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What Happens After Treatment?

While treatment choices differ, each year more men are surviving prostate cancer and winning back their lives. Prostate cancer can be a manageable disease if caught early and treated appropriately.

Once you have finished treatment it is time to think about any side effects you may have. It's also time to go on with your life. Talk to your health care provider about any side effects or problems you have after your treatment. You and your health care provider can decide what will be best for you.

What are The Emotional Effects Following Treatment?

After treatment, you may feel very emotional and even overjoyed. You could also feel anxious. You may worry about cancer returning. Whatever you're feeling, talk to your health care provider. Work together. Build a plan with your health care provider. And make a plan for dealing with side effects.

What are The Physical Effects Following Treatment?

Erectile dysfunction and urinary incontinence are the side effects reported most often:

Erectile Dysfunction (ED) Issues After Prostate Cancer Treatment

After prostate cancer, men can experience various side effects including erectile dysfunction. Your doctor can help you understand the causes of ED, and therapies that could help you recover.

What Causes ED After Prostate Cancer Treatment?

Surgery may damage the nerve bundles that control blood flow to the penis, causing ED. Nerves involved in the erection process surround the prostate galnd. While most surgeons try to perform a nerve sparing procedure, it is not always possible. In addition, there could be a decreased amount of blood flowing to the penis after treatment. The chance of ED after treatment depends on many things. It depends on your:

  • Age
  • Health
  • Sexual function before treatment
  • Stage of the cancer
  • Whether the nerves that control erection were saved

How Long Can ED Last?

An erection happens when sexual arousal causes nerves near the prostate to send signals. The signals cause the blood vessels in the penis to fill with blood. The blood in the vessels makes the penis erect. The two nerve bundles that cause erection are very close to the area where prostate cancer most often starts. It's often possible to save these nerves in surgery, except when there is a chance that cancer cells will remain.

Since the main goal of prostate treatment is to remove the cancer, these nerve bundles may be completely or partly destroyed. There is still a chance of getting erectile function back, unless both nerves are destroyed. Erectile function return may be slow. It can take up to 24 months or longer before you are able to have a full erection. Some men recover sooner. The average time for erections that allow intercourse is 4 to 24 months. In some men, it takes longer.

Men under age 60 have a better chance of regaining erections than older men. Even with nerve–sparing surgery, erections do not return right away. The recovery period can take up to 2 years. Erections do not always return fully to pre–surgery function. But they may recover enough for sex. There are medicines and devices to treat ED.

Even with full recovery, most men find that erections are less strong and long–lasting than before surgery. Younger men recover sooner. Men with strogner erections before the operation have a better chance of recovery than those who had weak erections before surgery.

Are There Treatments for ED After Prostate Cancer Treatment?

Erectile rehabilitation is usually advised treatment. There are treatments that can help ED. They include pills, vacuum pumps, urethral suppositories, penile injections, and penile implants. All may have side effects. A health care provider can help you decide if one would be right for you.

Incontinence Issues After Prostate Cancer Treatment

Incontinence can sometimes occur as a result of treatment for prostate cancer. Incontinence is the inability to control your urine. After prostate cancer treatment, you may experience four different types of Incontinence.

  • Stress Incontinence — is the most common, is urine leakage when coughing, laughing, sneezing or exercising.
  • Overflow Incontinence — is the inability to empty the bladder completely, taking longer to urinate and when you do urinate, it is not a powerful stream.
  • Urge (OAB) Incontinence — is the sudden need to go to the bathroom even when the bladder is not full because the bladder is overly sensitive.
  • Mixed Incontinence — is a combination of stress and urge incontinence with symptoms from both types.

Because incontinence may affect your physical and emotional recovery, it is important to understand what your options are.

What Causes Incontinence After Prostate Cancer Treatment?

Whether you have incontinence after your prostate cancer treatment depends on your age, former bladder function, and experience of your doctor. With more experienced surgeons, the risk of permanent incontinence is rare after prostate cancer treatment. Sometime during surgery there is scarring. Scar tissue may form at the bladder outlet where the prostate was removed. If your urine flow is blocked, you may need more surgery to fix the blockage.

How Long Will Incontinence Last?

Short–term incontinence after surgery is a common side effect. You may need to wear a pad for a few weeks to months. Usually incontinence does not last long. But it can last as long as six to twelve months. Most men will recover urinary control. Physical therapy focusing on the pelvic floor may help you recover bladder control. Your health care provider can write a prescription for the therapy. Most insurance will cover the therapy.

Long–term (after 1 year) incontinence is rare. It happens in less than 5–10 percent of all surgical cases. When it does occur, there are ways to solve the problem.

Incontinence depends mostly on the surgeon's experience. Your age and bladder health also matter.

Are there Treatments for Incontinence After Prostate Cancer Treatment?

Treatment is based on numerous factors including the type and severity of your incontinence. There are a variety of treatment options which can potentially help you regain complete control:

  • Kegel Exercises – strengthen your bladder control muscles.
  • Lifestyle Changes – include modifying your diet, losing weight and regular emptying of the bladder can decrease urination frequency.
  • Medication – affect the nerves and muscles around the bladder, helping to maintain better control.
  • Neuromuscular Electrical Stimulation – strengthens bladder muscles.
  • Surgery – consists of injecting collagen to tighten the bladder sphincter, implanting a urethral sling to tighten the bladder neck, or an artificial sphincter device used to control urination. There are also many products available that do not treat incontinence but help maintain a high quality of life.

What if Prostate Cancer Returns?

Prostate cancer may return. The likelihood of cure varies. It depends on the cancer. You need a PSA test (the screening test for prostate cancer) of less than 0.1 ng/mL for 10 years before the cancer is considered cured. If the cancer returns, you and your health care provider will talk about treatment choice.