Throw us a bone

by Donna Canada, RN, CURN

Skin irritations as a side effect of radiation treatment for prostate cancer are common and temporary. You may notice skin changes in any areas exposed to radiation but they should subside gradually within 4-6 weeks of the last treatment.

Long-term effects, which can last up to a year or more after treatment, may include a slight darkening of skin, enlarged pores, increased or decreased sensitivity of the skin and a thickening of the tissue or the skin itself.

How to Reduce skin Irritations from radiation treatment for prostate cancer

• Gently cleanse the treated area using lukewarm water and a mild soap such as Ivory, Dove, Neutrogena, Basis, Castile, or Aveeno Oatmeal Soap. Do not rub. Pat your skin dry with a soft towel or use a hair dryer on a cool setting.
   
• Try not to scratch or rub the treated area.
   
• Do not apply any ointment, cream, lotion, or powder to the treated area unless your radiation oncologist or nurse has prescribed it.
   
• Do not wear tight-fitting clothing or clothes made from harsh fabrics such as wool or corduroy. These fabrics can irritate the skin. Instead, choose clothes made from soft, natural fibers such as cotton.
   
• Do not apply medical tape or bandages to the treated area.
   
• Do not expose the treated area to extreme heat or cold. Avoid using an electric heating pad, hot water bottle, or ice pack on the affected area.
   
• Do not expose the treated area to direct sunlight, as sun exposure may intensify your skin reaction and lead to severe sunburn. Choose a sunblock/sunscreen of SPF 15 or higher. Protect yourself from direct sunlight even after your course of treatment is over.²⁶

Possible Side Effects of radiation treatment for prostate cancer

• Mild fatigue—patients should be able to continue their normal routine during their treatment, including fulltime work.
   
• Frequent urination, a weak urine stream or a mild burning with urination are all possible.

• Diarrhea is normal although uncontrolled diarrhea is rare. The radiation beam passes through normal tissues, such as the rectum, bladder and intestines on its way to the prostate. Consequently some healthy cells may be killed and the result can be diarrhea.
   
• Possible long-term problems include proctitis (inflammation of the rectum) with bleeding and diarrhea, incontinence, and impotence.²⁶

References:

1. SUNA 2010 Clinical Practice Guideline Prevention and Control of Catheter Associated urinary Tract Infection. Available at: http://www.suna.org. Accessed Feb.2, 2010.
2. Eastham et.al. Risk Factors for urinary incontinence after radical prostatectomy. J urol 1996;156L1707.
3. U.S. Dept of Health and Human Services,1996, Clinical Practice Guideline number 2 (Update). Rockville, MD Agency for health Care Policy and Research.Publication No. 96-0682.
4. Ellsworth et al. 100 Q & A about Prostate Cancer, 2007, 184,185,187,189.
5. Hulme Janet a. Beyond Kegels s 2nd Edition Phoenix Publishing Co. 2002; 124,11,120,72,73.
6. Sandhu J.S. Nat Rev Urol.7, 222-228 (2010);doi1038/Nrurol.2010.26.
7. Newman D, Wein A. Managing and Treating Urinary Incontinence, Second Edition, Health Professionals Press-Baltimore, MD. 2009, 234,235,371,459.
8. Mayo Clinic. Kegel exercises for men: Understand the benefits. Available at: http://www.mayoclinic.com/health/kegel-exercises-for-men/MY01402. Accessed on June 9. 2011.
9. Bernier F, Sims TW. Management of clients with urinary disorders. Medical-surgical nursing: Clinical management for positive outcomes (8th ed. P 727-778). St Louis, MO. Elsevier Saunders; 2009.
10. Ribeiro LH. Gomes CM et al. Prostate Cancer. Journal of Urology 184: 1034-9,2010.
11. Bauer et al. Contemporary Management of post prostatectomy incontinence. European Urology (volumes 59 issue 6 page(s) 985-996 EOI: 10.1016/j.eururo.2011.03.020) European Urology 2011/03/18. Available at: http://www.ncbi.nlm.nih.gov./pubmed/20518761. Accessed on June 9, 2011.
12. Bioderm. Liberty 3.0. Available at: http://www.bioderm.us/index.php?option=com_content&view=article&id=52&Itemid=168. Accessed June 9, 2011.
13. SeekWellness. Afex for managing male incontinence. Available at: www.seekwellness.com/male_incontinence/afex.htm. Accessed June 9, 2011.
14. Omni. URINCare. Available at: www.urinCare.com. Accessed on June 9, 2011.
15. NIH consensus conference. Impotence. NIH Consensus Development Panel on Impotence. JAMA 1993: 270 (1): 83-90.
16. Mulhall. Saving Your Sex life. Munster, IN: Hilton Publishing Company. 2008.
17. International Journal of Impotence Research. 2008:20, 121-126.
18. Nature Reviews. Urology. Volume 6, August 2009. p.424.
19. Urologic Nursing. December 2007:27:6-563.
20. Albaugh. Urologic Nursing. May-June 2010;30-3.
21. Raina R, PahlajaniG, Agarwai, Zippe C. The early use of transurethral alprostadil after radical prostatectomy. BJU Int. 1998;100;1317.
22. Burnett AL. Erectile dysfunction following radical prostatectomy. JAMA 2005;293(21).
23. J Urol 1997; 158 (4): 1408-1410.
24. Walsh PC, Worthington JF. Dr. Patrick Walsh's Guide to Surviving Prostate Cancer, Second Edition. New York: Wellness Central; 2007:435-441.
25. Moyad M. Promoting Wellness for prostate Cancer patients, 3rd edition, Ann Arbor: Ann Arbor Editions, 2010:93-104.
26. Radiation Oncology, Division of Nursing, James Cancer Hospital and Solove Research Institute, Patient Education Handout, The Ohio State University Medical Center.
27. Bostwicket al. Complete Guide to Prostate Cancer. Atlanta: American Cancer Society; 2005:306-308.

This article has been reviewed by a member of the Wellness Partners Editorial Board.

Posted June 2011