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 manage your side effects. It is time to create a long-term schedule with your doctor for future tests. It's also time to go on with your life.
Talk to your healthcare provider about the side effects or problems you have after treatment. You and your healthcare provider can decide your best next steps.
If you haven't yet started treatment, consider the expertise of your doctor before you begin. With more experienced surgeons, the risk of permanent side effects, like incontinence, is lower.
What are the Emotional Effects Following Treatment?
After treatment, you may feel very emotional. You may also worry about cancer returning. Many men still feel anxious and unsure, or upset about treatment side effects.
Whatever you're feeling, it's important to tell your healthcare provider about it. Work together. Build a plan with your provider or a counselor to deal with your emotional health and general wellbeing.
What are The Physical Effects Following Treatment?
Erectile dysfunction and urinary incontinence are the side effects reported most often by men following prostate cancer treatment.
Erectile Dysfunction (ED) Issues After Prostate Cancer Treatment
After prostate cancer, many men experience erectile dysfunction (ED). 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. ED happens when this process doesn't work well (or is damaged from surgery or radiation) and a man cannot keep an erection long enough for sexual satisfaction. Your doctor can help you understand the causes of ED and therapies that could help you recover.
What Causes ED After Prostate Cancer Treatment?
Nerves involved in the erection process surround the prostate gland. Surgery may damage the nerve bundles that control blood flow to the penis, causing ED. Or, these nerves may be removed with the cancer. Radiation therapy also can damage the erectile nerves causing ED. In addition, the amount of blood flowing to the penis can decrease after treatment.
While most surgeons try to perform a nerve sparing procedure, it is not always possible.
The chance of ED after treatment depends on many things:
- Sexual function before treatment
- Stage of the cancer
- Whether the nerves that control erection were damaged after surgery or radiation.
How Long Can ED Last?
If treatment causes ED, there is still a chance for erectile function to come back over time (unless both nerves were destroyed). It may take up to 24 months or longer before you are able to have a full erection, but it is possible. Some men recover sooner. The average time for erections that allow intercourse is between 4 and 24 months. 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 or to full pre-surgery function. But, they may recover enough for sex. There are medicines and devices to treat ED.
Even with no erection, or a weak erection, men can orgasm.
Are There Treatments for ED After Prostate Cancer Treatment?
There are several treatments that can help ED. They include pills, vacuum pumps, urethral suppositories, penile injections and penile implants. Individual treatments don't work for every patient. They have their own set of side effects. A healthcare provider can talk with you about the pros and cons of each method. They can help you decide which individual or combination of treatments is right for you.
Incontinence Issues After Prostate Cancer Treatment
Incontinence can sometimes result from treatment. Incontinence is the inability to control the release of urine.
After prostate cancer treatment, you may experience different types of Incontinence.
- Stress Incontinence — the most common. Urine leaks when coughing, laughing, sneezing or exercising.
- Urge (OAB) Incontinence — the sudden need to go to the bathroom even when the bladder is not full because the bladder is overly sensitive.
- Mixed Incontinence — 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 how to manage this problem.
How Long Will Incontinence Last?
Short-term incontinence after surgery is a common side effect. If you have stress incontinence (the most common type after surgery), you may need to wear a pad for a few weeks to months. Usually incontinence does not last long and urinary control will return. Still, it can last as long as 6 to 12 months.
Physical therapy focused on the pelvic floor may help you recover bladder control sooner. Your healthcare provider can write a prescription for the therapy. Most insurance plans will cover it.
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 this problem.
Are there Treatments for Incontinence After Prostate Cancer Treatment?
Treatment for incontinence depends on the type and severity of the problem:
- Kegel Exercises - strengthen your bladder control muscles.
- Lifestyle Changes - include modifying your diet, no longer smoking, losing weight and timed visits to the bathroom 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 - to inject collagen to tighten the bladder sphincter, implanting a urethral sling to tighten the bladder neck, or an artificial sphincter device used to control urination.
Products - There are also many pads and products available that do not treat incontinence but help maintain a higher quality of life.
What if Prostate Cancer Returns?
Prostate cancer may return. Durable (or long-term) remission depends on the specifics of your cancer. If you'd like to learn more about how to manage advanced prostate cancer, read our advanced prostate cancer article.
Updated August 2018