There are different types of internal and external radiation.

After about 9 years on active surveillance, I had 28 sessions of proton radiation (during April-May 2021) + 6 months of hormone therapy. Had only 1 day of minimal side-effects. Every day after each treatment I’d head directly to the gym for 1-1/2 hours of weightlifting followed by either a 5K jog or swimming laps for 35-45 minutes.

My proton radiation treatments were relatively uneventful. My wife later told me that if she hadn’t known I was undergoing radiation treatments, she wouldn’t have realized it from any change in me. And the short amount of time that I was gone each day for treatment were no different than any other time when I simply left to go shopping or to the gym.

Radiation kills prostate cancer by destroying the DNA, thus preventing cells from multiplying. This affects both cancerous and healthy prostate cancer cells. However, cancerous cells multiply wildly and rapidly so, when their DNA is destroyed, they cannot repair their DNA quickly enough, so they “die” at a faster rate than healthy prostate cancer cells, which results in the observed plummeting of PSA.

Hormone therapy (ADT) is often used with and following radiation treatments because ADT suppresses the DNA repair mechanism for months after radiation treatment has ended; ADT is a very important component to kill prostate cancer cells.

Radiation is typically used for Grade Group 3 and higher. You’ll spend very little time on the radiation table - and most of that time will be spent getting in the right alignment. (Compare it to getting your teeth x-rayed; not really anything to be scared about. But, radiation treatments for prostate cancer uses higher doses of radiation to destroy DNA.)

Most of the side-effects from radiation treatments that you’ll see mentioned can be avoided or minimized by the choice of treatment regimen, understanding what’s going on and why the side-effects happen, and by simply taking appropriate precautions and preventive actions. Having a competent radiation team (radiation oncologist, dosimetrist, physicist, and radiation team specialists) can play a major factor in side-effects experienced.

Radiation is a modern-day treatment approach to an age-old disease.