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Man lowering a bucket into a deep well, while a monster lurks below the ground

The Things They Don’t Tell You About Prostate Cancer

Eight years ago this month my prostate cancer treatment was starting to turn from an idea into a plan. On the way things happened that hadn’t been mentioned or discussed, so I thought I’d try to list them to help those following on a similar path.

More exams, biopsies, and scans

That first digital rectal exam won’t be the last time things go up there. You may have a transrectal biopsy, in which case a broom handle-type device with needles that shootout and go into your prostate will be inserted and deployed. Yes, your prostate becomes a shooting gallery for half an hour. It’s slightly painful and your semen may be blood-stained for a few days afterward.

I had a new type of scanner under trial put up there too. Another broom-handle, it whirred while it took pictures. A sort of radar up the backside. Not painful and no after effects. I don’t think I saw the pictures.

The pain I wasn’t prepared for…

Whatever your treatment type there’s a level of risk that your erections will be permanently affected. Of course I’d been told about this, but not the way it’d make me feel. I can remember well the day I was told that surgery was my only option, and I already knew the impact this would have, so think of being hit around the head with a shovel, hard and you may come close. All this time later I suspect I’m still grieving sometimes.

As with childbirth, they don’t tell you about the pain after surgery. I had spasms as my really quite sore bladder was having a good try at ejecting the catheter and particularly the balloon keeping it in place. These lasted about twenty-four hours and were really quite unpleasant. Back to my rectum again, as I had a suppository inserted there for pain relief.

Walking after surgery wasn’t impossible, but until you’ve had abdominal surgery you don’t realize how much your abdominal muscles do until someone cuts a two inch slot in them. It’s sore and you become tired quickly. Reaching up will be uncomfortable too, as you are trying to stretch muscles that are healing. I’m pretty sure that while my abs have returned to a good strength they have lost more of their elasticity than you’d expect just through aging.

Changes in urination

You are given lots of warnings about changes in urination. I’ve never had an issue with continence but sometimes it’s getting started that seems to be the problem. On rare occasions, it’s been really painful to get started too, though eventually, I get a good flow. I also seem to find that even if I’ve been careful about fluid intake in the evening I still get up twice most nights, but only to urinate really quite small amounts, despite a strong sensation that I need to go. I’m becoming pretty good at falling asleep again, but it’s not ideal.

All of these come under the heading of side effects. I’d rather not have them but for the fact that surgery has given me one more side effect – life.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.


  • Peter55
    3 weeks ago

    Nearly 12 months post radical prostatectomy now. I’m almost 100% continent and achieving good flow! Still get the “urgents” at times though.
    Viagra is achieving ok erections 💁🏻‍♂️ but no spontaneous ones. But something is better than nothing 😳
    Overall I’m feeling pretty normal now and my latest PSA was “non detectable”.

  • ninaw moderator
    3 weeks ago

    @Peter55, very glad to hear you’re doing pretty well with continence! Urgency is something quite a few folks have mentioned lately. I haven’t hard any particularly magical tips, but one person mentioned bladder training. Have you ever been offered this?

    The spontaneity is another thing folks have mentioned before. As one of our advocates Will says, it’s about embracing the “new normal.” Although, if you’ve had nerve sparing surgery, there’s perhaps a chance for further improvement still. Sharing one of his articles about the progress made and hope vs. expectation:

    Finally, what a relief to hear PSA undetectable! I hope that continues to be the case in all further PSAs!

    – Nina, Team
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  • poellnif
    2 months ago

    The incident of prostate cancer is different for Black and White men. Roughly 1 in 8 White men will get prostate cancer. The number increases to 1 in 4 for Black men. This significant statistical difference is almost never mentioned.

    For African American who have a close relative who has had prostate cancer, the likelyhood of another close relative getting prostate cancer increases from 1 in 4 to 2 in 3. As someone whose prostate cancer is in remission, I try to share these numbers with as many people as possible.

    Besides getting an annual PSA blood test, I also urge men of any ethnicity to get an annual medical check up.

  • ninaw moderator
    2 months ago

    @poellnif, thanks for bringing this up. It’s something a lot of our advocates have been frustrated about – there’s not enough education about prostate cancer in general, and especially the higher incidence for Black men. Our sexual health author, Dr. Nick, has talked about this in some of his articles here:

    Best to you and keep on spreading the message!

    – Nina, Team
    Want to hear more from the community? Join us on the Community page:

  • kevin
    3 months ago

    Does anybody have any information about the new radiation procedure called cyber knife

  • BIGt
    6 months ago

    Thank you for being unselfish with your time and demonstration of kindness.

  • sevensix
    6 months ago

    Robotic surgery 8-16 I acted as if nothing happened, there was never pain at any time although the analgesic bolus was mildly uncomfortable for a few hours. Not too bad. Recurrent cancer 8-18 with IMRT 60 Gy fractionated 39 days with Lupron and Casodex deprivation. Lupron is a mean animal. I’m 2 1/2 months post IMRT feeling ill, no energy, executive (bozo) malfunctioning. And MS contributes to my malady. Not happy, not fun. First PSA next month.
    I look in the mirror and some of me is missing.

  • BIGt
    6 months ago

    God Speed Brother.

  • Zzzippy
    7 months ago

    When the dr first told me i had cancer he asked if i had any questions… well i was new at this and really had no idea of what questions to ask…. So i said to him… i need the answers to questions i should soon know about shortly… through that open ended statement he did inform me of what i needed… the important stuff.. otherwise i had no idea what i needed to know about my cancer..

  • rwmj123
    7 months ago

    Thank you for sharing your story/experience. My consult for robotic prostectomy is the 6th of March, presumably soon followed by the procedure. It is good to know what you dealt with and are still to allow me not to be too overwhelmed…as if I’m not already..,with what are some things to expect. I am so terrified. But, like you, I want more “life.” Thank you. God Bless…

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