Side effects of ADT + RT

Your RT ended 8 months ago. Has this been a problem all of this time?
Have you tried any of the anti-urgency drugs (Gemtesa; Mirabegron/Myrbetriq; Tolterodine ER & others)? These work to relax the bladder. RT that hit the bladder can cause the symptoms you mentioned but usually goes away in a few months. My symptoms had not gone away in 3 months so I used the medications and they worked. If symptoms have been around since RT they are probably related to the RT. I do not know if abiraterone or prednisone can cause these symptoms.

I’ve been on ADT for almost 9 years and was on abiraterone For 2 1/2 years and didn’t experience what you’re talking about. Most likely, it’s the radiation that affects you, You’re getting cystitis that is delayed for some reason but that’s really what it is when it burns when you pee, And that is caused by the radiation. This is something you want to talk to your urologist about. They probably will want to do a cystoscopy where they put a scope down your penis to see what’s going on. I had that done a few months ago and it was one of the easiest procedures I’ve ever been through. I was even were able to watch the video as it was going on.

We hear occasionally people are getting proctitis or cystitis two or three years after having a radiation.

Flomax is what is used frequently for people with what you are describing. You could also get AZO, that they have in the pharmacy, without a prescription, It works for some people.

When I was feeling like I had to go two or three times at night, Knowing I didn’t need to, but having to get up anyway, I started taking Myrbetriq as @jim18 Has recommended. I don’t get up at night anymore. Well, maybe once every few weeks I get the need to go, but it’s very infrequent.

I had 40 sessions pelvic IMRT 80gy over a year ago along with Orgovyx and Zytiga / Prednisone which I'm still taking for about another six months. I didn't experience any burning sensation, however urinary frequency and urgency began about halfway through the radiation treatments. This continued for several months afterwards and caused me considerable stress especially the urgency when I was away from home. It has mostly abated at this point in time. I still get up twice a night to pee sometimes only once if I don't drink anything a few hours before retiring. Anyhow, my bet is with more time your situation should improve. I'm guessing, but you're burning sensation is likely due to radiation rather than ADT or ARPI. Dysuria can happen but I think rarely from the drugs? What type and how many radiation treatments did you have. I believe the shorter courses are more likely to involve radiation cystitis.

Thanks Jim and Jeff for your response; it's very helpful.
This problem has not been there all these 8 months, hardly any side effects. There are other things that probably need to rule out, like UTI. And it's possible these side effects have nothing to do with meds or RT and everything to do with UTI (if it's the case).
Appointment with Uro is tomorrow, will ask him about cystoscopy and the mentioned drugs.
Thanks again!

@swl1956
50.4 gy (28 sessions) to pelvic LNs and 70gy (28 sessions) to prostrate, SV & nodes. That's in the Radiation treatment summary.
Till date, there were absolutely no issues either on burning or frequency.

Thanks for your detailed response. Hopefully this should subside soon.

@swl1956
You don’t have to get up twice a night to pee if you get the right drug combination.

I am on Myrbetriq And it works great to stop that urgency at night, I don’t have it at all anymore. I used to wake up multiple times at night feeling I needed to go knowing I didn’t.

There’s another drug called Gemtesa Which works pretty much the same.

Ask your doctor if you can get one or the other and you can stop getting up in the middle of the night. You don’t have to take them forever, but they do help a lot.

Thanks Jeff for the info. When I get up at night to go pee, I really have to go and go quite a bit. I may be too hydrated before I retire? In any event, getting up does interfere with quality sleep and I think maybe the fatigue I'm experiencing is caused in part by this. Perhaps I might look into your suggestions.

Yes, hopefully your symptoms will subside soon, but if they don't it's good to know there are meds to help. Probably at least discussions with your doctors sooner than later might be prudent. Hang in there!