I had eight weeks of radiation therapy. Here are my top five take-aways.

TLDR - It's worse than they tell you

Feb 07, 2025

A few weeks ago I completed the last of 40 treatments of radiation therapy at the Swedish Cancer Institute in Edmonds, WA. I did everything I could think of to delay starting the treatments because I’m distrustful, both by nature and by profession, and because I was worried about what impact it would have on my body.

Now that my energy levels are starting to rise, I thought I’d write a short post with the top five things I’ve learned from this part of my ongoing prostate cancer treatment.

One - you’ll be really, really, really tired.

I was already feeling fatigued all the time due to the side effects of Androgen Depressant Therapy (ADT) drugs, but once I started getting daily radiation treatments, it became much worse.

Two - High Anxiety

My anxiety levels were off the chart during those eight weeks. I felt like I had zero control over my emotions. It became so bad that I had to get a prescription for an SSRI (Lexipro) and began seeing a therapist. When there’s no testosterone in your body, you have nothing to counter the effects of estrogen. This doesn’t happen all at once. It’s cumulative after many months of ADT meds, and then aggravated by the radiation. It was a huge shock, and scary as hell for me, but I learned how to manage it thanks to weekly visits with a therapist via telemedicine.

Three - you’ll have to give up spicy foods, acidic foods, and coffee, or pay the price!

I learned this the hard way. I love oranges, coffee, and hot and spicy asian dishes, and I continued enjoying them for the first few weeks of radiation therapy. I did experience some mild burning sensations while urinating, but it was only about a 3 on a scale of 1-10.

Then one morning, my pain level shot up to an 8. It was like a high voltage electrical current that ran from my urethra down both legs and rocked me back on my heels! I had to take two Meloxicam and four Tylenols for the next three days just to keep the pain level below 4. When your radiation oncologist tells you to eat bland food, trust me. Just eat the bland food.

Four - An increasing urgency to urinate

This is a real inconvenience. It’s normal to have to urinate more frequently as you get older, but the side effects of both the ADT drugs and radiation makes you feel like your bladder is about to explode if you can’t find a toilet NOW. It also makes it next to impossible to get a full night’s sleep. In my case, I was able to lower it from four or more interruptions while I was sleeping to only one or two thanks to getting my daily 60 ounces of water intake done before 5:30pm, and getting a prescription for Flomax.

Five - Side effects don’t stop when the radiation does

My radiation oncologist had the uncanny ability to predict every side effect that I would experience, just before I actually experienced it, and almost always within a 24 hour window. The one thing that he couldn’t do was predict the intensity. In some cases, it had less impact than he expected. In other cases, it was more. The same will be true for you if you find yourself having to battle cancer at some point in the future.

Once the radiation sessions are over, you might think that the side effects will end soon thereafter. That hasn’t been the case for me. I still cannot urinate without some pain and that may last for several more months. On the other hand, my fatigue levels improved within two weeks of my last session. According to my oncologist, that’s due in large part to maintaining a rigorous aerobic exercise program. In my case, it’s rowing, but it could be anything that gets your heart rate up and keeps it up for at least thirty minutes each day.

This sucks, but it’s better than the alternative

If, or when, you have to engage this adversary, don’t let the potential side effects frighten you from getting treated. The work of fighting cancer sucks, but as the Stoics put it, the obstacle is the way. The longer you postpone treatment, the more likely that your cancer will spread, and you don’t want it to spread.

If you find yourself with a diagnosis of prostate cancer and have questions, feel free to reach out. It’s not something that you want to go through without a strong support network.