What Happens After Treatment?

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:

  • Age
  • Health
  • 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.

Urinary Incontinence After Prostate Cancer Treatment

Urinary incontinence can sometimes result from prostate cancer treatment . Urinary incontinence is urine leakage without your control. Men may have many types of incontinence after prostate surgery.

  • Stress incontinence - Coughing, laughing, sneezing, or exercising can strain the pelvic floor muscles, causing urine to leak. This is the most common type of urinary incontinence.
  • Urge incontinence - You feel a sudden, urgent need to go to the bathroom, even when the bladder is not full. This happens because the bladder is overly sensitive. Urge incontinence is also called overactive bladder.
  • Urinary frequency - You go to the bathroom very often. You may feel the need to go every 30 to 60 minutes.
  • Mixed incontinence - You have symptoms of more than 1 type of urinary incontinence.
  • Because incontinence may affect your physical and emotional recovery, it is of great value to understand how to manage this problem.

How Long Will Incontinence Last?

It is common to have incontinence for a time after prostate surgery. If you have stress incontinence, you may need to wear pads for a few weeks or months. In most cases, urinary control will return. Still, incontinence may last as long as 6 to 12 months. It's rare for it to last more than a year.

Are there Treatments for Incontinence After Prostate Cancer Treatment?

Treatment for incontinence depends on the type and severity of the problem. Ask your doctor about treatment choices, risks and benefits, and what you should expect.

  • Physical therapy can help you regain bladder control. Your doctor can write you a prescription for it. Most health plans will cover it.
    • Kegel exercises build up the pelvic floor muscles, training them to keep urine in the bladder. If you're going to have prostate cancer surgery, your doctor may suggest that you start doing these exercises before your surgery.
    • Biofeedback may be used with Kegel exercises to help you judge how well the pelvic floor muscles are working and let you know whether you are doing the exercises the right way.
    • Neuromuscular electrical stimulation uses a device that sends electrical impulses to nerves, which causes muscles to contract. It may be used with Kegel exercises to help train the pelvic floor muscles to contract properly.
  • Timed voiding, a way to reduce urinary frequency with planned bathroom visits. It's used to help your bladder spread out so that it can hold more urine. Your nurse or doctor can help you make a plan for timed voiding.
  • Avoiding bladder irritants during the healing period. These foods and drinks can bother the bladder: 
    • Caffeine in coffee, tea, and sodas
    • Acidic drinks such as juices
    • Alcohol
    • Artificial sweeteners
    • Spicy foods
  • Medication can calm bladder irritability and help reduce urine leaks.
  • Surgery is mainly offered if your bladder has tried to heal on its own, but healing is not complete after at least a year. Your doctor will talk with you about these choices if other treatments haven't helped with your urinary problems.
  • Products such as pads can help reduce pain from urine leakage. These products do not treat incontinence but do help keep up 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 March 2019