224: Beyond the Shotgun: Dr. Eve Tiong on the New Era of Prostate Radiotherapy

In this episode of The Penis Project Podcast, Melissa is joined by Dr Eve Tiong, a radiation oncologist with Icon Cancer Centre in Western Australia, for a deep dive into how prostate radiotherapy has changed and why many of the horror stories people associate with radiation no longer reflect modern practice.

Dr Tiong walks through the shift from older, broad-field radiation techniques to today's highly targeted approach, explaining how image guidance and modulated delivery now concentrate dose on the prostate while sharply reducing exposure to the bladder and bowel. She and Melissa unpack what this means in practical terms for urinary, bowel and sexual side effects, and discuss how rectal spacer gel is helping to protect bowel function during treatment.

The conversation also covers how patients and their clinicians weigh up surgery versus radiation, the role of hormone therapy for higher-risk cancers, the difference between external beam radiotherapy and brachytherapy, and the emergence of focal therapy as a less invasive option for carefully selected men. Throughout, Dr Tiong returns to a consistent theme: informed decision-making, honest counselling about trade-offs, and the importance of taking sexual health and quality of life seriously at every stage of the prostate cancer journey.

In This Episode, We Cover

• Men on active surveillance who want to understand what triggers a move to treatment

• Modern radiotherapy is far more targeted than the broad “four-field box” approach used decades ago, sharply reducing dose to the bladder and bowel

• Severe long-term side effects from contemporary radiotherapy now sit below 5%

• Rectal spacer gel can further protect the bowel during treatment and dissolves naturally within four to six months

• Cure rates for surgery and radiation are equivalent for low-grade and favourable intermediate-risk prostate cancer

• Focal therapy, treating only the affected area of the prostate, is now emerging as an option in WA

• Sexual health and continence should be part of every prostate cancer conversation, regardless of treatment type

• higher-risk cancers

• PSA monitoring after treatment, the significance of the 0.2 threshold, and emerging PSMA PET tracers

• Reframing relapsed or advanced prostate cancer as a manageable, often chronic condition rather than an immediate death sentence

Key Message from Eve

A cancer diagnosis, including relapse, is not automatically a worst-case outcome. With the range of treatments now available, many men go on to live full, active lives for many years, and ongoing advances continue to expand what is possible.

Resources & Links

• https://iconcancercentre.com.au/doctors/eve-tiong/

• Steve’s YouTube channel – personal stories and practical experience from a prostate cancer survivor: Everyday Prostate Cancer Warrior on YouTube

• Book a telehealth appointment with our sexual health nurse practitioners at Restorative Health Clinic

• For more information check out our websites www.rshealth.com.au , www.makehardeasy.com.au and www.melissahadleybarrett.com.au

• Steve Fisher YouTube link to his Everyday Prostate Cancer Warrior. https://youtu.be/APLm1W8uPBA?si=SfaA9A74GqMNcvUq

• Click here to shop the Sompatherapy Pumps: The Touch II Automatic Pump, and the Response II Manual Pump

• Click here to watch Melissa’s YouTube video: Most Men Use the SOMA VED Wrong | Here’s the Correct Way

Book a telehealth consultation with our sexual health nurse practitioners:

• Restorative Health Clinic

For more information visit our websites:

• www.rshealth.com.au

• www.makehardeasy.com.au

• www.melissahadleybarrett.com

Need Support?

At Restorative Health Clinic, we support men and their partners with:

• Penile rehabilitation after prostate cancer treatment

• Erectile dysfunction

• Vacuum pump and constriction ring education and prescription

• Penile injection therapy

• Intimacy and sexual recovery

• Partner-inclusive support where appropriate

• Practical, evidence-based strategies for rebuilding confidence and function

We offer telehealth consultations Australia-wide and internationally, making it easier for men to access experienced, compassionate support no matter where they live. If Steve’s story sounds familiar, we would love to hear from you.

Restorative Health Clinic also has a psychologist-sexologist joining the team. If you are struggling with the emotional or psychological side of erectile dysfunction, prostate cancer recovery, or intimacy, we can support you there too – as an individual or as a couple.

Listen & Subscribe

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Connect With Us

We love hearing from real people navigating their health. If you would like to share your story or ask a question, get in touch.

Email: admin@rshealth.com.au

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• rshealth.com.au

• makehardeasy.com.au

• melissahadleybarrett.com

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• @restorativehealth.clinic

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• Melissa Hadley Barrett

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• Melissa Hadley Barrett

TEDx Talk:

• Watch on YouTube