Side Effects of Prostate Cancer Treatments

Prostate cancer treatments cause side effects. Treatments like surgery, radiation, hormone therapy, chemotherapy, or immunotherapy can all cause different problems. Below is a comprehensive list of treatment-related side effects that prostate cancer patients have reported. The information comes from patients sharing their experiences in prostate cancer communities online.

 Hot Flashes and Temperature Changes

– Hot Flashes: A hot flash is a sudden feeling of heat that can make you sweat and turn red. Many men on hormone therapy (like Lupron or other ADT drugs) get hot flashes. One patient shared that after two years on hormone shots, he had frequent hot flashes ([Lupron Side Effects:

-Hot flashes can happen any time, including at night, and might wake you up with drenching sweat. 

– Feeling Cold or Chills: Some patients on hormone therapy feel the opposite of a hot flash – they feel unusually cold for long periods. In one community poll, men on ADT reported feeling cold for at least an hour a day during the week. This means your body temperature sensations can swing both ways. You might be very warm at times and very cold at other times.

 Fatigue and Sleep Problems

– Extreme Tiredness (Fatigue): Almost all treatments can make you feel very tired. This fatigue is not like ordinary sleepiness – it’s an overwhelming lack of energy. People describe it as feeling wiped out or exhausted. For example, during chemotherapy, one patient said he had “flu-like” fatigue for several days after each treatment. Hormone therapy can also sap your energy over time, making you feel weak or sluggish. 

– Trouble Sleeping (Insomnia): Some treatments disrupt your sleep. You might find it hard to fall asleep or stay asleep. One man on hormone therapy (Orgovyx) noted that he suffered from insomnia during treatment.

– Not sleeping well can make your daytime fatigue worse. Sometimes hot flashes at night can also wake you up and disturb your sleep.

 Urinary Problems

– Frequent Urination and Urgency: Treatments can affect your bladder. You may need to pee very often or feel a sudden, urgent need to go. Radiation therapy in the prostate area can irritate the bladder. Men have reported a constant burning feeling in the urethra (the tube you pee through) and always feeling like they need to urinate. During radiation treatment, some found they had significant urinary side effects even with medication to help. This means you might be running to the bathroom more often or have a weak urine stream. 

– Pain or Burning When Urinating: You could feel pain, burning, or stinging when you pee, especially after radiation therapy. This is because the treatment can irritate the urinary tract. One person described a “constant burning in the urethra” during his radiation sessions). This can be uncomfortable, but doctors can give you medicines (like UTI pain relief or alpha-blockers) to ease the symptoms. 

– Urinary Leakage (Incontinence): Some patients lose control of their bladder for a while. This is common after prostate surgery and can happen with radiation too. It means urine can leak out when you don’t want it to. People often need to use pads or special underwear until it improves. In the forums, men frequently talk about incontinence as a side effect. In one discussion, a man was worried about “incontinence and impotence” after treatment. Over time, pelvic exercises and therapy can help, but you should be prepared that you may have some leaking, especially early after treatment.

 Digestive and Appetite Issues

– Diarrhea and Constipation: Radiation near the prostate can upset your bowel habits. Some men get loose, watery stool (diarrhea), while others might get constipated. One patient shared that he had a rough time during two months of radiation with bouts of diarrhea and constipation, and he lost about 25 lbs during treatment. Diarrhea might happen soon after starting radiation and usually improves weeks after treatment ends. Medicines like Imodium can help. Constipation can happen if you take certain pain medications or if your diet changes due to treatment. 

– Nausea and Vomiting: Feeling sick to your stomach (nausea) or throwing up can happen, especially with chemotherapy. Not everyone will experience this, because doctors give drugs to prevent nausea. One man noted that by taking precautions (like fasting before chemo), he had “virtually no nausea” during chemotherapy. However, without such measures, chemotherapy often causes nausea and sometimes vomiting. Radiation to the pelvic area can also cause an upset stomach for some people, though it’s more common if the radiation is near the abdomen. 

– Mouth Sores: Chemotherapy can affect fast-growing cells, including those in your mouth. Some patients get sore spots or ulcers in their mouth and throat. In a discussion about docetaxel (a chemo drug), a patient noted that mouth sores are listed as a side effect. These sores can make it hard to eat or drink certain foods until they heal. 

– Loss of Appetite and Weight Loss: Cancer treatments can make you not feel like eating. You might lose your appetite and begin to lose weight without trying. Digestive side effects like nausea or diarrhea can also make you eat less and lose weight. As mentioned, one man lost a significant amount of weight (25 pounds) during radiation because of severe diarrhea and bowel issues. On the other hand, some treatments (like the steroids given with chemo or certain hormone pills) might increase your appetite. It’s important to watch your weight and nutrition during treatment. 

– Taste Changes: Food may not taste the same. Some treatments, especially chemotherapy, can cause a bitter or metallic taste in your mouth. Patients have noted that a “metallic taste is common on docetaxel and other chemo drugs”. Even hormone therapies like enzalutamide (Xtandi) have been reported to alter taste for some people. This change can make foods you used to enjoy taste strange or bland. It often returns to normal a while after treatment, but it can affect your appetite while it lasts.

