Looking At Side Effects
Last updated: April 2022
I am often asked, "What are the potential side effects of prostate cancer treatments, and do the treatments affect men in the same way?"
A quick answer is NO. We are all different and similar and unique in many ways. The impact of treatment can vary wildly from one individual to the next depending on any number of circumstances.
The first choice for many men upon learning they need treatment for prostate cancer is a radical prostatectomy or the removal of the gland and any impacted lymph nodes. One immediate side effect following this type of surgery can be incontinence. How long you or anyone will experience leakage is unknown. Some men report they experienced little to no leakage within days while others report slight or significant leakage.
On average, men can begin to regain some urinary control starting in about 6 weeks to 6 months. The surgical team also should note it can take some men up to one year. If leakage issues are severe or no improvement is seen, men are advised to speak up and inquire about additional treatment.1
With surgery can also come a loss of erectile function for most men. Some men report regaining full function quickly while others do not. Men who had good erections before surgery may be able to regain their erections more quickly.4
Again, depending on your body, sexual function may or may not improve over time. Men who are not satisfied with their progress can also discuss the use of performance-producing RX pills, injections, or perhaps consider the use of a pump or the use of a penile implant. With the absence of a prostate, men experience a dry orgasm, meaning that no sperm is discharged during sexual intercourse.
The second treatment is brachytherapy or the insertion of radioactive seeds in the prostate gland. The intention of this treatment is to slowly impact the prostate cancer over time. Most men are surprised to learn that brachytherapy is not just half a dozen radioactive seeds but rather a number ranging from 100 to 125.2
The effects of this treatment are suppose to be slow-moving, but eventually sexual dysfunction can occur, and the after-effects can closely mimic those of surgery and external beam radiation. Immediately following seed insertion, men can experience an increased urgency to urinate or may have difficulty emptying their bladder.2,3
External beam radiation (EBRT)
The final approach I will discuss is external beam radiation (EBRT). Initially sexual function may be preserved for a period, but after a few years men can begin to experience dysfunction issues similar to a radical prostatectomy or seed implant therapy.4
Men undergoing EBRT or seed implants may also be advised to take hormone therapy (commonly called androgen deprivation therapy ADT) to weaken the cancer, slow its development and make it more likely to respond to radiation. Personally, I experienced a total loss of libido when I was on androgen deprivation, along with hot flashes and significant weight gain. Other men I know experience no impact to ADT. Why? Who knows?
Everyone reacts differently
While the side effects of prostate cancer treatment can be significant, they should be considered in the light of their ability to stop cancer and preserve your life. The one constant I have learned about side effects of prostate cancer treatment is that every man reacts in a different way, and unfortunately no one can tell you how you will react to a particular prostate cancer treatment.
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