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Side Effects

Some side effects of treatment include: Incontinence, Erectile Dysfunction, Decreased Libido, Decreased Emotional Wellness, Fatigue, and Infertility. This section will describe what these side effects are and methods to address them.

Incontinence

Incontinence means the involuntary leakage of urine. It is caused by the muscle (the sphincter)  that controls urine flow from your bladder being weakened. It can present itself as accidentally urinating when you don’t mean to (stress incontinence) or when you feel a strong urge to urinate (urge incontinence). Those who have gone through surgical removal of the prostate (radical prostatectomy) may experience incontinence temporarily for a few weeks to a few months, but there is a small number of men who may have permanent incontinence.

Various methods to address incontinence includes certain lifestyle changes (eg. drinking less liquid, caffeine and alcohol), certain medications, Kegel exercises and potentially surgery.

Erectile Dysfunction

Erectile dysfunction means to have difficulty maintaining an erection. Addressing this side effect depends on the treatment chosen for prostate cancer.

In particular, the surgical removal of the prostate (radical prostatectomy) may have impacted the arteries and nerves that control erections. There are “nerve-sparing” surgeries that increase one’s chances of recovering spontaneous erections over a few years, but this is not guaranteed.

Radiation therapy can also damage the blood vessels and nerves to cause erectile dysfunction, but a prescription medication often can help achieve an erection.

Hormone therapy works by lowering testosterone levels which decreases one’s ability to have an erection and lowers one’s libido (desire for sex). Men with prostate cancer should not receive testosterone therapy because this will increase their cancer growth. Talk to a physician or specialist.

Seeking the opinion of a professional counsellor or sex therapist can help walk couples through methods to ensure intimacy and provide a supportive environment for one’s feelings and experiences of erectile dysfunction. 

Decreased Emotional Wellness

Prostate cancer is a life changing and emotional experience may be experienced as fluctuating emotions, feeling sad, angry, anxious, numb and other emotions in between. One often feels alone, guilty and a loss of control. It is a complex experience that affects one’s sense of independence, strength, identity and meaning that may leave one feeling hopeless and uneasy.

Taking care of one’s emotional well being and mental health is extremely important in the prostate cancer journey. Having strong emotional support is key to addressing these overwhelming or heavy feelings. It is strongly recommended to talk about one’s experiences with your physician, a counselor, within a prostate cancer support group, your church leaders or members if applicable, and to involve your family in the journey. The worst possible thing to do is to not involve others in one’s emotional journey. A strong support network can give a sense of connection, find peace with your situation, and have others refer you to the proper support groups.

Fatigue

Fatigue is a strong feeling of being tired, weak or lacking energy. For those with cancer, often this fatigue is not addressed by increased sleep or rest. To address fatigue, ensuring you have adequate rest is important but balancing it with activity is key. Doing light physical activity, such as a 10 minute walk, can actually increase one’s energy level; eating healthy and staying hydrated to prevent feeling dizzy. It is important to have others to support you physically and emotionally, such as family or friends. This may look like them helping out with household chores if one is too fatigued. There are also some medications or treatments that a physician can prescribe to help fatigue.

Infertility

Infertility means one is unable to father a child. This is due to removal of the prostate by surgery (radical prostatectomy) or radiation therapy. The surgery often removes the seminal vesicles which is the source of semen which prevents one from ejaculating (however, one is still able to have orgasms). Radiation therapy may affect the ability of semen to transport sperm.

Men who undergo treatment may want to consider freezing their semen. It is recommended to speak with your physician. Visit https://www.canada.ca/en/public-health/services/fertility/fertility.html to learn more.