Conquering Prostate Cancer

Choosing a Prostate Cancer Treatment

You’re going to read about lots of unpleasant side effects (incontinence, erectile dysfunction) associated with prostate cancer treatment. While you can’t avoid them all entirely, understanding each treatment and the benefits it provides long-term is a far better measure of choosing a course.

The primary concern in your mind is probably function-you want to be reassured all the plumbing is still going to work, so to speak. “Surgeons have become outstanding at performing the nerve-sparing operation,” says Dr. Jonathan W. Simons, CEO and president of the Prostate Cancer Foundation. He does recommend that if surgery is your best option for treatment that you find a surgeon who performs it routinely. Only about 2% of patients who have radical prostatectomy performed by a top surgeon remain incontinent, and most of them will be older patients.

Radiation, brachytherapy and cryotherapy produce the opposite problem-while men notice no change at first in sexual function or urinary function, problems may develop over time as the nearby nerves gradually deteriorate. So if a man’s primary concern is retaining long-term sexual function, surgery may be his best bet.

“If you’re trying to save the nerves for erection, 70-80% of patients who have surgery will be functional,” says Dr. Williams. “In radiation, it’s about 60% who retain erections, depending on the dose of radiation. If you lose erections from surgery it will be immediate and take 12-18 months to return. If you have radiation nothing changes for 6 months to a year, and then your ability to have an erection goes away. It’s exactly the opposite.”

Men whose prostate cancer is a tortoise or a bird may receive androgen deprivation therapy, which consists of injections to block testosterone, which feeds prostate cancer. These men will lose their ability to have an erection as long as they’re receiving the injections, and they will lose their desire for sex as well.

There are other considerations with prostate cancer treatment, such as how much time it will take, how long you might be away from work and how the rest of your body might cope. Again, weigh all the options your doctor gives you, look at the facts and have your support team help you through the decision. Being treated for any kind of cancer isn’t pleasant, but the more you know, the better you’ll feel. And that’s a big part of getting through any change.