In the UK, external beam radiotherapy remains the most commonly used therapy for men with prostate cancer (19). Treatment usually involves multiple radiation doses over a number of weeks from an external source.
Advantages of radiotherapy:
- there is no need for hospitalisation
- the risk of surgical procedures and discomfort of surgical incision is avoided
- the incontinence risk is lower than in surgery, although impotence is still a potential problem (it may occur in between 30% and 50% of patients).
'Before undergoing radiotherapy patients should be counselled about the risks of bowel/bladder damage and impotence' (2).
Potential disadvantages and risks of EBRT include:
- outpatient visits for 5–8 weeks
- incontinence
- proctitis
- diarrhoea
- cystitis
- erectile dysfunction
- urethral stricture
- bladder neck contracture
- bleeding.
Because of the potential for bowel damage, radiotherapy is contraindicated in men with a history of inflammatory bowel disease. There are two ways of giving EBRT: conformal radiotherapy and IMRT.