4 things you can do to prepare for prostate cancer survivorship
By Jessica Saenz
Prostate cancer is the second most common cancer diagnosis in men. Approximately 1 in 6 men in the U.S. will be diagnosed with prostate cancer at some point, but thanks to improvements in early detection and treatment, survival rates are high.
"We've been successful at treating prostate cancer, and that means most men with this disease do not die from it," says Matthew Tollefson, M.D., a Mayo Clinic urologist. "It also means that many men may live for decades in survivorship of prostate cancer."
However, patients who survive prostate cancer may experience long-term side effects from treatment and the emotional toll of diagnosis. Planning for survivorship means having open discussions with your health care provider about the steps you need to take to care for yourself physically and emotionally during and after cancer treatment.
If you have been diagnosed with prostate cancer, here are four things you should do to prepare for survivorship:
1. Understand your treatment and its possible side effects.
"It's critical to have that discussion with your doctor. Ask questions like, 'Is the location of my tumor likely to impair my urinary control or sexual function,'" says Dr. Tollefson.
Cancer type, location and tumor size will determine your course of treatment, but your provider won't be able to address your questions and concerns about that treatment, unless you share them.
"The effects that we're dealing with, like erectile dysfunction and urinary control, are very personal," says Dr. Tollefson. "Having a good connection with your physician and making sure that they understand is critical because the concerns are so intimate that it can be difficult to share."
2. Ask your health care provider for help with the side effects of prostate cancer and its treatment.
You might not feel at ease discussing the adverse effects of prostate cancer and its treatment, but your health care provider will be better equipped to help you if you do.
"Regarding the specific issues of urinary control and sexual function, we have effective treatments and ways to manage these symptoms," says Dr. Tollefson. "Make sure you bring them up as you're meeting with your physician, and the physician can intervene at a time when the treatment is likely to be most effective."
Treatment for these side effects can be simpler than expected. Depending on symptom severity, your health care provider might prescribe physical therapy or medication.
After surgery or radiation therapy, it's common for men to experience erectile dysfunction, but oral medications and moderate to vigorous aerobic activity can improve this symptom.
Hormonal therapy also can cause difficulty achieving or maintaining an erection.
"Commonly used together with some of our other treatments, specifically radiation and focal therapy, is hormonal treatment. Dropping men's testosterone levels down has been shown to improve the efficacy of some of our treatments, but in the short term, that can have real effects, including a decrease in libido, hot flashes, decreased energy and weight gain. It's important for men to recognize that these are not necessarily permanent effects," says Dr. Tollefson.
3. Rely on your support network to help you feel more at ease.
Talking to those closest to you, especially partners, can help you feel supported.
"It's important to recognize that it takes a village, and we should encourage men to reach out to their support network for help. Every man is a little different with how expressive they want to be with these intimate issues," says Dr. Tollefson. "For partners, I think it's important to give men time after a diagnosis because the mental effect of having a new cancer diagnosis can take a toll."
While it's up to you to decide what you disclose to people in your support network, it's important to remember that prostate cancer affects many men, and you likely know someone who shares your diagnosis.
"Almost everyone at some point in their lives will know somebody who's had treatment for this disease," says Dr. Tollefson. "We should also recognize that not everyone's journey is the same. Some people may have a tougher road than others. But this is such a common disease that almost all of us will know people in our community who have been affected by it."
4. Take charge of your health.
It's common to feel nervous about prostate cancer recurrence, but this should not deter you from continuing your regular exams. Following your health care provider's guidance on testing frequency can help you and your physician keep a close eye on changes that require intervention.
Tests like the prostate-specific antigen test, also known as a PSA test, can detect prostate cancer recurrence early.
"There can be anxiety associated with testing. But frequently that testing is so accurate we may detect recurrences years before men have symptoms," says Dr. Tollefson. "We have to monitor for cancer recurrence like we would for any type of cancer. Most men who have treatment for prostate cancer will not have a recurrence in their lifetime, but PSA screening is important in detecting the disease."
Along with regular screening, survivorship should encourage you to reevaluate lifestyle choices and get back to doing things you love.
"For many men, this heralds a new understanding and focus on their health," says Dr. Tollefson. "Recognizing that and engaging in a healthy lifestyle is important. If the prostate cancer diagnosis can serve to encourage them to eat right, exercise and take care of themselves, this can be a blessing in disguise."
Dr. Tollefson discuss prostate cancer survivorship in this "Mayo Clinic Q&A" podcast video:
Learn more about prostate cancer and find a prostate cancer clinical trial at Mayo Clinic.
Join the Prostate Cancer Group on Mayo Clinic Connect.