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Complications
By Mayo Clinic staffComplications from prostate cancer are related to both the disease and its treatment. One of the biggest fears of many men who have prostate cancer is that treatment may leave them incontinent or unable to maintain an erection firm enough for sex (erectile dysfunction). Fortunately, therapies exist to help cope with or treat these conditions.
The typical complications of prostate cancer and its treatments include:
- Spread of cancer. Prostate cancer can spread to nearby organs or travel through your bloodstream or lymphatic system, affecting your bones or other organs. Treatments for prostate cancer that has spread can include hormone therapy, radiation therapy and chemotherapy.
- Pain. Although early-stage prostate cancer typically isn't painful, once it's spread to bones it can be. Not all people with cancer that has spread to bones have pain, but in some cases, pain is intense and doesn't go away. Treatments directed at shrinking the cancer often can produce significant pain relief. Medications ranging from over-the-counter pain relievers to prescription narcotics can alleviate pain. If your pain is severe, you may need to see a pain specialist. While it's not always possible to make all of your pain go away, your doctor will work with you to try to control pain to a point where you're comfortable. If you're in serious pain, tell your doctor. Pain can be controlled, and there's no reason you have to suffer.
- Difficulty urinating (urinary incontinence). Both prostate cancer and its treatment can cause incontinence. Treatment depends on the type of incontinence you have, how severe it is and the likelihood it will improve over time. Treatments include behavior modifications (such as going to the bathroom at set times rather than just according to urges), exercises to strengthen pelvic muscles (commonly called Kegel exercises), medications and catheters. If incontinence continues for a prolonged period without getting better, your doctor may suggest more aggressive procedures. These may include implanting an artificial urinary sphincter, placement of a sling of synthetic material to compress the urethra, or the injection of bulking agents into the lining of the urethra at the base of the bladder to reduce leakage.
- Erectile dysfunction (ED) or impotence. Like incontinence, ED can be a result of prostate cancer or its treatment, including surgery, radiation or hormone treatments. Medications and vacuum devices that assist in achieving erection are available to treat ED. Medications include sildenafil (Viagra), tadalafil (Cialis) and vardenafil (Levitra). If other treatments fail, penile implants can be inserted surgically to help create an erection.
- Depression. Many men may feel depressed after a diagnosis of prostate cancer or after trying to cope with the side effects of treatment. These feelings may last for only a short time, they may come and go, or they may linger for weeks or even months. Talk to your doctor if you have depression that interferes with your ability to get things done or enjoy your life. Treatment such as counseling or antidepressant medication can make a big difference.
References
- Wilson WG et al. Abeloff: Clinical Oncology, 3rd ed. Prostate Cancer. Ch 87
- Ferri FF. Ferri's Clinical Advisor 2008, 10th ed. Prostate Cancer.
- Small EJ. Prostate cancer (2007) Goldman: Cecil Medicine, 23rd ed. Chapter 211.
- National Cancer Institute. PC-SPES, Patient version (9/21/07). Accessed online, 1/20/08: http://www.cancer.gov/cancertopics/pdq/cam/pc-spes
- Gaziano JM, et al. Vitamins E and C in the prevention of prostate and total cancer in men: The physicians' health study II randomized controlled trial. Journal of the American Medical Association. http://jama.ama-assn.org/cgi/content/full/2008.862v1. Accessed Dec. 31, 2008.
- Lippman SM, et al. Effect of selenium and vitamin E on risk of prostate cancer and other cancer: The selenium and vitamin E cancer prevention trial (SELECT). Journal of the American Medical Association. http://jama.ama-assn.org/cgi/content/full/2008.864v1. Accessed Dec. 31, 2008.
- Castle EP (expert opinion). Mayo Clinic, Scottsdale/Phoenix, Ariz. Jan. 2, 2009.
