Diet during Pelvic Radiation - Advanced Prostate...

Advanced Prostate Cancer

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Diet during Pelvic Radiation


Hi everyone,

I am starting RT for my pelvic area and very concerned of what to eat during radiation.

I am currently on a whole plant based diet and enjoying it but RO wants me to do a high protein low fiber diet.Basically his example menu was almost from animal products .

I would welcome any advice or personal experience from some of you that went through this.

Thank you


47 Replies

Is your plant-based diet a religious/moral thing? Is it vegan? I guess it would be hard to get enough protein from a vegan diet without increasing the fiber content. One can only eat so much tofu. I guess you can drink a lot of protein drinks made from soy protein.

Keeping fiber low is very important. Fiber increases bowel motility. Bowel motility will increase radiation toxicity because the beams will not hit where they are supposed to.

VioS in reply to Tall_Allen

No is not religious or moral but I came to the conclusion is much better for my health and it brought my cholesterol down and it gives me a lot more energy.

But I guess I have no choice during RT and go back to animal protein to some extent.

Tall_Allen in reply to VioS

During the pandemic, they should be using a hypofractionated salvage RT protocol anyway, so it's only about 5 weeks. Exercise is important for many reasons.

VioS in reply to Tall_Allen

RO said 40 sessions Monday to Friday. I will to check and see if they changed anything. I do exercise almost every day:running (3xweek),rowing,lifting weights,etc.

Concerned-wife in reply to VioS

My husband had a consultation with a dietician for his recent radiation. He had to avoid foods that can cause gas. We were surprised that prunes can cause gas; the other foods were more obvious.

Before radiation, I found some readings that suggested berberine, soy derivatives (edimame), and intermittant fasting helps sensitize cancer cells to radiation. Try searching the forum for these posts. A no-no is to take Vit C supplements that help protect cancer cells.

Perhaps do a little research on short-term fasting (which your RO may or may not approve of, or be knowledgeable about). Don't know much about it for radiation, but there seems to be a bit of positive thought, and research, on its benefits for chemo. Some of the same principles would seem to apply.

At the very least you won't have to choose between animal-based or plant-based... you can have your (fruit/nut)cake and not eat it, too!

I am on a mostly plant based diet. My RO specifically told me not to eat quite a few vegetables that were part of my daily diet. Cruciferous vegetables among others mostly because they cause a lot of gas. I ate like crap during my 44 treatments. But I only had one issues with gas when I started eating veggies again a little foo early. My RT was early this year and I had up to my paraaortic for nodes blasted. As of today haven't had many issues. They started me on Zofran for nausea but I didn't need and stop taking it before the moved to just the PG for the last 16 sessions. I rode my bike to most , got there early and drank some water trying for the requested mix of full bladder but not too full and no gas. I must have done OK. If you want the list of foods my RO said not to eat just ask and I will try to dig it up and post it.

VioS in reply to treedown

Can you let me know of the foods that you kept eating like :beans,tofu,soybeans,any fresh vegetables,salads,fruits besides banana and peeled apples?

I know about cruciferous,lentils,nuts and seeds.

How about protein plant based smoothies?

VioS in reply to treedown

Wow you went through a lot! I am glad you are doing good.

I would appreciate if you could send me list of foods from your RO.Mine is not very detailed.

treedown in reply to VioS

I went through all the info I kept and apparently I did not keep the sheet that listed what vegetables "not" to eat.

I ate lots of things just not those veggies that were cruciferous so salads with non-cruciferous greens, nuts, pb&j, pizza. I ate a lot more carbs than I do normally so sandwiches. Sorry I can't remember exactly what I ate but was very clear what I could not eat which was unfortunately a very large part of my diet. The night of my 44th treatment I went to the store and loaded up on broccoli, cauliflower, collard greens, kale , chard, brussell sprouts, ..... . It was good to get back to normal.

On another note I rode my bike to each of the treatments. The minimum was 5 miles there and 5 miles back but I also rode additional miles. I think it came to 742 total miles during the 9 weeks. That was winter so there were many cold wet days. I think from what I have read on this forum and seen personally that it helped a lot. My Dr's think my level of exercise is helping me with many aspects of my treatment including side effects. I have edema in my left leg almost everyday and exercise gets rid of it. I have not been hit with fatigue, hot flashes or mental fog yet either. I am younger then many here but I am a big believer in the benefits of exercise to help fight this beast and the effects of the treatments and in some cases comorbidities.

