Side Effects From Radiation
Urinary symptoms from radiation treatment for prostate cancer are different from those caused by prostate surgery. Its more like a urinary tract infection-increased urgency and frequency, and men may some have bleeding or pain when they urinate, Calvaresi said. These problems often go away once treatment is complete.
Radiation also may cause bowel changes, such as constipation, loose stools or both. These can be managed by over-the-counter medication. Men may also see some blood in their stool during treatment-if so, let your health care provider know about this.
Men undergoing radiation are likely to have ED, but not immediately. It slowly sets in after radiation treatment, Calvaresi said. Treatments for radiation-related ED are the same as ED caused by prostate cancer surgery.
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What Are The Prostate Cancer Treatment Side Effects Of A Prostatectomy
The primary prostate cancer treatment side effects after a radical prostatectomy are incontinence and erectile dysfunction. These side effects are a product of the location of the prostate and the type of surgery performed. The prostate gland lies deep within the pelvis behind the pubic bone and in front of the rectum. The urinary bladder lies just above the prostate, the urinary sphincter control muscle is located just below it, and the erectile nerves lie just outside the prostate on either side. A patients age and overall health also influence the potential risks of radical prostatectomy just as it does with any major operation. Such risks include cardiac or pulmonary events, infections, blood clots, or injuries to structures around the prostate.
Following surgery, all men will have some urinary leakage. A good amount of bladder control is often regained within 12 weeks and continues to improve over 12 months. Multiple studies have shown that there is often a several month interval before a patient recovers normal erections, even with bilateral nerve-sparing surgery. Advantages to the Robot Assisted Laparoscopic Prostatectomy technique are a reduced risk of intra-operative bleeding and a shortened hospital stay.
Questions To Ask Your Doctor Or Nurse
You may find it helpful to keep a note of any questions you have to take to your next appointment.
- What type of surgery do you recommend for me and why?
- What type of surgery do you recommend for me? Will you try to do nerve-sparing surgery?
- How many of these operations have you done and how many do you do each year?
- Can I see the results of radical prostatectomies youve carried out?
- What pain relief will I get after the operation?
- How and when will we know whether the operation has removed all of the cancer?
- How often will my PSA level be checked?
- What is the chance of needing further treatment after surgery?
- What is the risk of having urinary problems or erection problems and what support can you offer me?
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How The Surgery Is Done
Different surgical methods may be used to remove the prostate:
- open radical prostatectomy usually done through one long cut in the lower abdomen
- laparoscopic radical prostatectomy small surgical instruments and a camera are inserted through several small cuts in the abdomen. The surgeon performs the procedure by moving the instruments using the image on the screen for guidance
- robotic-assisted radical prostatectomy laparoscopic surgery performed with help from a robotic system. The surgeon sits at a control panel to see a three-dimensional picture and move robotic arms that hold the instruments.
Other Possible Side Effects
Anorgasmia is the inability to achieve orgasm regardless of the level of stimulation.
2) Penile shrinkage
Removal of the prostate seems to initiate a phase of penile shrinkage that varies between 2 to 3 cm. For men with large organs, this may have little effect. But a man that starts on the small side might be very dismayed about it.
3) Urine leakage or pain during intercourse
4) Urine leakage at orgasm
5) Pain or discomfort at orgasm
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What Are The Side Effects Of Prostate Radiation
Even though both external beam radiation and brachytherapy use the same radiation as the cure from the cancer cells, they have some common side effects.
- Bowel problems: Radiation proctitis is a very common inflammation of the rectum that occurs as a result of the radiation treatment of prostate cancer where damage to the rectum was acquired. Proctitis can lead to diarrhea, with the blood in the stool, and rectal leakage. Most of these problems go away over time, but in rare cases, normal bowel function does not return. In order to minimize bowel problems, doctors will advise what kind of diet to follow during radiation therapy to help limit bowel movement during treatment.
- Urinary problems: Radiation cystitis is the side effect of inflammation and subsequent destruction of the normal work of the urinary bladder at the cellular level after the usage of radiation in the treatment. Patients will feel the need to urinate more often, have a burning sensation while the urinate process, and/or find blood in the urine itself. Urinary problems usually improve over time, but in some men, they never go away.
- Erection problems : Patience after the treatment, with radiation or through surgery, has the same rate of impotence level. These problems do not occur right after radiation therapy but are slowly developing over time. The effect of radiation treatment is more visible if the patient is elderly, where impotence is already on the low level.
Side Effects Of Prostate Removal Surgery
Prostate removal surgery is very effective in treating prostate enlargement and prostate cancer. However as with any surgical procedure, it carries certain risk and side effects.
