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Understanding Prostate Cancer

What to Know About Bowel Dysfunction During and After Prostate Cancer Treatment

(Read time: 4 minutes) 

This article is not intended to replace professional medical care or advice. If you have any questions or need additional information, please talk with your doctor. 

In 2019, the American Cancer Society estimates nearly 175,000 new cases of prostate cancer in the U.S. To put that into perspective, about 1 in 9 men (or 11.11%) will be diagnosed with prostate cancer during their lifetime. 

While 1 in 41 men who are diagnosed will die from this disease, the good news is, if detected early, localized prostate cancer is generally associated with a high survival rate. 

But while some may be familiar with the most common treatments for prostate cancer—such as surgery, radiation therapy, and active surveillance—far fewer people know about potential side effects, like bowel dysfunction. 

It’s important to know these side effects. That way, you put yourself in the best place to reduce your risk and have the best quality of life possible.   

What is bowel dysfunction? 

Bowel dysfunction is an umbrella term for a wide range of side effects that patients might experience during or after prostate cancer treatment. Such side effects can occur at varying levels of severity and may include: 

  • diarrhea 
  • frequent stools 
  • fecal incontinence 
  • inability to control bowel movements
  • rectal bleeding (in severe cases) 

The severity of bowel dysfunction symptoms 

Bowel dysfunction can be disruptive to anyone’s lifestyle, but most men will only experience mild symptoms. 

According to the Prostate Cancer Foundation (PCF), less than 10% of men who undergo radiation therapy for prostate cancer experience diarrhea. These types of minor complications may resolve within 6 to 12 months post-treatment. 

But 2–3% of men who undergo modern radiation therapy for prostate cancer will suffer from the most severe bowel dysfunction symptoms, like rectal bleeding. In some cases, rectal bleeding can last for months or even years after radiation therapy is completed. This may be related to damaged scar tissue that develops in the rectum and tears and bleeds with bowel movements. 

How can prostate cancer treatment cause bowel dysfunction? 

It’s important to note that bowel dysfunction is not common. In fact, not all treatments for prostate cancer will result in bowel problems. Active surveillance will not. And prostatectomy (the surgical removal of the prostate) leads to bowel dysfunction in less than 1% of all cases. Usually, this is only the case when advanced prostate cancer has already damaged the rectum. 

But bowel dysfunction is possible during or following radiation therapy. This happens because the prostate and the rectum (or the bowels) are adjacent to one another, meaning that any radiation targeted to the prostate may also affect the rectum. 

While radiation treatment techniques continue to improve in precision, there may still be a risk of damaging healthy cells nearby. As a result, the rectum may inadvertently receive high doses of radiation during prostate cancer treatment, causing the sensitive lining of the bowel to become inflamed. 

How bowel dysfunction can impact your lifestyle 

The complications can be unpleasant and occasionally can be severe. Consider these scenarios:

  • Planning to carry diapers before going on a day trip with your family
  • Choosing whether or not to go fishing with your friends because you can’t spend 4 hours out on a boat without needing a change of shorts
  • Understanding the impact it has on your significant other and what it can limit the two of you from experiencing together   

Understanding these different scenarios and what bowel dysfunction could look like for you can really put things into perspective. How might it impact your current lifestyle? 

Reducing the risk of bowel dysfunction should be a priority 

Although radiation therapy for prostate cancer has an excellent record of success, providing long-term survival in many cases, the potential for bowel dysfunction is a major concern when choosing a treatment pathway. 

But for prostate cancer survivors who live longer due to successful radiation therapy, considering ways to preserve the rectum and manage any potential risk of side effects should be a priority. 

Fortunately, recent advances in prostate cancer treatment and pre-treatments, such as SpaceOAR Hydrogel, make it easier than ever before to reduce the risk of injury to the healthy organs near the prostate, including the rectum. 

If you’d like to learn more about prostate cancer treatments, including radiation therapy, please take a look at our Treatment Options page. 

If you’d like to learn more about SpaceOAR Hydrogel with radiation treatment for prostate cancer, please contact our patient education team. 

  1. (2019). Key Statistics for Prostate Cancer| Prostate Cancer Facts. [online] Available at: [Accessed 23 Aug. 2019].
  2. Anon, (2019). Bladder and Bowel Dysfunction. [online] Available at: [Accessed 23 Aug. 2019].
  3. “Menu.” Further Detailed Information on Treatment and Side Effects | PCFA,[Accessed 16 Sept. 2019].]
  4. “Minimally Invasive Treatment for Severe Bladder Neck Contracture.” Johns Hopkins Medicine, Based in Baltimore, Maryland,[Accessed 16 Sept. 2019].
  5. Prostate Cancer Foundation. (2019). Bowel Dysfunction After Treatment | Prostate Cancer Foundation. [online] Available at: [Accessed 23 Aug. 2019].

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