Side Effects of Prostate Cancer Treatments

Short- or long-term urinary problems are a common side effect of radiation therapy and surgical treatment of prostate cancer and may include:

Urinary incontinence (loss of bladder control)
Incontinence symptoms can often be managed with special exercises and/or pelvic floor rehabilitation. Our specially trained physical therapists help men strengthen their core and pelvic floor muscles to improve bladder control. Other treatment options may include bladder training, lifestyle changes, medications, electrical nerve stimulation and/or minimally invasive surgical procedures.

Urinary obstruction (slow or blocked urinary flow)
Treatment options for urinary obstruction will depend on the cause and may include antibiotics (if an infection is the cause) and/or urine removal with a catheter or stent. In some cases, patients may require a minimally invasive surgical procedure to clear the blockage. The urology experts at University Hospitals are specially trained to provide both medical and surgical care for urinary obstruction.

Sexual problems are a common side effect of radiation therapy and surgical treatment of prostate cancer. Radiation and surgery can damage the blood vessels and nerves involved in sexual performance. And hormone therapy which manipulates testosterone levels - the main male sex hormone - may also cause some degree of sexual dysfunction in the form of lowered libido. The two most common sexual side effects of treatment include:

Erectile dysfunction (ED)
ED is the inability to get and maintain a firm erection. Even with advanced nerve- and vessel-sparing surgical techniques, prostatectomy surgery and/or radiation therapy for prostate cancer will almost always result in some degree of erectile dysfunction.

University Hospitals has multidisciplinary teams of sexual health experts and reconstructive urological surgeons with the training and knowledge to effectively treat ED caused by prostate cancer treatments with a variety of approaches that may include:

• Pelvic floor rehabilitation
• Medications
• Penile pumps
• Injections
• Surgical implants

The goal for treatment is always to maximize both sexual function and quality of life for our patients.

Infertility
Prostate cancer surgery and radiation therapy can both have a significant effect on a man’s ability to father children through sexual intercourse. Surgery removes both the prostate and the seminal vesicles, both of which are needed to make, store and transport semen. And radiation therapy can damage the cells of the prostate and seminal vesicles, resulting in the production of semen that cannot transport sperm effectively. Radiation may also damage the sperm itself, which is made in the testicles.

The men’s sexual health team at University Hospitals offers a wide variety of both fertility treatments and fertility preservation options for men.

Chemotherapy drugs are powerful anti-cancer medications that prevent cancer cells from dividing and making new cells. They can also, however, affect healthy cells to a lesser degree and cause certain side effects, including:

• Fatigue
• Hair loss
• Diarrhea
• Shortness of breath
• Loss of appetite
• Fluid retention
• Neuropathy (numbness in the hands and feet)
• Low blood platelet count

Patient response to chemotherapy medications can vary widely and most side effects will resolve on their own once treatment is completed. Some, however, may require medical treatment. In addition, modern chemotherapy drugs are usually very well tolerated, with some men, in fact, reporting an improvement in cancer-related symptoms such as pain, fatigue and low energy after starting this therapy.

Although very rare, prostate surgery and/or radiation therapy can damage the rectum and result in bowel problems like rectal bleeding, diarrhea or urgency.

With surgery, bowel side effects are more likely to occur in patients with locally advanced prostate cancer that has invaded the rectum. With modern radiation therapies, it is very rare to have serious bowel side effects and those typically improve within a few weeks of completing the therapy and are usually completely resolved by 6-12 months post-treatment.

If symptoms do persist, your care team may refer you for pelvic floor therapy or have you evaluated by a colorectal specialist.

Hormone therapy , or androgen deprivation therapy (ADT), is a type of prostate cancer treatment that aims to reduce, stop or block the production of male hormones (androgrens), including testosterone so that prostate cancers shrink or grow more slowly.

Testosterone is the primary male hormone. When it is lowered through therapy it can lead to a variety of side effects including loss of bone density (osteoporosis) and increased risk of fracture.

Your care team will check your bone density at the start of hormone treatment and periodically during and after treatment. If the scans show signs of bone loss, you may be given medications to reduce your risk of fracture. You may also be advised to make certain lifestyle modifications that include eating a heart-healthy diet and engaging in regular weight-bearing exercise to help maintain bone and muscle mass.

A diagnosis of cancer can take a psychological toll on a person. Prostate cancer can be a particularly emotional diagnosis for a man, given that the disease itself and its treatments are so intimately connected to his sexual health. Some men may experience symptoms of depression and/or anxiety at any stage of their diagnosis and treatment journey.

These feelings are normal and should be accepted. If they persist, however, and are interfering with your treatment and/or your ability to function on a daily basis, tell you doctor. University Hospitals has a robust behavioral health program that can help you cope with your disease and your related emotions.