How can I cope with radiation side effects during prostate cancer treatment?

I had 45 days of IMRT. Fatigue started two weeks after start. Afternoon naps helped. I was 71 at the time. Feeling well now at age 77; or, I should say, “Feeling 77 now.” I experienced radiation cystitis and proctitis. Had a hemi banded. Both problems resolved. Research I’ve seen supports high dose radiation in terms of time to recurrence and overall survival. I’d do it again, therefore given 6.5 years of remission with my Stage IV cancer.

I did proton radiation at the Emory Proton Center. 37 days of treatment 5 days on, weekends off. Radical Prostatectomy. Radiation to prostate bed and pelvic region after 1 lymph node infected and positive margins. PSA was never non detectable, indicating they didn’t “get it all.” Excellent facility and care. I had almost no side effects, a little stool problems, nothing else. 5 weeks after completion, still nothing to talk about. 69 years old. Currently taking Orgovix for testosterone suppression and Erleada( Appalutimide) to prevent cancer to uptake any testosterone. Currently PSA is <.01, non detectable, but that is while taking the drugs. Once off the drugs next November 2026, that is when PSA will be more realistic and find out if I am truly in remission. In the meantime, side effects of ADT are very present, hot flashes, weakness, nausea, the gamut. It’s not pleasant and some days are worse than others. It’s very important I lift weights as heavy as you can go, and do some cardio, walking is all I am doing, but it is up and down hills, so it gives me a workout.

Despite ADT improving overall survival in appropriately selected patients, it is accompanied with a range of adverse effects, including negative alterations to BMD, structure and strength, lean tissue mass and fat mass, which may contribute to the increased risk of osteoporosis, falls, fractures and cardiometabolic-related events observed in this population group. Although various guidelines exist for men with PCa treated with ADT, there is a need to implement and evaluate the growing body of evidence supporting the use of lifestyle interventions to ameliorate and manage the adverse effects of ADT. Clinicians should consider referring suitable men to practitioners within the allied health profession (for example, exercise physiologists and dieticians) to ensure these men receive the greatest quality of evidence-based care. Our proposed recommendations are outlined in Table 4. Future trials are required to assess both the risk and benefits of adhering to these guidelines and only then may these be fully incorporated into standard practice for men treated with ADT.

Taking a modified schedule approach with your radiation treatments shows wisdom in listening to your body's signals. Many patients in this community have shared that managing side effects like urinary discomfort and other issues during radiation requires patience and often involves working closely with the care team to find comfort measures that help. Your resilience at 86 is inspiring, and connecting with others here who've navigated similar treatment experiences can provide valuable insights and encouragement as you work toward completing your course.

I finished 20 IMRT treatments 10 days ago. Frequency of urination improving as well as the burning. Feeling tired after routine activity such as grocery shopping. I am 87 and declined ADT because the side effects at my age aren’t worth it. My Gleason was 4+3 with a PSA of 12.4. I’ll test it again late December.