What to Expect

Radiation therapy (also called radiotherapy) is offered after a prostatectomy for those men who may still have prostate cancer cells remaining in the region where the prostate surgery was performed. The aim of radiation therapy is to kill any remaining cancer cells in this region. Men offered radiotherapy after surgery fit into one of the following two groups:

  • Treatment soon after surgery – ‘adjuvant’ treatment
  • Radiotherapy for a rising PSA after surgery – ‘salvage’ treatment

Radiation treatment to the prostate after surgery, will generally involve 32-35 treatment visits to the Radiotherapy Unit over a period of approximately seven weeks.

Initial Consult:

As a prostate cancer patient, the journey through prostate or post prostatectomy Radiation therapy begins with an initial consult with either A/Prof Andrew Kneebone or A/Prof Thomas Eade. These consultations are available at GenesisCare centres at the Mater or Macquarie University Hospital, or publicly at Northern Sydney Cancer Care Centre or Gosford Cancer Care Centre.

The consult will involve in depth discussion of the prostate cancer diagnosis, the role for the varying Radiation therapy treatment techniques on offer, and an opportunity to ask any questions.. If fiducial markers are required and/or an MRI then this will be booked prior to the planning process.

Prostate Planning:

Before beginning prostate cancer radiation therapy, a planning or simulation CT scan must be done by the specialised prostate planning team. The appointment will commence with a consult by the friendly nursing staff for bowel and bladder preparation information. Due to the mobility of the prostate gland or prostate bed, patients are required to have a comfortably full bladder and an empty rectum.

Once this is achieved the planning staff will commence the simulation CT for your prostate cancer planning. You will be positioned on the planning CT bed just as you will be for your treatment. Three tiny permanent skin tattoos are used as reference points to mark the area we plan to treat. They are the size of a small freckle and are given with a small needle into the skin. We will also use some temporary texta ink marks on your skin. These texta marks can be washed away after the planning appointment.

After the CT scan is taken, you will be given a short tour of the unit to show you where to go on your first day of treatment. Depending on where you are having your treatment, the planning process can take multiple weeks to ensure that the IMRT or IMAT technique determine the best plan for you, as well as ensuring that the extensive quality assurance procedures are completed.

Your Treatment Schedule:

The radiation therapists will provide you with a tentative start date and time. The staff will call you once the start date is confirmed. It is important that you discuss any concerns with your treatment schedule with the Radiation Therapist at this time.

You will be able to drive yourself to the department for treatment and continue with your usual daily activities, such as working. If you have difficulties organising transport to the hospital for treatment, please inform radiotherapy staff as community transport may be available. Please be aware that there is generally a cost involved with community transport.

Your Treatment:

The Radiation Therapists (RTs) give the actual radiation therapy treatment. Each treatment session takes about 10 minutes; however you are likely to be in the Unit approximately 30 minutes (depending upon the number of patients waiting and if the machines are on schedule).

Please ensure that you have followed the instructions for having a full bladder and empty rectum.

Radiation therapy treatment is given daily, on weekdays only. There is no treatment offered on weekends or public holidays.


Treatment success is usually assessed using the blood test to check the PSA level. The first hurdle towards successful treatment is for the PSA blood test to show a downward trend following treatment and the second is for the PSA level to stay down.

In order to monitor ongoing PSA levels, you will need to see both your Urologist and your Radiation Oncologist periodically after completing the full course of treatment.

An appointment will be made for you to come back to the clinic to see the doctor, six weeks to three months after the last treatment session. We recommend that you have a check-up at least every six months for the first five years following treatment and then once yearly from then on. We can also arrange for telephone follow ups if that’s more suitable.

A blood test (PSA) is generally performed prior to each of these regular checkups.

Your follow up may be alternated between the Urologist who referred you and your Radiation Oncologist.

Click here to download our brochure on Radiotherapy following surgery.

Click here to download our brochure on External Beam Radiotherapy.