Managing possible side effects from prostate cancer

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Managing possible side effects from prostate cancer

The earlier start you get managing any side effects from a disease has been shown to help patients live longer, better lives. When treating a chronic disease such as prostate cancer, side effects are likely to happen. Whether from surgery or radiation, urinary and sexual issues can arise after these treatments are given.

How severe or how long they may last can vary significantly between men. A man’s best bet is to discuss possible side effects with his doctor at the beginning of his diagnosis. Before undergoing prostate cancer treatment, being aware of physical or mental changes that can occur will equip a man with knowing what to expect and what can be done to manage them.  Men who tend to do the best in surviving prostate cancer and handling possible side effects, are generally well-informed and have done their homework to understand the impact of each treatment on the quality of his life.

·      Erectile dysfunction

Almost all men who undergo a radical prostatectomy will experience erectile dysfunction (ED).  But fortunately, most men will begin to regain sexual function with six months. Men who are treated with radiation often have no initial ED, but over the next several months to years later this problem may happen.

Any man experiencing ED as a side effect of prostate cancer treatments should let his doctor know. There are several oral prescription medications for ED which include sildenafil (Viagra), tadalafil (Cialis), and vardenafil (Levitra). These medications relax the muscles in the penis allowing blood to rapidly flow in to cause an erection. On average, the drugs about an hour to begin working; the erection-boosting effects of sildenafil and vardenafil last about 8 hours, tadalafil lasts about 36 hours. About 75% of men who undergo nerve-sparing prostatectomy or more precise forms of radiation therapy have reported successfully achieving erections after using these drugs.

However, these drugs are not for everyone. Other options to consider might be the use of a vacuum constriction device, which includes a pump that draws blood into the shaft of the penis to create an erection.  Another option is an injection of medication directly into the penis to produce an erection. There are also penile implants which are surgically implanted.  These penile prostheses allow for more spontaneity and provide more predictable results.

·      Urinary side effects

Urinary side effects are not unusual especially after undergoing radical prostatectomy.  Many men may develop some degree of urinary incontinence and will need to wear protective pads to absorb urine leaks as they recover. Usually it takes up to six months to regain continence although some men may need more time. Radiation can also be a cause of urinary issues as it will irritate the tissues of the urinary tract and may cause painful urination.

To help with incontinence, limit fluid intake (especially in the evening), avoid caffeine and alcohol, and schedule regular bathroom trips to avoid rushing to urinate.  Many doctors recommend pelvic floor exercises or Kegels to help strengthen the muscles used to stop and start urination.

Other treatments for urinary side effects might include prescription medications that relax the bladder for men who experience painful urination, difficulty in emptying the bladder, or an increased urge to urinate.

For men who undergo external-beam radiation, they may have side effects of diarrhea, rectal bleeding and painful or difficult bowel movements. These symptoms usually require symptomatic treatment such as anti-diarrheal medication.

Men who continue to have bothersome urinary side effects persisting more than a year (affects a minority of men), they should ask their doctor about how to treat these lingering problems. Men do not have to live with their urinary incontinence and if they don’t speak up and let their doctor know about it, they will end up suffering in silence.

·      Fertility side effects

Men wanting to father a child after treatment for prostate cancer should strongly consider sperm banking for their best chance of fertility. Semen containing sperm is frozen in liquid nitrogen and, although the cells are technically alive, all cellular activity ceases. After thawing, up to 50% of sperm will regenerate and can be used for artificial insemination.

Another alternative to sperm banking is extracting sperm directly from the testicles. After harvesting sperm for testicular tissue, a single microscopic sperm is injected into a single microscopic egg. If an embryo forms, it is implanted into the woman’s uterine wall and allowed to grow.