VioS in reply to treedown

Thanks so much for your advice. I do to exercise daily running or lifting weights,stretch .

treedown in reply to VioS

Good try to keep it up during the treatments.

I am also a vegetarian and was during my radiation way back when. My advice is don't eat gas producing beans, cabbages etc. Drink protein shakes.

VioS in reply to Magnus1964

Thanks for your advice!Did you eat eggs,fish and cheese?Did you eat anything fresh?

Magnus1964 in reply to VioS

As I remember back then my diet was vegan. But I don't see anything wrong with organic eggs, fish or no hormone cheese.

Hmm... For what its worth, 3 months after HDR Brachy (4/18) I started 25 days of IMRT.

My MSK RO suggested no coffee (no big deal) and Metamucil daily to help with potential episodes of diarrhea.

Breezed thru the process and still take 7 psyllium caps every morning (an hour after my Zytiga and with my prednisone).

Bottom line no se's and I fully evacuate every morning (1/2 hour after Zytiga) 😁


VioS in reply to westof

Why are you taking psyllium caps?Are those to increase fiber ?Does Zytiga give you diarrhea?

treedown in reply to VioS

I actually stated taking psyllium at the end, the revised diet and the radiation possibly made me less regular. I think the psyllium made it all worse. Just my opinion.

westof in reply to VioS

No, Zytiga is working just fine! Started Z just before Brachy and 2 months later I reached my PSA nadir (0.014) and it remains the same to this day.

My MO plans to have me stop all meds (including Lupron) by years end!

And then we shall see...

Although I'm G9, I was localized stage 3

Psyllium just seemed to be the right thing to take (along with Flomax, I forgot to mention that) given the fact that I'll turn 72 next month.

I work as a medical courier (retired 10 years ago and needed to find something else to keep me busy)!

Drive about 110 miles a day and walk between 6-7 miles a day (according to my Smartwatch).

I'm 5'10 and weigh 160 lbs.

VioS in reply to westof

I am on Lupron,Cadodex and Zytiga for 3-4 months now and now RT on my pelvis for positive lymph nodes, Gleason 9,RP in 03/20 and MO said I will be on it for 2-3 years. I have some brain fog and night sweats but otherwise ok.PSA is <0.1 already.

Hope to get where you are ...

Wish you luck.

westof in reply to VioS

Thanks and all my best to you!


Being Concerned about diet is a good thing . I did 8 weeks x five days per of imrt . I was all vegan . I also did “ fast and live” ..there is a youtube video by this name . For me it was just two out of the five days were 500 calorie days . Lots of water all of the time . The theory is that the bad cells already weakened by the fast are more readily knocked off by the rt . I also super dosed with 50 mgs vitamin C IV’s bi-weekly for my first year and a half .. I went undetectable and have stayed here five years now . Does this mean that APC is done with me? Hell no ,once we are stage #4 we take this to the end . Live well beyond your treatments . It takes time to recovery . A healthy diet is a great start in my opinion. How much exercise we get and what we eat are two big things that we can control in our favor . Good luck . Follow your own path to healing yourself . Be proactive and shun negative thinkers .

VioS in reply to Hidden

Thanks so much for your encouragement! I am so confused if I should try and go vegan or flip to the meat,dairy,egg side . I know RO encourages it.So you did water fasting with the 500 calories in those 2 days a week made a difference in side effects?

Was it hard to go vegan and keep the fiber low?Did you use any smooth nut butter or fresh fruit besides bananas?

westof in reply to VioS

Hmm... You provide me with a dilemma of sorts.

My spouse ("Darling wife of 47 years", read my posts.) Is a veggie and my 2 adult children are vegan (daughter 30 ) and veggie (son 36).

And I'm a card carrying carnivore 🐂.

So, tomorrow, Carol and I will dine together with our separate palates.

Since my dx, I have eaten and drank (a few times to excess) anything I have wanted!

My blood work is better than before dx and I just keep on Truckin'!

Caution! I do not recommend my lifestyle and dietary habits to ANYONE!!

I've been doing this all my life without any major consequences (except fo APC)!


And thanks to everyone on this forum for all of the wonderful support!


