Advanced prostate cancer and side effects

Many men who have advanced prostate cancer experience side effects. Some of these side effects result from the treatments used to slow the spread of cancer. Other side effects come from the disease itself. Understanding these side effects can relieve fears and help you cope better. So can being an active participant in your own care. Ask your doctor questions. Learn about potential symptoms and options before receiving treatments. 

Prostate cancer and impotence

Impotence - the inability to achieve or maintain an erection - is a major side effect of most treatments for advanced prostate cancer. Erection problems are also a fairly common side effect of prostate cancer treatment.  Medicines to reduce testosterone levels, called hormonal therapy, also causes impotence in most patients. Some men who become impotent can regain erections over time, with no assistance. Other men seek treatment. Options range from devices worn externally, medicines taken orally or injected into the penis, and penis implants. Discuss these options with your doctor.

Prostate cancer and incontinence

Incontinence - the inability to control urine flow - is a common side effect of prostate cancer surgery and radiotherapy. However, most patients do eventually regain urinary control. Exercises to strengthen the sphincter and surrounding pelvic muscles can help you regain urinary control. These are called pelvic floor exercises. A training programme called biofeedback helps reinforce the proper performance of pelvic floor exercises. Medication may also help relieve incontinence. Ask your doctor about these options.

Prostate cancer and infertility

Many treatments for prostate cancer cause infertility. Several techniques can help preserve fertility, but they must be done before cancer treatment. If you want to preserve your fertility, tell your doctor before undergoing any treatment for prostate cancer.

Prostate cancer pain and weakening bones

Prostate cancer 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 hormone therapy that's often used to fight the spread of prostate cancer. However, doctors can offer treatments to relieve bone pain and support weakened bones.

Bisphosphonates to strengthen bones

These medications help reduce the risk of, or delay, problems such as fractures caused by bone metastases in prostate cancer. Researchers are also exploring the possibility of using new treatments to prevent the development and progression of bone metastases in prostate cancer.

Radiotherapy for bone pain

Radiotherapy is given to reduce bone pain in advanced prostate cancer.

• External beam radiotherapy: Radiation using a high-energy X-ray machine directs radiation to the prostate tumour. It can be used instead of surgery or if surgery doesn't remove all the cancer. It can also be used to treat lesions in bones where the cancer has spread. Doctors believe this form of radiotherapy is particularly helpful for patients who have lesions that don't pose an immediate risk of fracture, or when lesions are limited to a single area.
• Radioisotopes: Radiotherapy that's delivered through an injection. It targets and attacks the area of bone containing cancer. Strontium-89 is a commonly used radioisotope.

Surgery to stabilise bones

Doctors may recommend surgery to stabilise a weakened bone or bones. A surgeon may insert rods, plates, screws, wires or other devices to provide support to bones damaged by metastasis.

Lifestyle changes to maintain bone health

Specific lifestyle changes can also help maintain bone health. They include decreasing alcohol intake, stopping smoking, doing regular weight-bearing exercises and eating a healthy diet rich in calcium and vitamin D – and getting vitamin D from sunlight if you can.