| What can be done
about unwanted effects of the treatment
Short term unwanted
effects of treatments for prostate cancer
|
|
TUR |
Radical Prostatectomy |
Radiotherapy |
Hormone Therapy |
|
Urinary incontinence |
1 |
3 |
1 |
0 |
|
Impotence |
0 |
3 |
2 |
3 |
|
Diarrhoea / bowel problems |
0 |
1 |
2 |
1 |
|
Bladder symptoms |
3 |
3 |
2 |
0 |
|
Hot
flushes |
0 |
0 |
0 |
3 |
|
Tiredness / lack of energy |
1 |
1 |
1 |
2 |
|
Weight
gain |
0 |
0 |
0 |
0 |
| Sore
skin |
0 |
0 |
1 |
0 |
|
Breast
Enlargement |
0 |
0 |
0 |
1* | Key:
0 = no effect
1 =
rare effect (less than 10% of people treated)
2 = possible
effect (up to 40% of people treated)
3 = common effect
(more that 40% of people treated)
* Breast
enlargement is a common effect of flutamide (when used on its
own), but rare with other hormone
therapies.
Long term unwanted
effects of treatments for prostate cancer
|
|
TUR |
Radical Prostatectomy |
Radiotherapy |
Hormone Therapy |
|
Urinary incontinence |
1 |
2 |
1 |
0 |
|
Impotence |
1 |
3 |
2 |
3 |
|
Diarrhoea / bowel problems |
0 |
1 |
2 |
1 |
|
Bladder symptoms |
0 |
1 |
1 |
0 |
|
Hot
flushes |
0 |
0 |
0 |
3 |
|
Tiredness / lack of energy |
0 |
0 |
0 |
3 |
|
Weight gain |
0 |
0 |
0 |
2 |
|
Sore skin |
0 |
0 |
1 |
0 |
|
Breast
enlargement |
0 |
0 |
0 |
1* |
Key:
0 = no effect
1
= rare effect (less than 10% of people treated)
2 =
possible effect (up to 40% of people treated)
3 = common
effect (more that 40% of people treated)
* Breast
enlargement is a common effect of flutamide (when used on its
own), but rare with other hormone therapies
Unfortunately, as the
tables show, treatment for cancer of the prostate can cause
unpleasant and distressing unwanted effects, both short and
long-term. Before you have any treatment it is important that
you are fully aware of them. Obviously, doctors cannot predict
accurately who is going to be affected, which is why it is
important that you are fully informed about the risks
beforehand and have plenty of opportunity to discuss them.
Remember there are often choices to be made about which
treatment you should have, or even whether you have any
treatment. You can have as large or small a part in those
choices as is right for you.
Any course of treatment
may make you too tired to be interested in sex.
This is known as loss of libido and it is common to many
illnesses, not just cancer.
Many men, regardless of
age, find it very difficult to talk about such personal
subjects as sexual impotence, particularly with their doctor
or other medical staff. Impotence may not be permanent and can
sometimes be brought on by anxiety rather than the treatment.
Men may find it difficult to talk to their partners, for fear
of rejection - but these fears are often mistaken. Sexual
relationships are built on many things, like love, trust and
common experiences. Talk to your partner about your fears and
worries.
If you find the loss of
your sex life disturbing you should discuss this with your
doctor. There are practical ways to help overcome impotence
and your doctor will be able to give you further information
about these.
Physical devices such as
vacuum pumps and constriction rings can help you to achieve
and maintain an erection. Implants can be surgically inserted
into the penis so that it is permanently semi-erect.
Drug treatments are also
available. Alprostadil (Caverject) and papaverine are
injections given straight into the penis to achieve erection.
These work for many men, although injection can be sore and
alprostadil can sometimes cause a painful erection. After
careful teaching, men can give themselves these
injections.
A newer method is known
as MUSE: a small pellet containing alprostadil is put into the
tip of the urethra using a special applicator.
Sildenafil (Viagra) is
another new form of drug treatment. It is too early to say how
many men with impotence as a result of prostate cancer
treatment will be helped by this drug, although it has shown
some success in men who have impotence after radical
prostatectomy. Sildenafil has to be taken about an hour in
advance and will only work if you are sexually aroused. It
cannot be used by men who take nitrate based medicine for
heart problems.
Remember, your doctor is
likely to have treated several other men with the same problem
so try not to feel embarrassed.
Infertility
Most treatments for cancer of the
prostate are likely to cause infertility, which means you will
no longer be able to father a child. Following radiotherapy
to the prostate infertility is likely. Your doctor or
radiotherapist can give you more details of this before you
start treatment. This is obviously an important issue to
discuss with your partner before you start treatment.
Urinary
incontinence
Losing control of your bladder may be
caused by the cancer itself or following surgery or radiotherapy.
In recent years a lot of progress has been made in dealing
with incontinence and there are several different ways of
coping with the problem. Don't hesitate to discuss any worries
with your doctor or nurse. Some hospitals have medical staff
who are specially trained to give advice about incontinence
and the Continence Foundation (see chapter: "Useful
organisations") can also offer useful information.
It is important to stress
that these problems do not affect all men. Ask your doctor as
many questions as you like about your treatment and the
possible side-effects so you are better prepared to cope if
problems do arise. | 
