How to Prepare for Prostate SBRT Treatment

Proper bowel and bladder preparation plays an important role in the accuracy of prostate radiation therapy. This video explains how to prepare for prostate SBRT, including medication schedules, bowel preparation, dietary considerations, hydration, and what to expect before simulation and treatment visits.

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Developed in collaboration with Memorial Sloan Kettering Cancer Center.

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Read the full video transcript below:

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This video explains how to get ready for prostate SBRT. We’ll review what to do before your treatment visits, including any preparation steps your care team may recommend ahead of time. These steps focus on keeping your bowels empty and your bladder comfortably full, which helps your care team target the prostate accurately and protect nearby healthy tissue.

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We’ll start with bowel preparation before your simulation appointment.

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A simulation is a planning session to determine the precise positioning for you to receive your radiation treatments to best target your cancer.

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Three days before your simulation, you’ll begin two medications to help prepare your bowels. Bisacodyl helps you stay regular, and simethicone helps prevent gas and bloating. Taking both as directed helps keep your prostate in the same position for each scan and treatment.

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When you arrive for your simulation visit, a nurse will also give you a saline enema before the scan. This is a routine part of the process and helps make sure your bowels are empty for the imaging that will be used to design your radiation treatment plan.

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Three days before your first SBRT treatment, you’ll restart the same medications to support regular bowel movements and reduce gas. You’ll continue taking them every day until you complete your full course of radiation therapy, unless your physician tells you to stop. This consistency helps keep your internal organs as stable as possible from day to day.

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On treatment days, timing matters. Try to have a bowel movement within one to two hours before your scheduled appointment. If you’re unable to do so, you may need to give yourself a saline enema at home before leaving for your visit, or as close to your departure time as possible. If you do use an enema, do not eat solid foods afterward. Clear liquids like water, sports drinks, or clear juice are okay.

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Because one of the bowel prep medications is a laxative, it’s important to let your care team know if you develop diarrhea. Your laxative dose can be adjusted to keep you comfortable. And if you’re following all the instructions but still having trouble emptying your bowels before treatments, tell your care team. There are other options they can help you with.

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Diet can also make a big difference in reducing gas and bloating during treatment.

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To limit swallowed air, eat slowly, chew your food well, and avoid using drinking straws or drinking directly from bottles and cans. Try to avoid carbonated beverages like soda, sparkling water, or beer. Some foods naturally create more gas during digestion, including certain vegetables, onions, garlic, dried fruits, and dairy products if you’re lactose intolerant. Choosing cooked vegetables instead of raw ones can also help reduce bloating.

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Keeping track of what you eat and how your body responds can be helpful, especially if you notice increased gas or discomfort. An MSK dietician can help you find what foods you can eat that do not produce as much gas. Please let your care team know if you would like to meet with a dietician.

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Bladder preparation is just as important as bowel prep.

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For both your simulation and each SBRT treatment, you’ll be asked to have a comfortably full bladder. A full bladder helps move nearby organs out of the treatment area and can reduce side effects. Staying well hydrated in the days leading up to your appointments makes this much easier.

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In general, aim to drink about 64 ounces of water throughout the day unless another doctor has told you to limit fluids. Your care team will give you specific instructions on how much water to drink and when to drink it before each appointment, starting at your simulation visit.

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Following these preparation steps helps your treatment go smoothly and safely, and helps your care team deliver radiation as accurately as possible. If you ever have questions or concerns, or if something isn’t working well for you, reach out to your radiation care team. They’re there to help.

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This video is not meant to replace medical advice from your doctor.  Talk to your doctor before making any medical decisions.

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