Prostate Cancer: Managing Side Effects

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Men with prostate cancer should talk to their doctor about potential side effects before starting any treatment.

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Although important advances have been made in surgery and radiation therapy for prostate cancer, each is a significant therapy that can have side effects. At Memorial Sloan Kettering, we work to minimize side effects whenever possible, and have experienced specialists who provide follow-up care if they occur. Our doctors are also dedicated to addressing the full range of symptoms that can result from prostate cancer and its treatment, to give you the best possible quality of life.

This page contains information about some common side effects of prostate cancer and its treatment. You can also learn more about our extensive support program — which provides integrative medicine, rehabilitation therapy, counseling services, and more — by visiting Survivorship & Support.

Side Effects of Surgery

Because the prostate is located next to the muscle that controls urination and the nerves that contribute to erections, surgery to remove the gland can sometimes disrupt these functions.

Urinary Incontinence

Urinary incontinence (involuntary loss of urine) is one possible consequence of surgery. Incontinence can be caused by increased bladder pressure, muscle spasms, or damage to the sphincter muscle that controls bladder flow.

Improved surgical techniques have reduced the risk of incontinence following surgery. Over 90 percent of men experience a complete return of continence, usually within a few months after surgery.

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Urologic surgeon Jaspreet Sandhu describes advances in the management of incontinence after pelvic surgery.

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About 5 to 10 percent of all men who undergo prostate surgery experience mild but permanent stress incontinence, in which a small amount of urine passes while coughing, laughing, or exercising. This condition can be treated effectively with a regimen of pelvic floor exercises or with medications that reduce bladder pressure.

For men who experience more-severe, ongoing incontinence doctors at Memorial Sloan Kettering perform a variety of minimally invasive and surgical procedures that can alleviate these symptoms:

  • Urethral bulking — A bulking agent such as collagen is injected near the urethra. This can help to thicken the wall of the urethra and prevent leaking.
  • Mesh (bulbourethral) sling — This device is placed beneath the urethra to provide support and increase resistance to abdominal pressure. The sling is surgically attached to muscle or the pelvic bone.
  • Artificial urinary sphincter — This device, made of silicone rubber, is fitted around the urethra and can be inflated or deflated to control urination.

Erectile Dysfunction

Even when surgeons use the most advanced techniques, erectile dysfunction (impotence) can occur if prostate surgery disrupts nerves close to the prostate that control blood flow to the penis. In many cases, this side effect is temporary, although recovery of full erections may take as long as three years after prostate surgery.

If you experience erectile dysfunction after radical prostatectomy, Memorial Sloan Kettering’s sexual medicine team can help you to manage the side effects. Our team is composed of physicians, nurse practitioners, and psychologists who are at the forefront of research and treatment for men who experience sexual side effects of prostate cancer treatment. Our sexual medicine experts collaborate with your prostate cancer treatment team to minimize the impact of surgery on your sexual health. Learn more about our sexual health services.

Side Effects of Radiation Therapy

Although important advances have made radiation therapy much more precise than ever before, brachytherapy and external forms of radiation therapy can sometimes affect healthy tissue, causing side effects. Any side effects you experience will depend on which part of the body received radiation and in the case of techniques such as image-guided radiation therapy and stereotactic radiosurgery, which normal structures may be in the path of the radiation’s beam. In addition, radiation therapy is sometimes delivered in combination with hormonal therapy, which can cause impotence.

Bladder, urinary, and bowel side effects

During the course of radiation treatments, some patients may experience diarrhea and/or frequent and uncomfortable urination. Tell your treatment team if you have any of these problems. Medications and other methods are available that can ease these side effects.

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Maintaining sexual health is an achievable goal for young men with prostate cancer.

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Erectile dysfunction

Radiation therapy, whether external or internal (brachytherapy) can cause erectile dysfunction in some men. Memorial Sloan Kettering’s sexual medicine team can help you to manage these side effects. Our team is composed of physicians, nurse practitioners, and psychologists who are at the forefront of research and treatment for men who experience sexual side effects of prostate cancer treatment. Our sexual medicine experts collaborate with your prostate cancer treatment team to minimize the impact of radiation therapy on your sexual health. Learn more about our sexual health services.

Fatigue

Everyone responds differently to radiation treatment. Some patients feel little effect. Others may become fatigued as treatment progresses. Adequate rest is important, and after treatment is ended almost all patients return to their previous energy levels. However, you should certainly report any unusual fatigue to your treatment team.

Symptoms of Advanced Disease and How We Can Help You

When prostate cancer becomes advanced and spreads throughout the body, it can cause pain and other symptoms. Memorial Sloan Kettering has a comprehensive program for managing the complications that can result from metastatic disease.

Bone Loss & Fractures

One of the most common sites of prostate cancer metastasis is in the bones. As prostate cancer cells in the bone grow, they can cause pain and weakness. In addition, hormone therapy and other systemic therapies used to treat advanced prostate cancer can cause bone loss (osteoporosis) that can lead to an increased risk of bone fractures.

If you are receiving treatment for advanced disease, your doctor may recommend bone-targeting treatments in conjunction with other therapies you are receiving. These drugs can prevent or limit the growth of metastases in the bones. Learn more about bone-targeting treatments.

Palliative Care & Pain Management

Palliative care includes any treatment that is given to relieve symptoms caused by diseases such as cancer. The goal of palliative is generally not to cure the disease, but to improve your quality of life.

At Memorial Sloan Kettering, members of the Palliative Medicine Service work as a part of your disease management team. To provide the best palliative care possible, the service may call on specialists in pain management, rehabilitation medicine, psychiatry and behavioral science, integrative medicine, chaplaincy, social work, and other disciplines. Learn more about palliative care and pain management.