Radiation therapy for prostate cancer – Two main types

Radiation therapy for prostate cancer may be used in an attempt to cure the cancer.

Radiation treatment for prostate cancer may also be used to help shrink a tumor, or to prevent or relieve symptoms.

External and internal radiation

  • External radiation is often referred to as external beam radiation therapy or EBRT.  Read more
  • Internal radiation (called brachytherapy) is a procedure that is called seed implantation or interstitial radiation therapy.  Read more


In both external and internal radiation treatments, the prostate gland is not removed.

Sometimes combined

Sometimes radiation therapy is used in combination with other treatments, such as hormone treatment.

Studies have shown that hormone treatment prior to radiation treatment may help make the cancer cells more susceptible to radiation.

One study included men with locally advanced prostate cancer (cancer that spread beyond the wall of the prostate gland), who had radiation treatment in addition to long-term hormone treatment.

In this study, the combined treatments reduced men’s risk of dying of prostate cancer by more than half, compared to men who had radiation treatment alone.

Questions to ask about radiation therapy

Ask the doctor:

  • What type of radiation do you recommend?
  • Do you recommend hormone treatment prior to radiation?
  • How do you define being “cured” after radiation treatment?
  • What are the delayed side effects of radiation?
  • How many of your patients experience long-term impotence?
  • How do you define impotence?
  • How many of your patients experience long-term incontinence?
  • How do you define incontinence?
  • How many of your patients have undetectable PSA levels 5 years after treatment?

Can surgery still be performed?

While some men with recurrent prostate cancer undergo surgery for prostate removal after radiation treatment has failed (a procedure called salvage surgery), it is a much more complicated surgical procedure.

There are not that many surgeons who are capable of performing it.

The risk of long-term side effects is also much higher, including impotence and incontinence.

Return to treatments

References for radiation therapy for prostate cancer:

The American Cancer Society. Prostate Cancer. http://www.cancer.org. Accessed March 17, 2015.

Walsh PC. Guide to Surviving Prostate Cancer. New York, NY: Time Warner Book Group; 2001.

Widmark A, et al. Endocrine treatment, with or without radiotherapy, in locally advanced prostate cancer (SPCG-7/SFUO-3): an open randomised phase III trial. The Lancet. 2009;373 (9660):301-308.

Wo JY, Zietman AL. Why does androgen deprivation enhance the results of radiation therapy? Urol Oncol. 2008;26(5):522-9.

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