Thursday, 19 February 2026

Photons on the Prostate - Three Things I Wish I'd Known

Full Disclosure

Despite what you read in this blog, I believe the choice to undergo hypofractionated radiotherapy as my treatment option for malignant adenocarcinoma of the prostate gland (prostate cancer) was the right choice.

After the ordeal of a prostate cancer diagnosis, gruelling radiotherapy, and years of dealing with lingering side effects, you would think I am done with reading up on issues around prostate gland health.

Now, I am glad to say it was caught early. I believe I received as good care and support as could be given by advisory and medical teams, and I am convinced that I chose the best medical outcome for my situation.

3 Hidden Problems With Radiation Treatment for Prostate Cancer
© The Prostate Clinic

Unsolicited Advice and Misinformation

In the same vein, I am usually offered tips, hints, and advice about prostate health; mostly information shared on social media, none peer-reviewed by experts in either urology or oncology to prove their efficacy. The impressions are mostly anecdotal.

My father, for instance, has mostly been swindled or scammed by snake oil salesmen offering miracle potions to treat his prostate problems that medical science has been at pains to prove he ever had. We are left humouring him when it might be prudent to sternly upbraid him. He is educated and had a high-profile professional life; he should know better.

The Prostate Clinic Revelations

Recently, I have been following The Prostate Clinic, a YouTube channel hosted by Dr Charles Chabert, a urologist in Queensland, Australia, and it has taken a few days to properly digest what he had to say.

In July 2024, I met with consultants in surgery and radiotherapy for prostate cancer. Later, I spoke to a support worker at Prostate Cancer UK who opined I should opt for Active Surveillance or Watchful Waiting over the active treatment suggested at diagnosis. Even after reading up on extensive material and sharing my journey in a series of blogs, I had to manage my consumption of information to avoid being overwhelmed into stasis.

The Question of Sufficient Information

The question then becomes: how much more information, detail, reports, studies, and research should one access before knowing without any shadow of doubt you are making the right decision, all things being equal?

You are told so much going into treatment but not nearly enough about the aftermath, it would seem.

Three Hidden Problems

The Australian urologist addressed the aftereffects of radiotherapy on the prostate that could leave you concerned about several things, of which sexual dysfunction has been a recent blog topic. He called them “3 Hidden Problems With Radiation Treatment for Prostate Cancer”, suggesting why we should not opt for radiotherapy.

When the prostate gland is irradiated, it could damage the surrounding tissue connected to the bowel (radiation proctitis, very graphic, the pictures can cause distress) and bladder (radiation cystitis) systems. Irradiating the prostate gland shrinks, scars, and can make it fibrotic, leading to two other consequences: limited salvage options or progressively reduced sexual function.

Complications and Salvage Treatments

Complications might arise if there is a local recurrence of cancer, making salvage activity quite difficult. This portends more impactful consequences for the patient and radical alternatives for bowel movements. Salvage treatments are better managed post-surgery than post-radiotherapy, where options are severely limited.

The state of the prostate gland after irradiation means that sexual function will increasingly diminish. This touches on erectile dysfunction and reduced ejaculatory performance. These are weighty matters that make you wonder if you had known all this before you commenced treatment, whether you would have made that choice.

Managing Side Effects

Again, the issue with choosing any treatment comes down to how you perceive you can manage the side effects. For surgery, they are immediate, whilst for radiotherapy they are progressive.

The possible loss of total sexual function, because the consultant surgeon had already indicated my prostate was too enlarged to guarantee the salvage of any nerves, immediately made that option a non-starter. I was not going to wait and see what a malignancy was going to do in my body through Active Surveillance; it would never have been an option for me.

My Choice

Choosing radical radiotherapy was the most comfortable choice in my circumstances. Though having an additional prayer point before I had my prostate gland zapped might have made this discovery less of a surprise and caused less concern.

Ultimately, I believe I did the right thing and will make the best of the good fortune I have to enjoy life and write better stories, with cancer behind me. I thank God.

Check your Prostate Cancer risk in 30 seconds.

Blog - Men's things XXXI: Can Intimacy Be Reclaimed After Prostate Cancer?

Blog – Photons on the Prostate - A year from starting radiotherapy

Blog - A prostate cancer diagnosis, one year on

Blog - Men's things - Prostate Cancer blogs

A Google NotebookLM AI Audio Overview Discussion of this blog

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