Brachytherapy is a form of radiation treatment that is used for treating cancers of various kinds. Brachytherapy uses small radioactive seeds for treating the tumor cells more effectively. A radioactive seed is implanted directly on the tumor so that the radiation emitted from it is much more powerful and does not affect other organs and nearby healthy tissue as well. Of the two types of brachytherapy that is popularly used, namely LDR and HDR, LDR brachytherapy is commonly used for prostate cancer. The procedure is used for treating early stages of cancer when the cancer is contained only within the prostate. However, there are certain specific long and short term side effects that must be expected with this treatment.
Difficulty in urination
Not all men experience difficulty in urination after brachytherapy. While one in seven men experience difficulty in urination after the procedure, this is thankfully not a permanent condition in most men. The difficulty is concentrated more at the starting phase where men experience problems in starting the urination. It lasts only for about six months after which most men get back to normalcy. Only 1-2 percent of men have problems that could trouble them their entire lifetime. For such difficulties, the patients are normally advised to use a catheter until the symptoms are manageable. Medications too may be prescribed in case the problem persists.
Frequent urination
Just like the problem with initiation of urine, frequent urination is another side effect associated with prostate brachytherapy. Urination will become increasingly frequent for most men after a brachytherapy session. However, the urine flow may not be as strong. This is due to the narrowing of the urethra due to the procedure. Urination will also be painful during the initial weeks. Again, this too is a temporary side effect and can be mostly dealt with effectively with the help of medications and lifestyle changes like the use of a catheter until the patient is capable enough to gain control of the urination. Depending on the severity of the condition, catheter has to be used for several weeks or even months.
Burning sensation while urinating
Burning sensation while urinating is associated with the effect of surgery and radiation treatment. This can be controlled through medication as it is a temporary side effect of brachytherapy. Many men also find that bruising and inflammation of the scrotum is common after a surgical procedure in the groin area. Many men also complain that the frequency of the urination increases at night after brachytherapy. Due to the swelling, the urine flow weakens and emptying the bladder completely becomes a difficult task as well. These too will subside with time and the patient will return to normalcy after a few weeks.
Weak urine flow
All surgical procedures on the pelvic region can take a toll on bladder control and many changes in the bladder activity can be noted thereafter. Along with difficulty in frequency of urination, one would also notice that the flow of urine is considerably slow as compared to the flow before the procedure. This is a temporary condition in most cases as it is caused due to the swelling of the prostate after the procedure. Once the prostate starts healing and the inflammation subsides, the flow will become normal. In some cases, the inflammation of the prostate is such that the urine is entirely blocked. In such case a catheter is inserted and medicines prescribed to ease the discomfort.
Bruising
Swelling of the scrotum and bruising is common after a surgical procedure in the groin area. With brachytherapy, the bruising and swelling could be worse as the effects of radiation too are involved. Patients must be very careful as to not lift heavy objects and do heavy tasks for a couple of days after the surgery to give time for the wound and bruising to heal. Sometimes the swelling and bruising can be very severe that the patient may not be able to urinate for a day. In such cases, emergency medical care is needed where a catheter is placed for about a week until the scrotal swelling and bruising subsides.
Perineal irritation
Pain in the perineal region can cause a lot of discomfort after brachytherapy. The perineal region will be very sore after brachytherapy. Some people might also experience spotting from the perineal region and pain as well. Using a sitz bath helps in such cases. You may use a hot or cold or combination sitz bath depending on your comfort. However, ensure that you seek the advice of your doctor before venturing into such treatments. Pain medications and anti inflammatory drugs might also be needed to control the irritation and discomfort. As bowel movements can increase the rectal irritation, food control is also essential in such cases so that the pain and friction on the rectum can be minimized.
Urethral stricture
After any kind of radiation treatment on the pelvic region, a common complaint faced by all men is the narrowing of the urethra or urethral stricture, which has a direct impact on urine flow and emptying of the bladder. Urethra is the tube that allows urine to pass out of the body. Narrowing of the tube will reduce urine flow and also reduce the strength of the flow. Bladder will not be emptied completely in such cases, leading to urinary tract infections. Up to 8 percent of men undergoing brachytherapy experience this condition. Whilst some may not be so severe, there are others require surgical correction due to severe blockage or urinary incontinence.
Erectile dysfunction
All kinds of radiation treatments have some kind of effect on the sexual function of a man. Erectile dysfunction is a side effect that can be expected after brachytherapy. The reason for this could be the proximity of the sexual organs to the prostate while undergoing the treatment. Inability to attain and sustain an erection can sometimes be a permanent condition after brachytherapy. Sometimes, erectile dysfunction resolves on its own after a few years. It can last for about five years if it is a temporary condition. Some men can also develop infertility and impotence after brachytherapy. Therefore, assessing the sexual side effects and discussing possible treatment options is necessary before undergoing the procedure itself.
Rectal bleeding
After the surgical implantation of the radioactive seeds, men can also be faced with rectal bleeding due to the effect of high radiation that is concentrated around the groin area. The bleeding may not be just concentrated around the rectum. It can also be from the scrotum. Other associated symptoms include tenderness, bruising and burning around the groin area and inner thigh region. Rectal bleeding need not be taken seriously unless it causes severe discomfort and persists for more than a few weeks. Typically, these symptoms subside after a few days and patients are on the road to recovery in a week’s time. Any difficulty that persist beyond that requires medical attention immediately. Anti-inflammatory medications are prescribed in such cases.
Bloody urine and stools
This condition, also known as hematuria is another side effect that has to be expected after brachytherapy. Hematuria is characterized by the presence of blood in urine after the procedure. The presence of blood is not very dominant and in most cases, it subsides as the prostate gland starts healing. If the blood is much more than expected and does not stop after the stipulated time, it is important to undergo a checkup. Blood can also be present in the stools after brachytherapy. However, this is much less common as compared to bloody urine or hematuria. Some men might also find blood in their semen following an ejaculation which too is a common phenomenon after brachytherapy. All these symptoms are temporary and subside after a few weeks.
Diarrhea
Certain changes in the bowel movements must be expected after brachytherapy. The most common side effect of brachytherapy is diarrhea. Loose bowels can be very frequent after the procedure and it sets in within the first two weeks after brachytherapy. Diarrhea can last for two to three months after brachytherapy. During this period, the patient might require medications for controlling the symptoms. The symptoms mostly subside after two months and the patient does not require further medical intervention. However, if the symptoms of diarrhea persist after two to three months, it is important to seek medical advice to rule out complications. Diarrhea can also be controlled effectively through diet modifications. Avoiding insoluble fat and adding more lean meat and water to your diet helps a lot. Anti diarrheal medications will be prescribed to control the symptoms that are very severe.
