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Side effects
Sexual effects
Coping tips
Questions to ask your doctor
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Side effects

The treatment of prostate cancer may produce unpleasant side effects. You should ensure that you have a thorough understanding of the potential side effects before deciding on a treatment. It is therefore important that you discuss your concerns and possible implications in detail with your doctor.

The side effects of prostate cancer treatment may include the following.


As men get older, erections may be difficult to achieve or short-lived. Erection problems are also common in men who have had surgery and radiotherapy for prostate cancer, because these treatments can damage nearby nerves.

Fortunately, this problem can be treated using different methods, including the following.
Tablets that increase blood flow to the penis. These medications can cause headaches, nausea, blurry vision and facial flushing. Men with heart problems should check with their doctor before taking such tablets.

Injections to the penis, which you can learn to do yourself. The main form of treatment is called penile injection therapy. A substance is injected into the penis causing the blood vessels to expand and the penis to become erect. This treatment works well in most men but a few may experience some pain and scarring.
A pump device that uses suction to draw blood into the penis. This may be an option if injections or tablets have not worked.

Implants surgically placed in the penis. A pump is positioned in the scrotum and is turned on when an erection is needed.
Urinary incontinence

Not being able to control the flow of urine is called urinary incontinence. It is a common side effect of treatment.

The effects of incontinence vary. Some men may lose a few drops when they cough, sneeze, strain or lift. Others have more severe problems requiring the use of incontinence pads several times a day. It is usually worse straight after treatment, and gets better within a year. For most men incontinence is temporary, but for a few it is permanent.

Bladder control problems can be managed in a variety of ways. A wide range of aids is available to help cope with any urine loss and protect the skin, including absorbent pads, pants, bed sheets and chair covers.

Exercising the muscles in your pelvis can help stop or reduce leakage. Bladder training can help you to go to the toilet less often and to pass more urine when you go to the toilet.

If incontinence lasts longer than a year, it is unlikely to improve. You should then talk to your doctor about other treatments.

Change in body image

Cancer can change how you feel about yourself. Treatment or side effects such as incontinence may make you feel embarrassed or insecure.

While treatment side effects such as incontinence or impotence are often temporary and can be managed, they may make you feel less masculine.

The physical changes do not change who you are. Your intelligence, sense of humour and personality remain the same.

Take time to get used to body changes. Look at yourself naked in the mirror and, if you feel comfortable, touch your genitals to find out what is different and what feels sore or numb.

Show or tell your partner any changes in your body so you can get used to how that makes you feel.

It can also be helpful to share your feelings with other men who have had a similar experience.
Sexual effects

Sex life

You do not need your prostate to have sex, but treatment for prostate cancer can affect your sex life. After a radical prostatectomy or radiotherapy, the production of semen in the prostate and seminal vesicles will stop. This will mean you have a dry orgasm. You will still feel the sensation of an orgasm but little or no semen will be ejaculated when you climax.

After treatment for prostate cancer the way you have sex may need to change. Patience, practice and the following tips will help you manage impotence.

  • If you have a partner, it will help to talk to them. They are affected by the problem too. Discuss what works and does not work for you. Talking will also help reassure both of you of your need and affection for each other.
  • Take it slowly the first few times you have sex after cancer treatment. Start by touching each other. Tell your partner where you like to be touched or guide them with your hand. When you feel relaxed, include some genital touching. Ask your partner to be gentle because your penis may be sore. Practice reaching an orgasm through stroking with a hand or through oral sex.
  • Try different positions with your partner to find out what feels right and is suitable for both of you.
  • Touching, holding, hugging and caressing are other ways of reassuring your partner that you love them and find them physically attractive.
  • Explore your ability to enjoy sex through masturbation. Touching your genitals and bringing yourself to orgasm can help you find out if cancer treatment has changed your sexual response.
  • If you have difficulty continuing your usual sexual activities, talk with your doctor or a counsellor.

