Prostate Cancer Bowel Symptoms

People with prostate cancer may have problems with bladder and bowel function. Healthcare professionals may call these symptoms urinary or bowel incontinence. Urinary and bowel incontinence can be caused by the cancer itself or its treatments.^1,2

Many people can manage bladder and bowel symptoms with lifestyle changes. Symptoms may improve over time. Talk to your doctor about how to treat and manage your specific symptoms.^3,4

What are bladder and bowel incontinence?

Incontinence refers to a loss of control of your bowels or bladder. This can cause urine or stool to leak.^3,5

In people with prostate cancer, bladder symptoms can range from slow leakage to uncontrolled release of a full bladder. People with bladder or urinary incontinence often experience:³

• Accidental urine leakage
• Having sense of urgency or inability to hold urine
• Frequent urination
• Pain or discomfort while urinating
• Problems starting urination
• Weak flow or interrupted flow of urine
• Trouble emptying the bladder completely

Bowel incontinence symptoms can range from leaking small amounts of stool to total loss of bowel control. People with bowel incontinence often experience:^3,4

• Inability to control gas or stool
• Urge to move bowels before it happens
• Leaking liquid stool or mucus
• Diarrhea or constipation
• Frequent or urgent bowel movements

How else do bladder and bowel symptoms affect people with prostate cancer?

Incontinence is more than a physical problem. Losing control of your bladder or bowels can be very frustrating or embarrassing. It can interfere with your daily life. You may feel anxiety, depression, or anger. Fear of accidents might keep you from being intimate, enjoying hobbies, or exercising.⁶

Because talking about incontinence can be hard, it is important to find people you trust to support you. This may include a therapist or counselor. Support groups can also be a source of comfort and advice.

Why does prostate cancer cause bladder and bowel symptoms?

There are a few different ways that prostate cancer can cause bladder and bowel problems. These include:³

• A tumor in the prostate pressing on the urethra
• Cancer spreading to the spine and disrupting nerves that control bladder or bowel function
• Cancer spreading to the bladder
• Cancer spreading to the bowel (less common)
• Prostate cancer treatments, including radiation and surgery

Most commonly, cancer treatments are the cause of incontinence. Radiation therapy can damage the bladder and rectum because they are near the prostate. Bowel problems happen in up to 20 percent of people who undergo radiotherapy. Surgical removal of the prostate (prostatectomy) also can cause bladder problems.^4,6,7

How are bladder and bowel symptoms treated?

Bladder and bowel symptoms often get better on their own. Symptoms caused by cancer may improve after treatment. Symptoms caused by radiation or surgery may resolve weeks or months after treatment.⁴

However, incontinence may be permanent for some people. This can happen if nerves in their spinal cord are damaged. It is hard to predict how long bowel and bladder symptoms will last.⁴

Talk to your doctor about strategies to manage bladder and bowel symptoms. They may suggest:^3,4,7,8

• Exercises to strengthen your pelvic floor muscles (Kegel exercises)
• Bowel or bladder training, which helps you go to the bathroom at the same time every day
• Avoiding high-fiber foods and other foods that irritate the bowels
• Avoiding spicy, fried, and fatty foods
• Drinking 8 to 10 glasses of water each day
• Limiting caffeine and alcohol
• Avoiding tobacco use
• Gentle exercise
• Using incontinence products, such as absorbent pads, mattress covers, and adult briefs
• Over-the-counter laxatives or fiber supplements to relieve constipation
• Over-the-counter medicines for diarrhea, such as Imodium® (loperamide) or Pepto-Bismol® (bismuth subsalicylate)

Severe or long-term incontinence can lead to organ damage and other serious problems. If symptoms persist or are severe, your doctor might suggest medicines or procedures to address them. These treatments may include:^3,5,7,9

• Anticholinergic drugs to treat overactive bladder, such as Ditropan® (oxybutynin) or Detrol® (tolterodine)
• Stronger medicines used for bowel conditions
• Injecting Botox to paralyze bladder muscles
• Internal or external catheters to collect urine
• Implanting a urethral sling or scrotal pump
• Surgery to improve bowel incontinence (sphincteroplasty)

Talk to your doctor about the risks and benefits of incontinence treatment options. The right option for you depends on your specific symptoms and causes.