General Psychological Issues In Prostate Cancer
Psychological and social issues arise in 3050% of prostate cancer patients irrespective of the stage and progression of cancer or the type of treatment they receive. With effective assessment and intervention, clinicians can help to recognize troublesome and disturbing problems, reduce their negative impact and enhance the QOL for patients and those close to them. Some of the psychological issues that are commonly seen in prostate cancer are anxiety related to the cancer and its cure, depression and depressive symptoms, guilt and remorse after a diagnosis, fear with regard to PSA assessment, fear with regard to recurrence of the cancer after treatment, an impending fear and recognition of death, fatigue and pain, which may be aggravated by social and psychological factors and the ensuing sexual problems during and after treatment. However, making a psychiatric diagnosis in a prostate cancer patient can be complicated by overlapping symptomatology seen in psychological disorder and cancer that includes fatigue, weight loss, sleep disturbance, loss of appetite and anxiety. One needs to assess the more subtle psychological or cognitive symptoms, such as feeling a lack of pleasure, depressed mood, hopelessness and helplessness along with anxiousness to help establish a diagnosis.
Combined Hormonal Therapy For Advanced Prostate Cancer
If the cancer starts growing during treatment with an injection or implant, your doctor may advise taking an anti-androgen tablet as well.
Having the two drugs together can help to slow the cancer from growing or spreading. You will not usually have combined hormonal therapy as your first treatment. This is because you may have more side effects if you are taking two drugs. Your doctor or specialist nurse can explain more about this.
There are different types of hormonal therapy that may be used. Your doctor or nurse will explain the drug that is most suitable for your situation.
What Will I Learn By Reading This
When you have chemotherapy to control your prostate cancer, you may have side effects or unwanted changes in your body. Side effects are different from person to person, and may be different from one treatment to the next. Some people have no or very mild side effects. The good news is that there are ways to deal with most of the side effects. In this booklet you will learn:
- What nausea and vomiting are
- Why you have nausea and vomiting
- When you may have this side effect
- What medicines you can take to help with this side effect
- How to manage your nausea and vomiting
- When to call your doctor
It is important for you to learn how to manage the side effects you may have from chemotherapy so that you can keep doing as many of your normal activities as possible.
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Where Does Prostate Cancer Spread
The most common place for prostate cancer to spread to is the bones. It can also spread to the lymph nodes, liver and lungs and other organs.
A large tumour in the prostate gland can spread into or press on areas around the prostate, such as the back passage or urethra. The urethra is the tube which carries urine from the bladder to the outside of the body.
How Is Prostate Cancer Treated
For many;men with prostate cancer, treatment is not immediately necessary.
If the cancer is at an early stage and;not causing symptoms, a policy of “watchful waiting” or “active surveillance” may be adopted. This involves carefully monitoring your condition.
Some cases of prostate cancer can be cured if treated in the early stages. Treatments include surgically removing the prostate, radiotherapy and hormone therapy.
Some cases are only diagnosed at a later stage when the cancer has spread. If the cancer spreads to other parts of the body, typically the bones, it cannot be cured and treatment is focused on prolonging life and relieving symptoms.
All treatment options carry the risk of significant side effects, including erectile dysfunction and urinary incontinence. For this reason, many men choose to delay treatment until there is a risk the cancer might spread.
Newer treatments,;such as;high-intensity focused ultrasound ;or cryotherapy, aim to reduce these side effects.;Some hospitals may offer them as an alternative to surgery, radiotherapy or hormone therapy. However, the long-term effectiveness of these treatments are not yet known.
Read more about treating prostate cancer
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Bladder And Urinary Troubles
A prostate tumor that has grown significantly in size may start to press on your bladder and urethra. The urethra is the passage the carries urine from your bladder out of your body. If the tumor is pressing on your urethra, you might have trouble passing urine.
One of the common areas for prostate cancer to spread to is the bladder, because the two organs are close. This can cause additional problems with urination and bladder function.
Some symptoms your bladder and urethra are being affected by cancer include:
- urinating more frequently
- getting up in the middle of the night to pee
- having blood in your urine or semen
- feeling like you have to urinate often and not actually passing anything
Its not as common, but prostate cancer can also spread to your bowel. The cancer first spreads to the rectum, which is the part of your bowel closest to the prostate gland.
Symptoms of cancer thats spread to the bowels include:
- stomach pain
Psychosocial Aspects Of Hrqol In Prostate Cancer
Apart from the general worries of a new cancer diagnosis, there is still controversy about the selection of primary treatments for prostate cancer, making the decision about treatment difficult. For early-stage cancer, primary treatment options are radical prostatectomy, radiation therapy and active surveillance, which can lead to differences in specific areas of functioning, such as sexual, urinary or bowel functioning over time. Because surgery and radiation treatments seem to be equally effective in treating early-stage prostate cancer, controversy exists about selection of primary treatments for prostate cancer. Early treatment decisions are fraught with the sense of having to choose between QOL and longevity, even though it is unclear what the outcome will be on either side of the balance. Many men entertain multiple second opinions regarding their primary therapy, although this for some men adds to more confusion and distress because of the lack of agreement among practitioners. They often take in information from reasonable and reliable sources and any number of unverified sources on the internet. This amount of information can lead to significant anxiety while trying to make a reasonable treatment decision.