Fertility problems

After surgery, radiotherapy or hormone therapy for prostate cancer, most men become infertile. It is best for you and your partner to talk about these issues with your doctor.

Loss of fertility may not be a problem for many men diagnosed with prostate cancer as they are usually older and have had children. If you want to have children, you may be able to store sperm before treatment starts for use at a later date. Ask your doctor about this.

Loss of interest in sex

A lack of interest in or a loss of desire for sex is common during cancer treatment. This is known as a loss of libido. Sometimes it can be brought on by anxiety and worry rather than the treatment. Your sex drive usually returns after treatment.

Coping tips
Once you receive a diagnosis of prostate cancer or treatment for this disease, you may experience a range of feelings, including disbelief, fear, anger, anxiety, emptiness and depression. You may not be able to get rid of these distressing feelings but you can find positive ways to deal with them so they don't dominate your life. The following strategies can help you cope with some of the difficulties of prostate cancer.
  • Be prepared: Ask your doctor questions and read about prostate cancer and its potential side effects. The fewer the surprises, the more quickly you'll adapt.

  • Maintain as normal a routine as you can: Don't let the cancer or side effects from treatment dominate your day. Try to follow the routine and lifestyle you had before your cancer diagnosis. Go back to work, take a trip, and join your children or grandchildren on an outing. You need activities that give you a sense of purpose, fulfilment and meaning. But also realise that initially you may have some limitations. Start slowly and gradually build your level of endurance.
  • Get plenty of exercise: Exercise helps fight depression and is a good way to relieve tension and aggression.
  • Open up to a friend, a family member or a counsellor: Cancer is too heavy a load to carry alone. Sometimes it helps to talk with someone about your feelings and fears. The better you feel emotionally, the better you'll be able to cope physically with your illness. You may find joining a support group helpful, because it can provide you with a sense of belonging, give you an opportunity to talk with people who understand your situation and provide you with advice. Call Cancer Fund’s free service hotline on 3656 0800 to ask about patient support.
  • Don't avoid sexual contact: Your natural reaction to impotence may be to avoid all sexual contact. Don't fall for this feeling. Touching, holding, hugging and caressing can become far more important to you and your partner. In fact, the closeness you develop in these actions can produce greater sexual intimacy than you've had before. There are many ways to express your sexuality.
  • Look for the positive: Try not to focus on only the negative aspects of live with cancer. Facing cancer may lead you to grow emotionally and spiritually, to identify what really matters to you, to settle long-standing disputes and to spend more time with people important to you.
Questions to ask your doctor

You may find this checklist helpful when thinking about the questions you want to ask your doctor about your illness and treatment. If there are answers you do not understand, it is fine to ask your doctor to explain again.

  1. What type of prostate cancer do I have?
  2. How big is the tumour? Has the cancer spread? Is it affecting any of my organs? What stage is it?
  3. What treatment do you recommend and why? What are the risks?
  4. Are there any other possible treatments?
  5. I heard that cancer treatments include surgery, radiotherapy and chemotherapy. Do I only need to receive one treatment? Or do I have to undergo a series?
  6. How long is the course of treatment? Do I need to stay in the hospital? How might it affect my life? Do I need to leave my job?
  7. Are the side effects serious? How can they be relieved? Are there any long-term effects?
  8. How much will the whole course of treatment cost? Will my insurance cover the cost?
  9. How will I know if the treatment has been successful?
  10. How often do I need to visit you again after treatment? What regular follow up treatment should I receive?
  11. What would the impact be if I decided not to have treatment at this time?
  12. Will treatment make me weak? Will I be able to work again and take care of my children?
  13. What is the likelihood of a relapse?
  14. Will I have a scar on my body after the tumour has been removed?
  15. Can the cancer be passed on to my children? What are the chances of my children having this type of cancer?
  16. During the course of treatment, can I also consult with a Traditional Chinese practitioner? How will the two treatments react with each other?