If you've recently been diagnosed with prostate cancer, this article is for you.
Being diagnosed with prostate cancer often comes as a shock, and can be overwhelming, making it hard to think about the questions you may need to ask.
We've put together a handy list of common questions to help you consider your options.
What are the side effects of the different treatment options?
Prostatectomy
Urinary incontinence and erectile dysfunction are two common side effects of surgery. Urinary incontinence is the involuntary leaking of urine and usually improves within one to six months, although some men experience incontinence for longer.
Surgery can also result in the loss of erectile function, and while some men regain function fairly rapidly, others will have more difficulty. This largely depends on your individual situation and whether your surgeon was able to spare the nerves that control your erections. It is common for the restoration of erectile function to take 18 to 24 months.
It's important to ask your specialist at an early point about your options for pre-habilitation and re-habilitation. You should also discuss the available treatment options, and any costs, for managing any longer-lasting side effects that concern you.
With a prostatectomy, other risks can include infection, blood clots, bleeding, and injury to nearby organs. The good news is, these types of complications are uncommon, and your specialist will be able to give you individual advice about any particular risks related to your procedure.
Radiation therapy
This may result in short term urinary frequency, urgency, a burning sensation, increased need to urinate during the night, and in some cases, blood in the urine. This usually peaks at two to four weeks after completion of radiation and improves within three to six months. Longer term, you may experience changes in urinary flow, resulting in altered stream, urgency or frequency and further blood in urine. Monitoring and identifying these changes early are key to managing these.
Other side effects can include bowel issues. Many men may experience more frequent and looser stools, bloating and increased gas. These side effects usually resolve within 3-6 months. The good news is, a lot of bowel side effects may be managed through dietary changes, stool bulking agents, or anti-diarrhoea medications.
Changes in sexual function may also occur over time after radiation therapy. Make sure you discuss options for managing these with your radiation oncologist during follow-up.
Focal therapy
Focal therapies such as High-Intensity Focused Ultrasound, NanoKnife, or focal laser therapy, may have initial urinary side effects including urgency, frequency, and blood in urine, though this usually settles within one to three months.
Hormone therapy
Men may experience urinary retention when starting certain types of hormone therapy. Treatments to manage this may include urinary catheterisation, medications, or surgery to improve urinary flow. There is also likely to be a loss of libido, genital shrinkage, and delay in getting or maintaining an erection. Hormone therapy can also alter your experience of orgasm and your ejaculate volume. The long-term impacts of these side effects will depend on the duration of your treatment and treatment response. Importantly, there are a range of options for managing these side effects.
Those prescribed hormone therapy may also experience effects including mood changes, hot flushes, fatigue, loss of muscle mass, loss of bone density, weight gain, breast enlargement and tenderness, and impaired memory or concentration and body hair loss. Not all men will experience each side effect and many experience these to varying degrees of bother.
Make sure you ask about the management options that are suitable for you and discuss these with your specialist and partner.
Chemotherapy
While chemotherapy does not typically impact your urinary or erectile function, it can damage healthy cells in the body. Men may experience altered blood cell counts, nausea, vomiting, diarrhoea, fatigue, and hair loss. Some men also experience peripheral neuropathy (damage to the nerves surrounding the brain and spinal cord) and swelling in their lower limbs. With improved chemotherapy medications, the side effects have lessened and can usually be well managed.
Check with your specialist about your individual situation and don't be afraid to ask direct questions.