Hidden in reply to westof

So ! A true carnivore .. ? 🦃🐂🤔

Hidden in reply to VioS

There was some juice also to get 500 calories . Probably with protein , I use hemp. I lost 60 lbs.from 233 strong down to 165 and gaunt .I came back up to 195 after I recovered from RT . Ican’t be exactly sure what worked but I went undetectable . ? I threw a lot of natural spaghetti upon the wall to see what would stick .. I was 53 and made the holistic change . It was dramatic for a guy like me that was a foodie before .. Ive seen others here say that you can’t starve cancer . I belive that cutting processed foods especially sugar is good for everything .. I think we can intake only good and natural foods and eliminate the junk . Occasional cheating ok .

The uro that diagnosed me told me it didn’t matter what I did or ate I was going to kick the bucket at 36 months ..I’m at 69 now and counting .. .We went to a nat oncologist and he put me on a plan .. I can’t recommend eating meat or dairy . Most RO ‘s & MO’s Dont know squat about nutrition . This is the time to go super healthy in all that you do .. You must make your own choices . Everyone has their own opinion on diet . Get through it all and recover well . Good luck brother 😎✌️

I had 20 VMAT 60GY sessions and the hardest part was ensuring I had a full bladder when I went in. They radiated my prostate, bladder and pelvis. I asked my RO about diet and supplements and he simply said, it won't make much difference but if it makes you feel better, then eat/take what you like. So I ate as normal and had a few beers at the end of the week. I had no issues during the four weeks of treatment. However, I began having loose bowel movements 2 weeks after the treatment (week 6), which lasted for about a fortnight. Each to their own, everyone is different, hope it all works out well for you, 👍 😎 DD.


It is very important to eat food that does not inflate. Before radiation, drink plenty of water 0.5-0.7 deciliters so that the organs do not receive a dose of radiation. Be sure to empty your bowels daily. Avoid fruits, vegetables. Eat cooked meat. I do not remember everything, but strictly adhere to the diet. Some who did not, had a lot of side effects.

I was told to eat starchy foods to help combat the possible diahrea and it was a constant battle but lots of noodles helped for me...mashed potatoes also....good luck

I was advised to eat protein twice daily, it was getting a bit much at the end.

Completely avoid foods that cause gas and try and make sure that your bowels are completely empty before going in.

I was pretty religious on the charging up with water.

I would drink a litre and a half over about an hour, then go to the toilet half an hour before setting off, so I was pretty full again when I arrived. Quick dose of radiation and I would fly off to the loo!

I asked about taking vitamins and the doctor said fine as long as you do not overdo it, they had a thing about metformin, I think that maybe because it causes diarrhoea in some people.

There seem to be general rules that every department follows and then some rules that only certain departments think worthwhile.

I was given a list of cruciferous vegetables to avoid but there were certain glaring exceptions that others are told to avoid.

I was told to use Dove soap and almond oil but my skin never became inflamed so in the end that is still sitting in the bathroom.

Small thin turds with no gas is the goal. If your intestines are bulging out they will get in the radiation beam path and get scorched. Drink a quart of thin liquid one hour before the session. This pushes your bladder out of the way to keep it safe too.

So, if yer seein' yellow, have had your morning poop and can't fart yer good to go. They do check before each session, at least mine did, they take a picture. Sometimes they rejected the guy before me so I got in early.

Doseydoe in reply to ck722

It's a brave man who farts 😱 during radio

During pelvic RT any visceral belly fat present (from ADT etc.) is actually protective of the non-target “organs at risk”. Meaning it provides a space cushion fromthe pelvic floor and major vessels. Makes it safer to target the proper field. So do not lose any fat weight during the RT after the planning CT scan has been done. After the radiation is completed you can go for it with your chosen diet. More protein from fish chicken eggs and dairy won’t hurt you on the short term. And psyllium BTW is pure fiber so don’t use that nor antioxidant supplements during the treatment.

My system ran like clockwork, so I chose an appointment time that matched when my bowel would be empty -- lunch time. Didn't avoid many foods at first, since they and their side effects were out of my system by appointment time. For the last week, I went to the low residue diet due to stool starting to loosen up a little. I think that more attention needs paid to appointment time selection -- ex. why choose an early morning time if your bowels aren't naturally empty by them?

fluffyfur in reply to farmanerd

THIS imo is the most important thing in the whole thread. If you choose a 7 am appointment time and typically empty your bowel at 9 am things will not turn out no matter what you plan on eating. Hubs scheduled his RT appointments at 10 am so he could prep his bowels and bladder prior to each session. Yes they measure too and if you're not ready they send you off.

