Fifty per cent of patients with cancer are treated with radiotherapy during the course of their disease. Although side-effects have been described in studies, these are often not representative of the impact that these symptoms have on the individual. This article explores one area of radiotherapy management, that of pelvic radiotherapy in men, and describes how symptoms that patients experience during and following treatment can be a debilitating outcome of cancer therapy. At present, there is limited knowledge on how best to prevent symptoms from occurring, who is most at risk and how to manage these symptoms. Technology has advanced with accelerated regimes, conformal planning and new radiotherapy treatments. Yet still we are no further forward in dealing with toxicity from treatment. The focus of research has been on developing new cures and only now are questions being raised about the quality of life of patients having radiotherapy treatment.