What to Expect After Internal Radiation (Brachytherapy) Treatment for Prostate Cancer

These are some common side effects of internal radiation during the first week or so after the procedure:

• Swelling or bruising in your penis or scrotum

• Pain

• Red-brown urine

• Red-brown semen when you ejaculate during an orgasm

• Pain or burning when you urinate

• Bowel problems, such as diarrhea

These should go away. Ask your doctor or nurse to tell you whether there are any side effects that mean you should call them immediately. You should be able to return to work in three or four days. Some experts recommend limiting your contact with pregnant women and small children during the first few months because the seeds give off a small amount of radiation.

You will also need some follow-up care. The seeds tend to lower the prostate specific antigen (PSA) level gradually, and it can take up to two years to reach its lowest level. The level is not likely to become completely undetectable, even if treatment is successful, because some normal prostate cells will still remain in the body making PSA. You’ll need to have your PSA level checked every several months after the procedure for at least a few years--your doctor will discuss a proposed follow-up schedule with you. Some men have a temporary rise in their PSA level between the first and second year after seed treatment. As long as the level does not continue to rise, this is called a benign PSA bump.

The following effects may continue after internal radiation. Or they may not appear until months or years later:

• Bowel problems, such as irritation of the lining of the rectum, which could lead to diarrhea or pain during bowel movements

• Urinary problems, such as having to go often or inability to completely empty the bladder due to a narrowing of the urethra

• Inability to have an erection called erectile dysfunction

Talk with your doctor about ways to cope with these longer lasting side effects.