Radiation therapy has emerged as one of the most common treatments for prostate cancer. The prevalence of this disease makes it important to understand how radiation fits into the therapeutic toolbox at the disposal of doctors.

About 1 man in 8 will be diagnosed with prostate cancer during his lifetime, according to the American Cancer Society. Other than skin cancer, it is the most common cancer in American males. Experts predict more than 34,000 deaths in the United States will be attributed to prostate cancer in 2022.

However, prostate cancer can often be treated successfully, especially if the disease is caught in its early stages. In addition to surgery, one of the most widely used treatments is radiation therapy, which employs high-energy rays or particles to kill cancer cells or keep them from growing or dividing.

It can be used to treat both early stage cancers of the prostate gland and more advanced stages that may have spread beyond the prostate. It can also be used alone or with other treatments.

The prostate, part of the male reproductive anatomy, is a rubbery gland located just below the bladder and in front of the rectum. It is about the size of a walnut and surrounds the tube that empties urine from the bladder.

While the exact causes of prostate cancer are unknown, we know that family history of the disease is a risk factor. In addition, Black men are more likely to get prostate cancer than white people. Reasons for this disparity are complex, and more research is needed to understand why.

Partly because prostate cancer is typically slow-growing, experts say only about one in 35 men will die of it. That positive outlook is also due in part to effective screening practices and treatments, including the use of radiation.

Here are five things men should know about radiation treatment for prostate cancer.

1. Prostate cancer radiation treatment comes in two general forms: external beam radiation and internal radiation, also known as brachytherapy. With the external versions, beams of radiation are focused on the prostate gland from a machine outside the body. It is the most common form of radiation treatment for prostate cancer and it is painless, much like an X-ray. External radiation therapy requires regular sessions, usually five days per weeks, over a period of about five to eight weeks. This type of radiation can be used to try to cure all stage cancers, or to help relieve symptoms such as bone pain if the cancer has spread to a specific area of bone. With internal radiation, a doctor places radioactive pellets or seeds, each about the size of a grain of rice, into the prostate using needles. The seeds emit radiation to destroy the cancer cells in their vicinity. Generally, internal therapy is used only in men with early stage, slow-growing prostate cancer, but is sometimes used in conjunction with external radiation for higher risk prostate cancers.
2. When treating those in the early stages of disease, patients frequently do well with either brachytherapy or external beam radiation. Success rates of around 90 percent or higher can be achieved with either approach.
3. Side effects for both types of radiation therapy are relatively mild for most patients. With external beam radiation, patients may experience an increased need to urinate, a weak urinary stream, burning or tingling with urination and occasional diarrhea. Some patients may also experience fatigue and skin changes in the area of the radiation. Most of the symptoms ease after the therapy ends. Brachytherapy patients may experience many of the same side effects with the addition of perineal pain, a brief period of blood in the urine and scrotal swelling.
4. In cases where cancer hasn’t spread beyond the prostate, patients are often presented a choice between radiation therapy and surgery. The main type of surgery for prostate cancer is a radical prostatectomy. In this operation, the surgeon removes the entire prostate gland plus some of the tissue around it. The major possible side effects of radical prostatectomy are urinary incontinence and erectile dysfunction. Both surgery and radiation treatments work well. With either treatment, the chance of your cancer spreading is low.
5. If it has been a while since your last annual wellness exam, it’s a good idea to schedule an appointment with your primary care provider. A prostate-specific antigen (PSA) blood test can help determine if you have prostate cancer. Early detection is an important tool in getting appropriate and timely treatment.

Bonus tip: Prostate is often mispronounced as “prostrate.” Prostrate means to lie face down.