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How Can I Prevent A Prostate Problem
Researchers have not found ways to prevent prostate problems. Men with a greater chance of developing a prostate problem should talk with their doctor about any lower urinary tract symptoms and the need for regular prostate exams. Recognizing lower urinary tract symptoms and knowing whether you have a prostate problem can help you get early treatment and reduce the effects of prostate problems.
Do Prostate Problems Cause Other Problems
Yes, a prostate problem may cause other problems, such as
- problems having sex
- feeling stressed due to chronic pain
- inflammation in areas near your prostate
- bladder stones
- kidney failure
Which problem you may get depends on the type of prostate problem you have. Other problems may vary from man to man for each type of prostate problem.
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Controlling Sickness In Advanced Cancer
It is;not always possible to cure advanced cancer. But even if your cancer can’t be cured, treatment is available to control your symptoms, such as sickness.
Advanced cancer means that;the cancer has spread from where it started or has come back some time after you were first treated.;
Up to 7 out of 10 people with advanced cancer have nausea and vomiting.
Some people may have more than one cause of sickness;and it may not always be linked to the cancer itself. For example, you might feel sick if you have an infection.;
Drugs To Treat Cancer Spread To Bone
If prostate cancer spreads to other parts of the body, it almost always goes to the bones first. These areas of cancer spread can cause pain and weak bones that might break. Medicines that can help strengthen the bones and lower the chance of fracture are bisphosphonates and denosumab. Sometimes, radiation, radiopharmaceuticals, or pain medicines are given for pain control.
Side effects of bone medicines
A serious side effect of bisphosphonates and denosumab is damage to the jaw, also called osteonecrosis of the jaw . Most people will need to get approval from their dentist before starting one of these drugs.
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Getting Help For Depression
Depression can be treated. Below are common signs of depression. If you have any of the following signs for more than 2 weeks, talk to your doctor about treatment. Be aware that some of these symptoms could be due to physical problems, so it’s important to talk about them with your doctor.
Emotional signs:
- Fatigue that doesn’t go away
- Headaches, other aches and pains
If your doctor thinks that you suffer from depression, he or she may give you medicine to help you feel less tense. Or, he or she may refer you to other experts. Don’t feel that you should have to control these feelings on your own. Getting the help you need is important for your life and your health.
What Will Happen After Treatment
Youll be glad when treatment is over. But its hard not to worry about cancer coming back. When cancer comes back it is called a recurrence. Even when cancer never comes back, people still worry about it. For years after treatment ends, you will see your cancer doctor. At first, your visits may be every few months. Then, the longer youre cancer-free, the less often the visits are needed.
Be sure to go to all follow-up visits. Your doctors will ask about your symptoms, examine you, and might order blood tests and maybe other tests to see if the cancer has come back.
Having cancer and dealing with treatment can be hard, but it can also be a time to look at your life in new ways. You might be thinking about how to improve your health. Call us at 1-800-227-2345 or talk to your doctor to find out what you can do to feel better.
You cant change the fact that you have cancer. What you can change is how you live the rest of your life,;making healthy choices and feeling as good as you can.
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What Is Advanced Prostate Cancer
When prostate cancer spreads beyond the prostate or returns after treatment, it is often called advanced prostate cancer.
Prostate cancer is often grouped into four stages.
- Stages I & II: The tumor has not spread beyond the prostate. This is often called early stage or localized prostate cancer.
- Stage III: Cancer has spread outside the prostate, but only to nearby tissues. This is often called locally advanced prostate cancer.
- Stage IV: Cancer has spread outside the prostate to other parts such as the lymph nodes, bones, liver or lungs. This stage is often called advanced prostate cancer.
When an early stage prostate cancer is found, it may be treated or placed on surveillance . If prostate cancer spreads beyond the prostate or returns after treatment, it is often called advanced prostate cancer. Stage IV prostate cancer is not curable, but there are many ways to control it. Treatment can stop advanced prostate cancer from growing and causing symptoms.
There are several types of advanced prostate cancer, including:
Biochemical Recurrence
If your Prostate Specific Antigen level has risen after the first treatment but you have no other signs of cancer, you have “biochemical recurrence.”
Castration-Resistant Prostate Cancer
Non-Metastatic Castration-Resistant Prostate Cancer
Metastatic Prostate Cancer
- Lymph nodes outside the pelvis
- Bones
- Other organs
Metastatic Hormone-Sensitive Prostate Cancer
Diagnosis Of Prostate Cancer
Prostate cancer is diagnosed using a number of tests, which may include:
- Prostate-specific antigen test the prostate makes a protein called PSA. Large quantities of PSA in the blood can indicate prostate cancer or other prostate problems.
