant for that matter)--they just are different.

@dwheels8 I had 5 mridian linac, narrow margin, radiation treatments finishing February 2023. I had restrictive urination after the 3rd treatment but I immediately took Flomax and was better overnight. I had no pain or bleeding whatsoever. I got off Flomax after a month or two. Semen flow took about a year to recover but not fully.

I had 86 grays over 40 days. I experienced significant urinary issues for 2-3 weeks post treatment for which I took flomax and cialis which had a significant benefit. I’m still taking them 5 weeks from the radiation completion.

Wow! I had 60 gy of SBRT to my prostate, and I (apparently mistakenly) thought that was close to the maximum dose. It sounds like you're recovering well, all considered.