Patient Education

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Men's Health

December 2013

Managing the Side Effects of Prostate Cancer Treatment

Men diagnosed with prostate cancer today have several treatment options. One is surgery, a common treatment if the cancer hasn't spread beyond the prostate gland. You can also choose radiation or watchful waiting—when you forgo immediate action to monitor the cancer's growth with regular checkups.

No matter your treatment of choice, long-term side effects are possible. Below are the most common ones, along with some ways to manage them.

Erectile dysfunction (ED)

ED is the inability to have or maintain an erection. It affects nearly all men with prostate cancer, especially in the first few months after treatment. Why? The nerves and blood vessels in the penis are fragile. Any trauma—whether from surgery, radiation, or the cancer itself—can damage them.

ED may go away over time. But it can linger for years. Prescription medications, such as Viagra or Cialis, can effectively manage the condition. They relax muscles in the penis to promote blood flow. That, in turn, causes an erection.

If you can't take these medications because of your health, another option is a vacuum erection device. It pumps blood into your penis. For severe cases of ED, surgery may be needed to insert a penile implant.

Urinary incontinence

Many men with prostate cancer develop urinary problems, such as leaking urine or needing to go often. In fact, one-quarter of men who have surgery for prostate cancer suffer from urinary incontinence. During treatment, the nerves and muscles that control urine flow can be damaged.

Simple behavioral changes may relieve urinary problems. Try scheduling regular bathroom breaks or limiting fluids at certain times. You may also benefit from Kegel exercises. They strengthen pelvic muscles so you can hold urine better.

Your doctor may also prescribe medication, depending on your symptoms. Various drugs can reduce urine flow, relax bladder muscles, or shrink the prostate. If problems persist, surgery may help. In one procedure, the surgeon attaches a sling around your urethra to keep it closed until you are ready to urinate.

Bowel problems

Bowel problems include diarrhea, frequent or uncontrolled bowel movements, and rectal bleeding. They are more common in men who undergo radiation.

Antidiarrheal medication and dietary changes can help with bowel problems. Drink plenty of clear fluids and try eating several smaller meals throughout the day. You may also want to avoid spicy, fried, or greasy foods. Some people also fare better if they avoid fiber-rich foods, such as raw fruits and vegetables. But too little fiber in your diet can cause constipation.

Easing the Effects of Hormone Therapy

Hormone therapy is another treatment option for prostate cancer. It blocks the body's production of testosterone—the hormone that causes cancer cells to grow in the prostate. It can be used alone or with other treatments.

Men on hormone therapy have reported hot flashes, breast swelling, fatigue, loss of sexual desire, weight gain, and bone loss. Intermittent use of the therapy may ease these side effects. So, too, might exercise. But don't bother with soy or the drug venlafaxine. A recent study found they don't help men, despite their potential power in women.   

Click here to learn more about hormone therapy and other treatment options.

Online resources

Agency for Healthcare Research and Quality - Treating Prostate Cancer

National Cancer Institute - Treatment Choices for Men with Early-Stage Prostate Cancer

Prostate Cancer Foundation - Side Effects

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