Doseydoe in reply to farmanerd

I did the same and scheduled my radio sessions for after lunch. 👍

We all probably put a little too much emphasis on what to and not to eat, myself included. I chose a plant based diet and left Mickey D's and Chic-fil-a behind and I feel much better in doing so. I also exercise every other day, run a few miles and lift and stretch. I am 48 and God willing, trying to raise my kids well into adulthood. That being said, I remember being very concerned about what to eat during my radiation to my prostate and other hotspots, and my radiologist main concern was to empty my bowels and fill my bladder just before my radiation. I did not change my diet which is/was lots of fruits, veggies, salads, beans "tree hugging, hackysack kicking" diet. I was able to continue my exercising throughout all 33 sessions. Breakfast was oatmeal with blueberries, bananas and some chia/flax seeds. Like clockwork, I went #2 always just before my morning radiation.

I ate a regular diet through my 39 sessions and didn't have a problem until years later they found I had a stricture in my left urinary tract from the frying. Make sure you ask the doc about a SPACEOAR HYDROGEL (which I did NOT have)...

Good Luck, Good Health and Good Humor.

J-o-h-n Wednesday 11/25/2020 6:22 PM EST

SPEEDYX in reply to j-o-h-n

Come on you had to have a tube of at least generic Oar-a-gel.

j-o-h-n in reply to SPEEDYX

Ok I'll admit it.........I used it as topping on my Chocolate chip ice cream (two scoops)...

Good Luck, Good Health and Good Humor.

j-o-h-n Wednesday 11/25/2020 6:52 PM EST

Hidden in reply to j-o-h-n

Dear j-o-h-n , luv ya buddy . Two scoops !

j-o-h-n in reply to Hidden

Ok two scoops for you too.... but only this one time......

Good Luck, Good Health and Good Humor.

j-o-h-n Thursday 11/26/2020 3:57 PM EST - HTD

Hidden in reply to j-o-h-n


I stopped all anti oxidants supplements prior to PBLN IMRT to make the radiation work better.

I began taking CVS maximun strength Probiotic (20 billion dose) pill, one per day, everyday BEFORE you begin the radiation to protect the intestine lining from damage.

You'll have a simulation day, and then all your days of radiation, do the same process to keep the same full bladder for all sessions.

Use the same amount of water each day. I had two large water bottles 20 ounce or so.

I began drinking the first water bottle 45 mins before my radiation start time. I completed that bottle in 15 mins.

I then began drinking the second bottle sipping every minute or so over the next half hour, having finished 3/4 of that bottle before walking into the radiation room.

Every day exactly the same.

The radiation techs will take quick alignment x-rays every session and a CT scan of the target area at least once a week before beginning the radiation delivery to adjust for any changes to your body or alignment.

I always had bowel movements earlier in the morning and a light breakfast before that.

VioS in reply to TJGuy

Thank you for all these details !Very helpful.How about eating plan?

TJGuy in reply to VioS

I remember being provided a list of foods to avoid, and recommend foods.

Off hand I can't remember making much of a change in diet. I'm vegetarian but not vegan.

My radiation sessions were mid morning 10:00 am with a late rising for me having retired.

So I started each day as normal for me with a bowl of oatmeal, a small glass of OJ, and half a bagel.

I went through radiation with few symptoms, and just a little degree of burn when urinating in final week.

Any symptoms it seems can build towards the end of the Mon - Friday sessions and disappear over weekends.

I had a few episodes of diarrhea, seemed to follow the day after having a few pints of beer usually on a Saturday.

My RO said to me that he had heard that Horgarten beer was good for radiation like probiotics.

Said he didn't know for sure if that was true, but if I was going to drink a beer or two anyway, I might try that and let him know if there was any difference, I never completed that test and just avoided beer towards the end of the 33 sessions.

I did experience some symptoms after completing radiation, such as a few diarrhea episodes, some incontinence which went away, then reappeared a half year later, then disappeared, then reappeared, then disappeared. So I started kegals again to shore that up.

I've noticed alcohol and cabonnated drinks can contribute to incontinence. So I don't drink carbonated drinks and limit alcohol to two drinks.

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