- Digital rectal examination using a gloved finger in the rectum, the doctor feels for enlargement and irregularities of the prostate.
- Biopsy six to 12 tissue samples are taken from the prostate and examined in a laboratory for the presence of cancer cells.
If prostate cancer is diagnosed, more tests may be needed to see if the cancer has spread to other areas of the body. These may include computed tomography scans, magnetic resonance imaging scans and bone scans.
Test results can take a few days to come back. It is very natural to feel anxious while waiting to get your results. It can help to talk to a close friend or relative about how you are feeling. You can also contact the Cancer Council Helpline on 13 11 20 and speak with a cancer nurse.
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How Does Cancer Cause Signs And Symptoms
A cancer can grow into,or begin to push on nearby organs, blood vessels, and nerves. This pressure causes some of the signs and symptoms of cancer.
A cancer may also cause symptoms like fever, extreme tiredness , or weight loss. This may be because cancer cells use up much of the bodys energy supply. Or the cancer could release substances that change the way the body makes energy. Cancer can also cause the immune system to react in ways that produce these signs and symptoms.
Loss Of Libido And Erectile Dysfunction
The hormones that are often used to treat advanced prostate cancer can decrease libido and cause erectile dysfunction , which occurs when a man isnt able to have or keep an erection to have sex, according to the University of Rochester Medical Center in Rochester, New York.
As a result, for couples, theres a real struggle to recover that sense of life together how to be intimate without having sex, says Michael J. Morris, MD, an oncologist at Memorial Sloan Kettering Cancer Center in New York City.
Depending on the type of treatment that caused the ED, the ability to have an erection may improve over time, according to the University of Rochester Medical Center. You and your partner may want to explore other ways to be intimate in your relationship. A sex therapist or couples counselor may be able to help. There are also treatments available for erectile dysfunction, such as medications and implants.
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What Tests Will I Have
You may have more tests to find out how far the cancer has spread. Some of these tests can also be used to check how you are responding to treatment.;
X-ray tests
You may have bone X-rays if the bone scan shows up hot spots. These X-rays will help to confirm if the cancer has spread or not. A chest X-ray may be done to check your general health.
PSA blood test
Prostate specific antigen is a protein that can rise due to disease in your prostate gland. A sample is taken from your blood and measured. A PSA test can also show how well your cancer is responding to treatment.
Biopsy
A biopsy is where a sample of your prostate tissue is taken and examined under a microscope. It isnt common to have a biopsy with metastatic prostate cancer, but if this is your first prostate cancer diagnosis it may be necessary. Treatment can still start without a biopsy.
Bone scan
Metastatic prostate cancer often spreads to the bones.; Bone scans can find cancer spots before they show up on an ordinary X-ray. For this test, a tiny amount of radioactive liquid is put into a vein, usually in your arm. After the injection you will have to wait up to 3 hours. A scan is then taken of all the bones in your body. Abnormal bones takes up more radioactive liquid than normal bone. These areas will show up on the scan and are known as ‘hot spots’. The scan can also show bone changes like arthritis.;
CT scan
A type of X-ray that gives a detailed picture of the tissues around your chest, abdomen and pelvis.
Will Radiation Therapy Cause My Hair To Fall Out
Only people who get radiation to the scalp or the brain may have hair loss. Others won’t. If it does happen, itâs usually sudden and comes out in clumps. In most cases, your hair will grow back after therapy stops, but it may be thinner or have a different texture.
Some people choose to cut their hair short before treatment begins to make less weight on the hair shaft. If you lose hair on top of your head, be sure to wear a hat or a scarf to protect your scalp from the sun when you go outside. If you decide to buy a wig, ask the doctor to write a prescription for one and check to see if it’s covered by your insurance or is a tax-deductible expense.
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What Are Other Possible Early Side Effects From Radiation Therapy
Other early side effects you might have usually depend on where you get the radiation.
Eating Problems
Radiation therapy to the head, neck, or parts of the digestive system can make you lose your appetite. But it’s important to keep eating a healthy diet while youâre having treatment to keep your body strong.
- Try eating five or six small meals spread out through the day instead of three large ones.
- Try new recipes or foods.
- Keep healthy snacks on hand. It will help you eat when you’re hungry rather than waiting for mealtimes and maybe losing your appetite.
Mouth Problems
Before you start radiation to your head or neck, see your dentist for a thorough exam. Radiation can cause problems in your mouth that include:
- Mouth sores
- Lack of saliva
- Trouble swallowing
- Jaw stiffness
Tell your cancer team about any of these problems so they can help you feel better. To help manage these side effects:
- Avoid spicy and acidic foods.
- Don’t smoke, chew tobacco, or drink alcohol.
- Brush your teeth often with fluoride toothpaste and a soft brush.
Hearing Problems
Radiation therapy to the head can sometimes cause hearing problems. One reason might be that it hardens the wax in your ears. Let your doctor know if you have trouble hearing.
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