Life After Prostate CancerYour life expectancy and quality of life after prostate cancer will depend largely on what treatment you opt for, and those treatment will depend a great deal on if the tumor has spread or not. If the tumor is still inside the prostate, you can use radiation therapy to kill the cancer cells or have a surgery called radical prostatectomy. However, tumors that have spread outside the edge of the prostate will not be treated with radiation or surgery. Instead, this type of tumor is usually treated with hormones, which will slow the growth of the cancerous cells. Surgery Surgery that removes the whole prostate gland and the closest lymph nodes is called radical prostatectomy. Usually, the patient is put under general anesthesia for this procedure. Until everything heals (usually 2 to 3 weeks), a catheter remains in place to help pass urine. You typically only stay in the hospital for 2 or 3 days and are released back to work in a month. The immediate drawback is bladder incontinence for anywhere from a week to a few months afterwards. The best part of having surgery is that you are most certain that the cancer was removed than with any other treatment. However, the surgery does have risks of certain complications. As with any surgery, you could need a transfusion due to lose a lot of blood. The most common risks with prostate cancer surgery are loss of bladder control and impotence. Typically, most men have only mild incontinence after radical prostatectomy. Much like women who have had several children, about 35% of men have a tiny urine leakage when they do heavy lifting, cough or laugh really hard. If the tumor is small enough that the surgeon can avoid cutting nerves, the chance of impotence after surgery decreases. Doctors are working on developing laser technology that will avoid damaging the healthy tissues around the tumor, so this may be a fading risk. Another factor that will play into the risk of impotence is your age and how well of a sexual function you had before having the surgery. Most men under 50 years old at the time of surgery will be likely to regain full sexual function. Patients older than 70 are more likely to lose their sexual function. Even though the ability to maintain an erection for sexual intercourse is lost, feeling in the penis and the ability to orgasm is not affected. For patients who have that trouble, medicines and devices are available to help maintain an erection. Radiation For those who are considering radiation treatment, you should know that there are 2 types to choose from. First, there is the external beam radiation therapy. Through this type of treatment, the radiation is given in an x-ray like format from a machine. Second, there is "seed" therapy in which radioactive pellets (the "seeds") are placed inside the prostate gland. Both treatments have about the same effectiveness in curing the cancer. Life after the radiation treatment may have more complications. About 50% of men who take the radiation become impotent over the 2 years following treatment. The radiation depletes energy, so many men complain of being very tired. Short term discomfort such as urinary burning or bleeding, frequent urination, rectal bleeding or discomfort, or diarrhea occur in about 15%-30% of patients. Although it is rare to have serious complications, a degree of uncertainty as to how much cancer was there and if it is all gone is a part of radiation treatment. The prostate gland and lymph nodes are left, so the doctor can't determine any of this. This means the cancer could return years later. Hormones Hormone therapy lowers the level of androgens, male hormones, which are made in the testicles mainly. Some androgens, like testosterone, encourage the growth of the prostate tumor. The hormone therapy can be done in one of two ways: monthly shots or removal of the testicles. Once the guilty androgen is out of the body, the tumor usually begins to shrink. This option is typically used for patients who have a tumor that has grown out of the bounds of the prostate gland. This option will eventually stop working and there is not treatment option after it to cure the cancer. After any treatment After prostate cancer treatment, you will need to have a PSA (prostate-specific antigen) blood test every 6 months for the first 5 years and yearly after that. If PSA levels rise, it usually indicates that the cancer is growing back. A yearly rectal exam is also recommended. |