 Sexual Side Effects

– Loss of Sexual Desire (Low Libido): It is very common to have a lower sex drive during and after prostate cancer treatment. Hormone therapy deliberately lowers the male hormones that feed prostate cancer, which often means you have little to no interest in sex. Men in the community have shared that their desire for sex dropped a lot on ADT. You may not think about sex as much, or you may feel “asexual” while on treatment. This can be temporary for some men (improving after treatment ends), but for others it lasts as long as the hormone therapy continues. 

– Erectile Dysfunction (Impotence): This means trouble getting or keeping an erection firm enough for sex. It’s a frequent side effect, especially after surgery or radiation to the prostate, and also from hormone treatments. In one discussion, a new patient was concerned about impotence and decided against certain treatments because of it. Many men do experience ED after a prostatectomy (surgery to remove the prostate) or radiation therapy. Nerve-sparing surgical techniques and medications like Viagra can help, but there is a chance erections will be weaker or not possible. Hormone therapy also causes ED by lowering testosterone. Even after stopping treatment, it might take time for sexual function to come back, and sometimes it doesn’t fully return. 

– Changes in Ejaculation or Fertility: Some treatments can result in dry orgasms (little or no semen). Surgery often causes semen to no longer come out (because the glands producing it are removed or the pathways are sealed). Radiation can thicken semen or reduce the amount. While this side effect is not harmful, it does mean you would not be able to father children naturally. If having children is a concern, discuss sperm banking before treatment. Patients mainly talk about the more immediate sexual changes like ED and libido, but it’s important to know that fertility loss is a possible side effect of prostate cancer therapy.

 Physical Body Changes

– Weight Gain and Body Fat Increase: Hormone therapy can cause you to gain weight, especially around the belly. Your body’s metabolism changes when testosterone is lowered. One man on long-term ADT noted weight gain as one of his main side effects. Some men might gain 10 pounds or more during their treatment. You might notice your clothes fitting tighter. Diet and exercise can help manage this, but the weight may come on more easily than before. 

– Muscle Loss and Weakness: Along with fat gain, you can lose muscle mass when on hormone therapy. Testosterone helps maintain muscles, so without it, muscles can shrink or weaken. The same patient above cited muscle loss as another big side effect he experienced. You might feel weaker or find it harder to lift things that used to be easy. Regular light exercise or resistance training (if approved by your doctor) can help reduce muscle loss. 

– Breast Swelling or Tenderness (Gynecomastia): Some treatments cause changes in breast tissue. Men can develop swelling of the breast area or even a small amount of actual breast growth. It can also make the breasts sore or tender to touch. In one forum post, a caregiver noted that after being on long-term hormone shots (Eligard), her husband developed new side effects including breast swelling and breast pain. This can be upsetting or uncomfortable, so let your doctor know if you notice your chest area changing or hurting. They might suggest treatment to reduce this side effect (such as medication). 

– Appearance Changes: You might notice changes in your general appearance. For instance, some patients on newer hormone medications reported getting bags under their eyes, changes in skin texture, or even changes in teeth color. These are not universal side effects, but they show that treatment can affect things you might not expect, like your complexion. It’s good to be aware that your body might look a bit different (tired-looking skin, etc.) while on treatment.

 Mood and Memory Changes

– Mood Swings and Irritability: The medications that change your hormones can also affect your mood. You might feel more irritable or even tearful. Some men experience sudden mood swings – feeling fine one moment and angry or sad the next. In the forums, loved ones have observed that their family member became very moody on hormone therapy. You may also experience anxiety (constant worry or nervousness) as a direct effect of the treatment on your brain chemistry. These mood changes are real side effects of the treatment, not simply an emotional reaction. It’s important to recognize them so you can get support or treatment for them if needed. 

– Depression: Many prostate cancer patients struggle with feelings of depression during treatment. This can be caused by the treatment’s physical effects as well as the emotional strain of the illness. Hormone therapy increases the risk of depression. Doctors on the forums remind readers that depression is common in men going through these therapies. You might feel persistently sad, lose hope, or lose interest in activities you used to enjoy. Depression is a medical condition, so if you notice these symptoms, talk to your doctor. They may suggest counseling, support groups, or medications to help. 

– Memory and Concentration Problems: Some treatments can cause cognitive side effects – in other words, changes in thinking. Patients sometimes call this “brain fog.” You might have trouble concentrating, or you might forget things more easily. One discussion noted that hormone therapy can lead to cognitive issues, and even referenced studies linking ADT to higher dementia risk. For example, a study found the risk of Alzheimer’s and dementia could be increased by up to 28% with. Not everyone will have memory problems, but it’s something men have reported. You could find yourself searching for words or feeling less sharp than before. Usually, if these effects occur, they develop gradually over months. Always mention any memory changes to your healthcare team.

 Bone and Joint Issues

– Weaker Bones (Osteoporosis): Over time, hormone therapy can make your bones thinner and weaker. Testosterone helps keep bones strong; without it, bones lose density. This can lead to osteoporosis and increase the risk of fractures (broken bones). Men on long-term ADT are often advised to get bone density scans and might take calcium or vitamin D supplements. One forum post explicitly listed osteoporosis as a side effect of ADT. This means you could be more prone to breaking a bone if you fall. Weight-bearing exercise (like walking) and certain medications can help protect your bones if you’re on ADT for a long time. 

