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Preparing for radiotherapy to
the prostate or prostate bed
2 | Preparing for radiotheray to the prostate or prostate bed
The advice in this booklet explains what you need to do before
you attend your CT planning scan, as well as during your
radiotherapy treatment.
A radiographer will explain what you need to do when you come
for your planning scan.
Why do I need to follow these instructions?
As all of the organs in the pelvis sit very close to each other,
following these instructions will help to ensure that your
internal organs are in the same position each day
Following these instructions can also help to reduce the side
effects of your treatment by moving the rectum (back passage),
bladder and small bowel away from the treatment area
Diagram to show the position of the prostate
Prostate
Rectum
Urethra
Penis
Bladder
Testicle
Treatment
Beam
Preparing for radiotheray to the prostate or prostate bed | 3
What do I need to do?
Please start to follow this information from the day you receive
this booklet.
It is important that you are well hydrated (drinking lots of uid)
and have a comfortably full bladder for your CT scan and
treatment. A comfortably full bladder means your bladder feels
full but that you dont have the urgency to empty it.
How can I be sure I am well hydrated?
From today onwards, we ask you to aim to drink 2-3 litres (4-5
pints) of uid per day. This quantity can be spread out during
the day, but avoid drinking excessively in the evening. The uid
doesnt have to be water, but please reduce your intake of
caffeinated, zzy and alcoholic drinks.
How can I have a comfortably full bladder?
As well as ensuring that you drink this quantity of uid
throughout the day, it may be benecial to your treatment to
practice lling your bladder and keeping it full. We suggest you
empty your bladder and drink 500ml (approximately 1 pint)
of water within 5 minutes. Then try to wait for 1 hour before
passing water. Please try to do this everyday.
What if I cant wait that long?
If you cant hold 500ml of liquid in your bladder and you need
to pass water, try 400ml and again hold for 1 hour. If you still
cant hold on, try decreasing the amount of uid you drink until
you nd your comfortable amount. Then increase the volume of
water daily aiming to get closer to 500ml.
What do I need to do during my CT planning
scan appointment?
Ideally, we would like you to have a comfortably full bladder and
an empty rectum (back passage) for your planning scan and each
4 | Preparing for radiotheray to the prostate or prostate bed
treatment.
To empty your rectum we would like you to use a micro-enema.
You will be given these at your CT planning scan appointment.
These enemas are safe to use unless you are allergic to any of the
ingredients:
sodium citrate
sodium lauryl sulphate
sorbitol
or
you have an inammatory bowel disease, such as Crohns.
If you think you this may apply to you, please discuss with the
radiographer at your scan appointment.
A radiographer will explain the procedures below and will give
you a supply of micro-enemas to keep at home.
How do I use the Micro-enema and ll my
bladder?
Cap
Nozzle
Micro enema tube
To use the micro-enema:
1. Take an enema tube from the packet and go into the toilet
2. Pull or twist the cap off the end of the nozzle
3. Squeeze a drop of liquid onto your nger and smear over the
nozzle
4. Insert the full length of the nozzle into your back passage
Preparing for radiotheray to the prostate or prostate bed | 5
5. Gently squeeze the tube until it is empty
6. Keep squeezing the tube as you pull the nozzle out of your
back passage. This is to stop the medicine being drawn back
into the tube
7. Throw the empty tube into the bin
8. Go back into the waiting room and wait for 15 minutes or
until you feel the need to empty your bowels
9. Go back into the toilet and try to empty your bowels. Please
dont strain and dont worry if you cannot empty your bowels
or if only wind is passed it may be that your back passage is
already empty
10. Empty your bladder at the same time. If you have a catheter
please ask the radiographers for a clamp and clamp it shut
11. Return to the waiting room and drink 4 cups or 1 pint
( litre) of water in no more that 5 minutes
12. Your bladder will take at least 30 minutes to ll up after
nishing drinking. Please tell the radiographers if you need
more lling time
13. If you nd that your bladder becomes uncomfortably full,
please tell the radiographers. You may need to empty your
bladder, drink and ll again. This may delay your appointment
time
At your radiotherapy treatment
Please empty your back passage (steps 1-9) at the radiotherapy
department before each radiotherapy treatment or at home (no
more than 2 hours before your appointment time) if you live close
by. You may nd it more comfortable to insert the micro-enema
whilst lying on your side on your bed.
