For a man, the diagnosis of Prostate Cancer can be devastating. The concern is not so much for his ultimate survival (five-year survival rates are almost 100%; and at 10 years, almost 99%.). It’s the specter of potential treatment side effects that strike directly at his “manhood” — possible incontinence and erectile dysfunction. “Newer treatments, plus technical advances in surgery and radiation therapy, can reduce the side effects,” says McLeod Radiation Oncologist Dr. T. Rhett Spencer. “Understanding the signs and symptoms of prostate cancer is important, because early treatment can also help limit the side effects.”
KNOW THE SYMPTOMS
The prostate gland is about the size of a walnut and is on either side of the opening that empties urine from the bladder.
These signs may indicate prostate cancer, but also may reflect other health issues.
Prostate cancer is detected mostly in older men. Overall, about 1 in 5 men will ultimately be diagnosed with prostate cancer. If you are experiencing the above prostate cancer symptoms, see your personal physician or a urologist to conduct tests.
Watchful Waiting (or Active Surveillance) is unique to Prostate Cancer. The tumors in this organ are usually very slow growing and doctors don’t want to intervene unless the cancer appears to be growing fast or is in danger of spreading. In this case, the specialist continues to see the patient on a regular basis. A variety of tests are performed. If and when appropriate, the physician may recommend moving to a more aggressive treatment phase.
Like most other cancers, tumors in the prostate can be treated by radiation therapy or surgery. Modern developments, such as Stereotactic Body Radiation Therapy (SBRT), use very highly focused radiation beams, resulting in fewer radiation sessions needed.
Internal radiation therapy (brachytherapy) can also be delivered by injecting small radioactive beads into the tumor. It’s generally limited to men with slow-growing, early-stage tumors.
In addition, surgeons can perform a Radical Prostatectomy to remove the prostate, using minimally invasive techniques that require only a few small incisions. Patients have less pain and speedier recovery than with traditional surgery.
Incontinence, urinary problems or leakage are the primary side effects of treatment for prostate cancer. After surgery, some 25% of patients have a problem. After external radiation, about 45% of men have urinating problems but most of those problems resolve after a year. Internal radiation treatment results in 70% of men needing pads or medications. But that may drop to about 30% over time.
Difficulty in having an erection (erectile dysfunction) is a problem in almost all men following treatment, although age, the ability to get an erection before treatment and whether the nerves controlling erection were affected by surgery may impact erectile dysfunction.
Radiation and surgery have a traumatic effect on the delicate nerves and blood vessel that control the physical aspects of erection, not to mention the impact on a man’s mental and emotional state. Two years after surgery, 30% to 60% of men will return to pre-treatment function. After external radiation therapy, about 50% of men have erectile dysfunction problems, but they improve over time. With internal radiation therapy, the number of men who experience erection problems is lower, but it does not improve over time.
Sources include: McLeod Health, National Institutes of Health, Prostate Cancer Foundation, Journal of Clinical Oncology, American Cancer Society