June 2011 Newsletter:  Managing Prostate Cancer Side Effects
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Concerns about Prostate Cancer Side Effects

Prostate cancer is the second most common cancer among men in the United States. Men with prostate cancer face challenges that go beyond fighting the disease. They worry about how the disease and its treatments will impact their lifestyle and relationships.

Some potential side effects of prostate cancer and its treatment include:

  • Urinary incontinence (inability to control urination)
  • Erectile dysfunction (impotence)
  • Bowel problems
  • Emotional issues (e.g., anxiety, depression)
  • Loss of libido (sex drive)
  • Fatigue
  • Infertility

What Causes UI and ED?

Some men with prostate cancer experience urinary incontinence (UI) and/or erectile dysfunction (ED) during or after treatment. A prostatectomy (removal of the prostate) can damage the valves of the bladder and disrupt the way it holds urine. It can also damage certain nerves and blood vessels that control a man’s ability to get or keep an erection, ejaculate or reach orgasm.

Radiation therapy to the pelvis can affect bladder function by changing the nerves and muscles used to control urine flow. It can also damage the arteries that bring blood to the penis and cause problems with getting or keeping an erection. Some hormonal therapies, chemotherapies and medications can also cause UI and/or ED.

Depending on the type of treatment received, extent of the damage, and other individual factors, UI and ED may be temporary or permanent. It often takes a longer period of time to regain erectile function (e.g., 6 -12 months) than it does to overcome incontinence.

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Getting Back to Normal after Prostate Cancer

Getting back to “normal” after prostate cancer is a real concern for many men. Fear or embarrassment over urine leakage may keep you from participating in activities you enjoy. Anxiety about sexual performance can put a strain on intimate relationships. Other side effects, like fatigue, nausea or constipation, can decrease sexual feelings.

Fortunately, even if urinary incontinence and/or erectile dysfunction do not completely resolve, you can learn how to manage these conditions so you can continue to live an active life after treatment.

Managing UI and ED

Treatment for UI and ED depends on the type, severity and cause of the problem, and may include a combination of approaches. Fortunately, new and innovative techniques in prostate cancer treatment can help lessen damage to the bladder valves and to the nerves and blood vessels that control erections.

Your doctor may recommend nerve-sparing methods during surgery to preserve erectile function. Also, advanced radiation technologies, like the Calypso® 4D Localization System™, target cancerous cells and protect healthy tissues, helping to minimize sexual and urinary side effects.

If ED occurs, treatment methods may include: medications, injections, vacuum devices, implants, or testosterone replacement. Your doctor may also recommend counseling, as sexual dysfunction can cause emotional distress.

Treatment for UI may include surgical interventions and/or certain medications that help to reduce bladder muscle contractions and block the nerve signals that cause urine urgency and frequency. Your doctor may also recommend biofeedback methods to help you learn how to control the muscles you use to urinate. Additionally, products like absorbent pads can help hide urine leakage.

NOTE: THIS INFORMATION IS NOT INTENDED NOR IMPLIED TO BE A SUBSTITUTE FOR PROFESSIONAL MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF YOUR PHYSICIAN OR OTHER QUALIFIED HEALTHCARE PROVIDER REGARDING PROSTATE CANCER SIDE EFFECTS, SUCH AS URINARY INCONTINENCE AND ERECTILE DYSFUNCTION.

10 Tips for Managing Prostate Cancer Side Effects

  • Understand your options. Advanced technologies for treating prostate cancer can help to minimize side effects like UI and ED. Learn about all the options available to you before, during and after treatment. Understanding your options can help you make the right treatment choices for you.
  • Communicate with your care team. Ask your doctors what side effects you can anticipate from prostate cancer treatment, and how your care team will help you manage these side effects. Be open about any sexual dysfunction, incontinence, or other symptoms you may experience during treatment.
  • Give yourself time. It takes time to adjust to the physical and emotional changes prostate cancer brings to your life. Try to be patient if certain side effects, such as depression, pain or fatigue, lower your desire for sexual activity. Also, remember that it may take time to resolve symptoms of incontinence.
  • Plan ahead. It’s important to plan ahead if you’re dealing with UI or ED. Empty your bladder (even if you don’t think you need to) before leaving the house and going to bed. Since levels of sexual desire vary during prostate cancer treatment, try to plan sexual activity for when you have the most energy.
  • Try other forms of intimacy. Even if you can’t have sexual intercourse, you can still maintain intimacy through loving affection and touch. Start out slowly by cuddling, kissing and touching. Give your partner a massage. Even going for a walk or watching a movie together can create intimacy.
  • Try bladder retraining techniques. Bladder retraining can help increase your bladder capacity so it can hold more urine for longer periods of time. Set routine times to urinate. Instead of urinating whenever you feel the urge, try to wait a few minutes and gradually lengthen the time between bathroom trips.
  • Enhance your self-image. Prostate cancer can affect your feelings of attractiveness, desirability and masculinity. Simple boosts like a new haircut or clothing may help you feel better about yourself. Your doctor may also recommend medical options (e.g., devices to improve erectile function, etc.).
  • Get healthy in other areas. Maintaining a healthy lifestyle, including regular exercise and good nutrition, can help increase energy and improve mood, which can stimulate sexual desire. Also, avoid foods that can aggravate UI, including dairy products, acidic or spicy foods, vinegars, sugar, alcohol and caffeine.
  • Talk openly with your partner. You may feel embarrassed about urine leakage or anxious about resuming sexual activity after prostate cancer treatment. It’s important to share your feelings and concerns with your partner so you understand each other’s needs and preferences.
  • Seek emotional support. Prostate cancer side effects can cause emotional distress, including depression and anxiety. It may help to meet with a professional counselor, social worker, or chaplain. Also, support groups allow you to share your concerns and trade advice with others in similar situations.

NOTE: THIS INFORMATION IS NOT INTENDED NOR IMPLIED TO BE A SUBSTITUTE FOR PROFESSIONAL MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF YOUR PHYSICIAN OR OTHER QUALIFIED HEALTHCARE PROVIDER REGARDING YOUR CANCER CARE.

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I hope this information has helped you in some way. I will check in with you again next month.

Sincerely,

Jill Kafin

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