The Penis Project Podcast: Breaking Taboos in Men’s Sexual Health
The Penis Project Podcast: Breaking Taboos in Men’s Sexual Health
Sexologist Melissa Hadley Barrett
224: Beyond the Shotgun: Dr. Eve Tiong on the New Era of Prostate Radiotherapy
1 hour 2 minutes Posted Jul 14, 2026 at 10:00 pm.
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Show notes
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 appro