– Joint and Muscle Aches: Various treatments may cause aches and pains in your joints or muscles. Chemotherapy, for example, can lead to body aches. One patient reported sharp, stabbing pains in his joints (like elbows, wrists, knees) for about 10 days after each chemo infusion. These aches did go away, but they were quite uncomfortable. Hormone therapy can also cause joint pain or stiffness in some men. You might feel like you have arthritis even if you didn’t before. Staying active with gentle movement can sometimes ease this, but some aches might persist during treatment. 

– Muscle Cramps: In addition to general aches, you might experience muscle cramps or spasms. A man on ADT (Orgovyx) noted he had muscle cramps in his hands as a side effect. Cramps are sudden, tight muscle pains. They can happen in various muscles, such as your legs, feet, or hands. Drinking plenty of water, having enough electrolytes, and gentle stretching can help. If you get frequent painful cramps, let your doctor know.

 Skin and Hair Changes

– Skin Rashes and Irritation: Some treatments affect your skin. External radiation can sometimes cause a sunburn-like effect on the skin in the treated area. Immunotherapy drugs like pembrolizumab (Keytruda) can also cause skin side effects. One patient on Keytruda mentioned that skin irritation is a known side effect to watch out for. He was asking others about a skin reaction he was having. You might see redness, peeling, or itchiness on your skin. Most rashes are manageable with creams or medication, and they often go away after treatment. 

– Dry or Thinning Skin: Hormone treatments can lead to changes in your skin texture. Some men say their skin becomes drier or thinner. There are anecdotal reports of men noticing their skin aging faster or getting “lousy skin” after months on certain medications. This can also tie in with the appearance changes mentioned earlier (like eye bags). Keeping your skin moisturized and protected can help if you experience this. 

– Hair Loss: Chemotherapy for prostate cancer (such as docetaxel) often causes hair loss. Not every chemo drug causes you to lose hair completely, but many men will notice hair thinning or shedding a few weeks into treatment. In the community, one caregiver asked if all patients on docetaxel lose their hair, as her husband was starting to lose some after chemo. Hair loss from chemo is usually temporary – hair will generally grow back after treatment ends. Hormone therapy typically does not cause head hair loss, but some men do notice less body hair growth over time. If losing your hair is distressing, consider cutting it short before chemo or using wigs/hats; remember that it should return in a few months.

 Heart and Circulatory Health

– Heart Problems: Some prostate cancer treatments can affect your heart and circulation. Hormone therapy in particular has been linked to a higher risk of heart issues. An article shared in the patient forum noted that men on ADT had a significantly increased risk of dying from stroke or heart disease. Other reports have observed more heart attacks and high blood pressure in men during hormone therapy. This doesn’t mean everyone will have a heart attack, but it means doctors will watch your heart health closely. If you already have heart conditions, inform your doctor before starting ADT. They may monitor your blood pressure, cholesterol, and blood sugar during treatment. Staying active and eating a healthy diet is also important for your heart. 

– Anemia and Low Blood Cell Counts: Chemotherapy can lower your red blood cells (causing anemia) and white blood cells (weakening your immune system). When one patient went through his first round of docetaxel chemo, his white blood cell count dropped very low (neutropenia). Low red blood cells can make you feel very weak and pale (this is anemia). Low white cells make it easier to get infections. That’s why during chemo; doctors do blood tests and sometimes give shots to boost your blood counts. If your immunity is low, you will need to be careful to avoid germs until your counts recover.

 Pain and General Discomfort

– Perineal or Pelvic Pain: Some men experience pain in the pelvic area (between the legs). For example, a man who had brachytherapy (internal radiation seeds) reported having off-and-on pain in his perineum months after treatment. This area can be sore if it was affected by radiation or surgery. Scar tissue or inflammation may cause lingering aches. Typically, this kind of pain improves with time or with medications to reduce inflammation. 

– General Aches: Beyond specific joint pains, treatment can cause general body aches or flu-like feelings. Some hormone therapies can cause back pain or bone pain as well. Chemotherapy often makes you feel like you have a bad flu with muscle aches all over for a few days. Over-the-counter pain relievers can help with these aches but always check with your doctor on what you can safely take. 

– Swelling (Edema): Some treatments can cause your body to retain fluid, leading to swelling in the legs or feet. One user mentioned having slight lymphedema (swelling caused by lymph fluid build-up) in his legs after completing chemotherapy. Also, if lymph nodes are removed during surgery, it can lead to swelling in the genital area or legs. Wearing compression socks and doing light exercise can manage mild swelling. Always let your doctor know if you have sudden or severe swelling.

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These side effects range from mild to serious. You might experience some of these and not others. Every patient is different. This list covers many of the common and less common side effects that prostate cancer patients have shared in the advanced prostate cancer community. It’s important to report any side affects you have to your doctor. They can help treat or manage side effects so that you stay as healthy and comfortable as possible during your prostate cancer treatment.