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tip of penis sore after finishing IMRT

Posted by melvinw @melvinw, Nov 23, 2025

I just finished 38 sessions of IMRT for locally recurrent PCa last Tuesday (Nov 18). As I’ve posted about previously, the only notable side effect was fatigue.

For the past few days, the tip of my penis has been a bit sore. No pain on urination, but more like the tip feels slightly bruised. I’m not sexually active, so that can be ruled out as a cause of the irritation.

This morning I noticed a spot of swelling and redness at the urethral opening that corresponds to the locus of the soreness. The spot was “capped” by a small brown spot, about 2 mm in diameter. Could be a blood blister, or something more concerning. I’ll contact my PCP on Monday to get advice on how to proceed. Fortunately, I also have an appointment with my dermatologist in mid December for a routine exam.

In the meantime, has anyone experienced anything like this during or following RT?

I’m wondering if this is a skin irritation on my penis from the RT. I haven’t had other skin issues from the RT. Definitely don’t want to shrug it off in case it is something worse. Assuming horses until there is evidence of zebras, but...

Thanks as always for any shared experiences.

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brianjarvis | @brianjarvis | Nov 25, 2025
In reply to @jc76 "@brianjarvis What I found out from my medical doctors was radiation can lower you immune system..." + (show)
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@brianjarvis
What I found out from my medical doctors was radiation can lower you immune system as your body fights off the damage to radiation. I can't remember but a poster on MCC mentioned the immune system when his doctor associated his lowered immune system could be from radiation.

The post I did was about a sore on a poster's penis that would not heal. I had the same thing but like I posted I get them all the time as I bike to/from my home to swim and exercise in pool and found I would developed rash, sore from the wet bathing suit rubbing on my testicles and penis.

Problem was I had a test that prevented me from bike riding and I noticed the sore (like the poster mentioned) was not healing and I was not aggravating it with wet bathing suit bike riding.

So I went to dermatologist who did biopsy and came back SCC. I was told SCC can develop out of sores and most likely indicates a recurrence of HPV caused SCC. Totally unaware of that medical information.

Then discussion of relationship of radiation and immune system. My R/O, PCP mentioned to me common side affect of radiation is fatigue. Fatigue will cause your immune system problems.

So the intent of my post was to inform the other poster to check and see if his sore was SCC since would not heal and my experience with same finding out my sore was SCC and most likely caused by HPV which immune system usually keeps dormant.

The poster is seeing a dermatologist. When I had my in office visit the dermatologist was a female. Talk about embarrassing but they told me they have seen and done biopsies on every parts of the body and not uncommon at all to do biopsies on penis.

Jump to this post

@jc76 So far, I’ve never had SCC. My wife sees a dermatologist regularly for pre-cancerous lesions that often appear.

We (my RO, MO, and myself) had much discussion on this topic - minimizing radiation to otherwise healthy nearby tissues and organs— as part of our treatment planning. The center I chose for treatment not only used proton for prostate (& other adult) cancers, but also pediatric cancers (since it was primarily a children’s hospital). They were experts in hitting small cancers in tight spaces and avoiding critical nearby areas.

Yes, avoiding radiation damage to the rest of the body provides many benefits - less chance of fatigue, fewer incidences of secondary cancers, fewer impacts on bone marrow, fewer impacts on immune system, land more.

Post-radiation, in addition to regular PSA, testosterone, CBC, and CMP testing, we also did one immune system test. I don’t recall all the assays we did, but many of the regular ones were out of range: RBC, HBG,HCT, neutrophils, & platelet count - likely due to the radiation. (Platelet count remains out of range to this day, but without any apparent side-effects, I’m not too concerned about it.)

During the time of and after my radiation treatments, I also swam a lot (USMS and Senior Olympics) and exercised regularly. Fortunately, I never experienced rashes or sores from those activities.

Hopefully others will see this information and incorporate it into discussions with their medical teams.

As for the dermatologist being female - by the time most of us reach this stage of our diagnosis and treatment, pride is almost always a thing of the past…..

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