- Erection problems after the surgery.
- Ejaculation problem after surgery.
- Inability to control urine flow.
- Severe bleeding during the time of surgery and may need blood transfusion.
- Nausea, vomiting and high blood pressure for the first six hours after the surgery.
- Stricture in the urethra.
- Damage to other organs while performing surgery.
- Reaction to medicines.
- Blood clots in the deep vein that can go into the lungs.
- Infection in the bladder and kidney after the operation.
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Risks Of Prostate Surgery
The risks with any type of radical prostatectomy are much like those of any major surgery. Problems during or shortly after the operation can include:
- Reactions to anesthesia
- Blood clots in the legs or lungs
- Damage to nearby organs
- Infections at the surgery site.
Rarely, part of the intestine might be injured during surgery, which could lead to infections in the abdomen and might require more surgery to fix. Injuries to the intestines are more common with laparoscopic and robotic surgeries than with the open approach.
If lymph nodes are removed, a collection of lymph fluid can form and may need to be drained.
In extremely rare cases, a man can die because of complications of this operation. Your risk depends, in part, on your overall health, your age, and the skill of your surgical team.
How Bad Is The Pain After Prostate Surgery
The level of pain is lower than that of open prostatectomy, due to smaller incisions. However, you will be administered pain medication both orally and intravenously, through an IV. Make sure you have someone to pick you up from the hospital, as you wont be able to drive right away. Ask your doctor to recommend some pain medication and dosages that you can take from home most common ones are Tylenol or Ibuprofen. Even though the recovery is fast, you should get plenty of rest and not force yourself with lifting weights or exercises in the first few weeks.
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What Are The Risks Or Complications Of Radical Prostatectomy
Radical prostatectomy is generally very safe. Surgeons try to protect the nerves that run from the prostate to the penis. But problems due to nerve damage can occur. There is a risk that you may experience:
- Urinary incontinence: Some people experience urinary incontinence, although most people recover continence. Your provider can help you manage loss of bladder control and urine leakage.
- Erectile dysfunction: Many people have problems maintaining erections after this surgery. The likelihood of recovery of erectile function depends on your erections before surgery and your surgeons ability to spare the nerves that control erection at the time of surgery. You may need to use erectile dysfunction medications or other treatments. The older you are, the more likely problems may occur.
There is also a small risk that you may experience:
Impotence Or Erectile Dysfunction
This means your penis cannot get hard enough for sex.
An erection is a way your penis gets hard. If you can have an erection before surgery, the doctor will try not to hurt it during the surgery. This is called a nerve-sparing approach. But if the cancer is too close to or growing into these nerves, they will need to be removed.
If you have both nerves removed, then you wont be able to have spontaneous erections. If only one side is removed, you might still have erections, but it would be less likely. If neither are removed, then maybe your erections will go back to normal after surgery.
After surgery, you will have an erection if you were able to before the operation and if the nerves were not cut. But, if you had an issue with your erection before surgery and the nerves were cut, you will probably lose this ability after surgery too.
Doctors who do many radical prostatectomies tend to report lower impotence rates than doctors who do the surgery less often. There are many different rates of impotence in the medical literature, but every man is other, so it is best to ask your doctor about their success rates and what will happen if you have this surgery.
If your ability to get erections returns after surgery, it often takes a while before you can do it yourself. It might take up to two years. During the first few months, you may not get an erection at all and will need help from medicines or other treatments.
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Pelvic Radiation Therapy Effect On Erections
Prostate, bladder, colon, and rectal cancer are sometimes treated with radiation to the pelvis. This can cause problems with erections. The higher the total dose of radiation and the wider the section of the pelvis treated, the greater the chance of erection problems later. If radiation therapy is part of your treatment plan, talk to your doctor before it starts. Ask how your arteries and nerves might be affected by radiation therapy so you know what to expect.
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What Are The Side Effects
The most common side effects of surgery are leaking urine and problems with getting or keeping an erection .
Your risk of getting these side effects depends on your overall health and age, how far the cancer has spread in and around the prostate and how likely it is to grow, and your surgeons skill and experience.
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If Youre Getting Radiation Therapy To The Brain
People with brain tumors often get stereotactic radiosurgery if the cancer is in only one or a few sites in the brain. Side effects depend on where the radiation is aimed. Some side effects might show up quickly, but others might not show up until 1 to 2 years after treatment. Talk with your radiation oncologist about what to watch for and when to call your doctor.
If the cancer is in many areas, sometimes the whole brain is treated with radiation. The side effects of whole brain radiation therapy may not be noticeable until a few weeks after treatment begins.
