What are the most common side effects of prostate cancer treatments?

The prostate is close to the bladder and rectum. It’s surrounded by a network of nerves and blood vessels that help you get an erection. Treatments for prostate cancer can affect how you urinate, how your bowels work, and your sex life.

It's important to talk to your doctor about any side effects you have while you are being treated. Keeping your doctor updated will help them handle your side effects as soon as possible.

Leaking urine: It’s normal to lose some bladder control (called urinary incontinence) and leak urine after surgery or radiation, but for most men, this gets better over time. For more information, see our section on what it is like living with prostate cancer.
Bladder problems: Needing to urinate often, feeling urgent need to go, waking up at night to urinate, or having a weak stream are common after radiotherapy and can sometimes happen after prostate surgery too. Many of these symptoms improve over time. If they continue and bother you, talk to your doctor about ways to manage them.
Bowel problems: Damage to the rectum caused by surgery or radiation therapy can lead to bowel problems, including bleeding from the rectum, diarrhoea, or feeling an urgent need to go to the toilet. But this is very rare. Some men have softer stools during radiotherapy, but this goes away after the treatment has stopped.
Erection problems: Some treatments can damage the nerves and blood flow to the penis, which can make it hard to get or keep an erection. This is known as erectile dysfunction, and it’s the most common side effect of prostate cancer treatment.
The good news is that there are ways to manage this during treatment, and most men with intact nerves see improvement over time once treatment has stopped. For more information on coping with this and other changes, see our section on what it’s like living with prostate cancer.

If you are having surgery, you may be offered nerve-sparing surgery, depending on the stage and type of your cancer. This type of surgery aims to protect the nerves that help with erections and bladder control, reducing the risk of erectile dysfunction and leaking urine. However, for some cancers, it’s not possible to remove the tumour without cutting or damaging these nerves. In those cases, you might always need treatments to help get an erection.

Possible treatments