Please make sure you arrive at the radiotherapy department 60
minutes before your appointment time to use the micro-enema
and ll your bladder (steps 1-12). Or if you are using the mico-
enema at home, please arrive at the radiotherapy department 40
minutes before your appointment time to ll your bladder (steps
10-12).
6 | Preparing for radiotheray to the prostate or prostate bed
Please bring a spare micro-enema with you in case of delays (see
below).
To assist the radiographers in positioning you for treatment, it
would be very helpful if you could wear either track suit bottoms
or trousers with an elasticated waist and slippers for every
treatment appointment.
What if there is a delay?
If you are kept waiting and are unable to hold your bladder
full, please tell the radiographers. You may need to empty your
bladder, drink and ll again with approximately half the amount
of uid (1-2 cups). Please discuss this with the radiographers if you
are unsure of what to do.
If more than two hours passes since you emptied your bowels
please tell the radiographers. You may need to repeat using the
micro-enema.
What if I use hospital transport?
If you are travelling by hospital transport, we suggest you wait
until arriving at the hospital to follow all of the steps above (the
same as at your scan appointment). If there is a delay in the
treatment room the radiographers will inform you when to ll
your bladder (use the enema on arrival).
What if I nd this difcult?
If, at any point during your course of treatment, you have trouble
keeping your bladder full or using the micro-enema, please tell a
radiographer, nurse or doctor.
Is there anything else I can do to help my
treatment?
We recommend that you also drink plenty of uids throughout
your course of treatment.
Preparing for radiotheray to the prostate or prostate bed | 7
Aim for 2-3 litres (4-5 pints) during the day. It is also sensible to
drink less caffeinated, carbonated and alcoholic drinks as they can
irritate your bladder. We would recommend following a healthy
balanced diet during radiotherapy treatment. Please do not be
tempted to miss meals. This will not help to keep your rectum
empty.
It is unlikely that your skin will get sore because of the treatment.
However as a precaution we would recommend using a mild or
baby soap and avoiding using any products containing metals (e.g.
zinc) in your pelvis area during your course of treatment.
Appointment times
The radiotherapy department is open from 08:00-18:00. You will
be offered treatment times within these hours.
Car parking
Car park D is directly opposite the doors to the Cancer Centre on the
hospital drive. If you park here and bring in the ticket you have taken
to access the car park, the radiographers on the treatment room
will exchange this for a prepaid one so you can exit the car park.
This has only been negotiated for patients who are attending for
radiotherapy planning or treatment appointments so unfortunately
the radiographers will not be able to give you a ticket if you are
attending for a follow up appointment.
What if I have a question?
If you have any questions about preparing for radiotherapy to
the prostate or prostate bed, please contact the pre-treatment
radiographers on 0121 371 5055.
For further information about prostate cancer or radiotherapy in
general, please visit the Patrick Room in the foyer of the Cancer
Centre.
PI13/0871/03 UHB/PI/0871 (Edition 3) Author: Liz Southgate
Date: November 2013 Review date: November 2015
The Radiotherapy Department
Queen Elizabeth Hospital
Mindelsohn Way, Edgbaston,
Birmingham, B15 2TH
Telephone: 0121 371 5055
Quick guide to preparation on your treatment
days
To assist the radiographers, it would be very helpful if you could
wear either track suit bottoms or trousers with an elasticated
waist and slippers for every treatment appointment.
It is important to follow the instructions below each day to help
to reduce the side effects of your treatment.
1. Arrive in department at least 60 minutes before your
appointment time and use the micro-enema in the
radiotherapy department and empty your bladder
2. Empty your bowels if possible 15-20 minutes after your enema
3. 40 minutes before your appointment time ll your bladder
with 4 cups or 1 pint ( litre) of water and drink this within 5
minutes
*Please ensure you have a full bladder
for your appointment time*
We recommend that you also drink plenty of uids throughout
your course of treatment. Aim for 2-3 litres (4-5 pints) during the
day.
The Trust provides free monthly health talks on a
variety of medical conditions and treatments. For more
information visit www.uhb.nhs.uk/health-talks.htm or
call 0121 371 4957.