Radiotherapy department

Bowel and bladder preparation

for prostate radiotherapy
Information for patients, relatives and carers
Introduction
This leaflet is designed to give you practical information about preparing for your radiotherapy
for prostate cancer. Before you start radiotherapy there are some important things you can do to
help us give you the best treatment and reduce your risk of side effects. Some things, such as
establishing a regular bowel habit, may need to start a few days before your planning scan. This
leaflet is not meant to replace the consultation between you and your medical team, but aims to
help you understand more about what is discussed. If you have concerns about any aspect of
your treatment, please speak to a member of the medical team.

Radiotherapy open evenings

Open evenings have been designed to answer any questions you may have about radiotherapy,
they have been running for the last 20 years and has helped many patients, carers and their
relatives understand more about their radiotherapy treatments. The open evenings are held in
the radiotherapy department at Charing Cross Hospital from 18.00 to 19.00 and usually take
place on the 2nd and 4th Thursday of the month. To book yourself in and for more information,
contact the radiotherapy department call 020 3311 1737.

What does the male pelvis contain?

The male pelvis contains the following areas: prostate, rectum, bladder, testicles, penis, lower
end of the large bowel, part of the small bowel and the lymph nodes.

Diagram used with permission from Patient website, http://patient.info/health/prostate-cancer-leaflet ©2015,

Egton Medical Information Systems Limited. All Rights Reserved.
What is the prostate?
The prostate is a walnut-sized gland located in front of the rectum, just below the bladder. It
surrounds the urethra which takes urine from the bladder and out through the penis.

Why do I need to have a full bladder for radiotherapy?

We need you to have a comfortably full bladder for your radiotherapy planning scan (called a
CT scan) and then every day for your radiotherapy. We want your bladder to be a similar size
each day. There are two main reasons for treating you with a consistently full bladder:
1. A large bladder helps to limit the amount of bladder and small bowel in the radiotherapy
treatment area. This will help to reduce the side effects that you may experience. A full
bladder helps to push the small bowel up and out of the pelvis – so it is moved away from
the radiotherapy treatment area.

2. To ensure that we treat exactly the same area every day.

Preparing your bladder

At your radiotherapy planning CT appointment, and each day before treatment, we will ask you
to empty your bladder. We will then ask you to re-fill your bladder by drinking a specific amount
of fluid. Please make sure that you are well-hydrated when you come for the planning scan, as
well as when you come for your radiotherapy. You will need to wait while your bladder fills up
before the treatment is given. The amount of fluid you need to drink and the length of time you
then need to wait will be confirmed during your CT appointment. The staff at the CT scanner will
tell you what you need to do each day for your radiotherapy.
You may find it difficult to keep your bladder full until your treatment, especially if the machine
you are due to be treated on is running behind. Try to keep your bladder full for treatment, but if
you are unable to hold your water, speak to one of the radiographers at your treatment
machine. They will ask you to empty and give you a time at which to start re-filling your bladder,
to fit in with where you are in the treatment queue.

Are the appointments arrival times or actual treatment times?

The appointment times you are given for your radiotherapy are the times at which you will need
to be ready for treatment. You will need to arrive earlier than this in order to prepare your
bladder as described above. Please check when you arrive that your machine is running on
time. For example, if you need to drink three cups of water then wait 30 minutes and your
treatment appointment is at 10.00, you will need to arrive in the department at least 35 minutes
before this time (09.25). This is so that you can empty your bladder, drink your fluid, then allow
your bladder enough time to re-fill and be ready for 10.00.

Does the fluid need to be water?

It is best if the fluid you drink is water. If you struggle drinking water you can bring in squash to
drink each day. We do not advise undiluted fruit juices, sodas, tea or coffee as these do not
work as well. Filtered, chilled water is available for free in the radiotherapy department.

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Why are daily bowel movements important?
Your prostate lies next to your rectum, and moves depending on whether your rectum is empty
or full. It is best if your rectum is empty for treatment as this means your prostate is less likely to
move, thus allowing the most accurate radiotherapy. Ideally you should open your bowels each
day before your radiotherapy.

If you normally open your bowels less frequently than this, you may find using a laxative helpful.
Your doctor or clinical nurse specialist (CNS) can advise on this. Ideally we would like you to
have a daily bowel movement pattern before you attend for your planning scan.

If this bowel movement pattern is not possible (it may be, for example, that you have treatment
appointments very early in the morning), then it is important to ensure you are maintaining a
regular bowel habit, and you are managing to open your bowels every day. This will help to
reduce the build-up of gas in your body and will also help to improve the accuracy of your
treatment. Please ensure that you inform your treatment radiographers if you suffer with
constipation during your radiotherapy treatment.

What if I have any questions or concerns?

It is important that you understand and follow the instructions given to you regarding your
radiotherapy preparation and treatment. If at any time you have any concerns or questions,
please speak to one of your radiographers for guidance.

Useful contact telephone numbers

Imperial College Healthcare NHS Trust has a Macmillan navigator service, which can answer
questions on behalf of CNSs. Navigators will also refer you to the relevant CNS team, and to
other specialist clinical staff, as needed. The service is available Monday to Friday 08.00–20.00
and 09.00–17.00 at weekends. Telephone: 020 3313 0303

Below are other telephone numbers that may be useful. Answerphone messages will be
checked daily.

Radiotherapy reception: 020 3311 1737 (Monday to Friday, 08.00-17.00)

Review radiographers: 020 3311 8804 (Monday, Tuesday, Wednesday Friday, 09.00-17.00;
Thursday 09.30-15.30)
Dr Falconer’s/Dr Mangar’s secretary: 020 3311 1740 (Monday to Friday, 08.45-17.00)
Dr Stewart’s secretary: 020 3311 1742 (Monday to Friday, 08.45-17.00)

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How do I make a comment about my visit?
We aim to provide the best possible service and staff will be happy to answer any of the
questions you may have. If you have any suggestions or comments about your visit, please
either speak to a member of staff or contact the patient advice and liaison service (PALS) on
020 3313 0088 (Charing Cross, Hammersmith and Queen Charlotte’s & Chelsea hospitals), or
020 3312 7777 (St Mary’s and Western Eye hospitals). You can also email PALS at
pals@imperial.nhs.uk. The PALS team will listen to your concerns, suggestions or queries and
is often able to help solve problems on your behalf.

Alternatively, you may wish to express your concerns in writing to:

Chief executive - complaints

Imperial College Healthcare NHS Trust
Trust Headquarters
The Bays, South Wharf Road
London W2 1NY

Alternative formats
This leaflet can be provided on request in large print, as a sound recording, in Braille, or in
alternative languages. Please contact the communications team on 020 3312 5592.

We have a free and premium Wi-Fi service at each of our five hospitals. For further information
please visit our website: www.imperial.nhs.uk.

Radiotherapy department
Published: October 2016
Review date: October 2019
Reference no: 2582v1 updated
© Imperial College Healthcare NHS Trust