Urge to urinate & pain and burning due to radiation: Tips?

Hello... 1st time asking a question or posing my situation on this format. Long story short...I have had two bouts with radiation to combat prostate cancer. My PSA was finally in the teens after several years of monitoring. 1st radiation was CyberKnife radiation treatment (over two years ago I believe). It seemed to work but then PSA started to rise again after 6month to a year. So, ended up in a different hospital system further away that could re-radiate via HDR (high dose radiation) brachy therapy...this was done on Non 14th of 2024.
I have experienced the strong sense of urgency, weak stream, up-4 to 6 times a night, hard to start and hard to stop, and worst of all the burning (I call it peeing acid now) every single time I go. Recently (within the last month) I feel the same type of burning (not nearly as severe) during my bowl movements. Also, there is blood in my urine every so often but not a lot. Used to be worse a couple of months ago but it has becoming much less. Monday, I am going in for a cystoscopy procedure to see if they could see why the pain is so severe and also preforming a UroLift procedure to see if this helps.
Getting hard to tolerate the constant daily/hourly pain and if Monday's procedures do not allow for relief some how, I believe next step is to reach out to another facility.... thus starting with this conversation I guess.... sorry for the long comment... VR

Hi @david2000, great place to post your message in a existing discussion related to your question. It also helps you to see what others have already posted on the topic of urgency related to radiation.

The sign of blood along with urgency and burning most definitely require medical attention and I'm glad to read that you have appointments tomorrow.

If getting a second opinion at one of the Mayo Clinic locations is an option for you, here is how to submit a request http://mayocl.in/1mtmR63

David, did you talk with your radiation oncologist when the burning first started?

Apologies if already asked, but is anyone going through radiation treatments experiencing a constant urge to urinate? With very little output. And with “tolerable“ burning pain while feeling the urge? No burning while urinating. Just while feeling the constant urge. Also just FYI I am on second monthly Lupron injection and so far, so good. No intolerable side effects. Someone on this forum mentioned monthly injections as they were slightly less potent. Thanks everyone and hang in there.

It sounds like you're having a tough time, and of course, you don't want to feel like you're being lectured (even if that wasn't someone's original intention).

My own experience is that sharing my stage-4 cancer details with family and friends (including my then 80-year-old mother) was really tough at first — heartbreaking, even — but eventually turned out to be a positive experience. I learned that people loved me unconditionally, not just because I was strong and helpful, and that was one of the few actual gifts cancer has given me. It's also been important to them (both remote and nearby) to be on this difficult journey with me since 2021.

Of course, everyone's experience is different, but if you do see an opportunity where *you* think it might be appropriate to share with the people you love, I think you won't regret it.

Best of luck, whatever you choose.

No, I'm not having a rough time.

In the six months since the post on which you are commenting, the urinary issues I mentioned have largely resolved. Fourteen more months of ADT sucks but I can take it. The side effects are no fun but I am secure enough to actually enjoy my enhanced (but temporary) feminine side and I can easily joke about that and my chemical emasculation with a select audience.

Some members of my family had a need-to-know due to my CHEK-2 mutation and happily they have all had good results from genetic and PSA tests (which are less routine where they live). A few additional friends know as a courtesy. I have had superb support from my core group of friends and colleagues. Despite all the doctor appointment, tests and scans, I did not miss a single day of work since I was diagnosed fifteen months ago. I've travelled domestically and internationally ten or more times. PC treatment is tough but I feel that I have maintained a positive mental attitude throughout.

I appreciate your immensely more polite response but I do feel that the other poster is doing the real disservice by telling people how to manage their disease and that you have unfortunately bought into his incorrect analysis.

My burning came to my attention about a year after the radiation to my prostate. I voided some blood, had problems with incontinence, and repeated UTIs.

Imaginging (cystoscopy) showed mild radiation cystitis — light burns to the lining in the bottom of my bladder. They're probably permanent. It took a few months to get things under control, but it's only a minor nuisance now.

If lifestyle changes like keeping hydrated and minimising food/drink that irritate you don't end up helping enough, there are other treatments, like filling your bladder with pure oxygen periodically to promote healing. Talk to your urology oncologist about diagnosis and options.

Best of luck.

Thanks for your help, did you take any medications.