Radiation to the brain can cause these short-term side effects:
- Trouble with memory and speech
Some of these side effects can happen because radiation has caused the brain to swell. Medicines are usually given to prevent brain swelling, but its important to let your cancer care team know about headaches or any other symptoms. Treatment can affect each person differently, and you may not have these particular side effects.
Radiation to the brain can also have side effects that show up later usually from 6 months to many years after treatment ends. These delayed effects can include serious problems such as memory loss, stroke-like symptoms, and poor brain function. You may also have an increased risk of having another tumor in the area, although this is not common.
Talk with your cancer care team about what to expect from your specific treatment plan.
What Have I Learned By Reading This
You learned about:
- Why prostate cancer treatment can cause erectile dysfunction
- What can be done about erectile dysfunction
- How erectile dysfunction may affect your sex life
- What your partner can expect
If you have any questions, please talk to your doctor or health care team. It is important that you understand what is going on with your prostate cancer treatment. This knowledge will help you take better care of yourself and feel more in control. It will also help you manage any side effects you may have from your treatment.
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Prostate Cancer Pain And Weakening Bones
Prostatecancer most commonly spreads to the bones. This is called bone metastases. This condition can cause pain. It can also weaken bones and make them prone to fractures. So, too, can the endocrine therapy thats often used to slow the spread of prostate cancer. But doctors can offer treatments to relieve bone pain and support weakened bones.
Bisphosphonates to Strengthen Bones
These drugs help reduce or delay problems such as fractures caused by bone metastases in prostate cancer. The drug zoledronateÃ can improve bone density but is not approved to reduce fractures or bone loss in men with prostate cancer on endocrine therapy
A new class of drugs, the rank ligand antagonists, specifically denosumabÃ , has been found to be superior to zoledronate in reducing fractures in castrate independent prostate cancer. It is administered subcutaneously. Denosumab is also used to prevent osteoporosis caused by endocrine therapy for non-metastatic prostate cancer,
Both denosumab and zoledronate have the unique side effect of destroying the jaw bone. Therefore, before beginning either therapy dental disease should be addressed.
Radiation Therapy for Bone Pain
Radiation is given to reduce bone pain in advanced prostate cancer.
Surgery to Stabilize Bones
Lifestyle Changes to Maintain Bone Health
Open Rp Versus Robotic
The ability to perform robotic-assisted laparoscopic RP was first described in 2000. Over the past decade, RALRP has gained widespread acceptance and now is the dominant approach to RP in the United States. Many attribute the adoption of the RALRP to marketing as opposed to any objective outcomes data showing superiority over the open approach.
All of the intermediate- and long-term HRQOL outcomes reported in the literature are limited to open RP. The question is, are these findings relevant to RALRP?
Unfortunately, there are no randomized studies comparing HRQOL outcomes following open versus robotic RP. The majority of studies comparing HRQOL outcomes between the two techniques are flawed in design. First, the level of experience of surgeons performing the two techniques and their patient volume are often not comparable. In addition, validated instruments for capturing outcomes are usually not employed. Surgeons are sometimes involved in the data acquisition, entry, and interpretation, which can introduce bias. There are several studies that have examined large administrative databases, which often mitigate bias, but the quality of outcome measures is subject to criticism. A few studies stand out as objective and worthy of comment.
Barocas and colleagues compared men undergoing open and RALRP and failed to show any advantages of either approach for preventing biochemical recurrence.
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What Is The Prostate
The prostate is a small gland in the male reproductive system, and it is about the shape and size of a walnut. It lies low in the pelvis, underneath the bladder, and simply before the rectum.
The prostate helps produce semen, the milky liquid that brings sperm from the testicles through the penis when a man ejaculates. Additionally, it encompasses part of the urethra, a cylinder that carries urine out of the bladder and through the penis.
If you think you have a prostate problem, you might consider massaging them to regulate your prostate health.
Pros And Cons Of The Psa Screening Test For Prostate Cancer
After skin cancer, prostate cancer is the most common cancer affecting American men. The American Cancer Society estimates that 1 in 9 men will be diagnosed with prostate cancer. This year alone, 164,690 new cases of prostate cancer will be diagnosed.
Prostate cancer is a serious diseaseand is the second leading cause of cancer death for American men . However, most men who are diagnosed with prostate cancer dont die from it. Thats because in most cases, prostate cancer grows very slowly, and you can live with it for years if not decades without symptoms.
Of course, as with all cancers, the sooner detected and treated, the better the outcome. Thats why we offer mammograms and PAP tests for women to detect cancers that may not yet show symptoms. For men, the PSA blood test is used the same way, but because of the nature of prostate cancer and the reliability of the test, its important to weigh the pros and cons on how useful the test is.
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