Most people are aware that side effects are a normal, expected part of any sort of medication or medical treatment.
Treatment for prostate cancer is no exception. Depending on your individual case, there are various different prostate cancer treatment options that may be available to you.
Within many healthcare settings, treatment for prostate cancer is focused solely on eradicating the cancer. While there’s no escaping that becoming cancer-free should be the goal of any cancer treatment, at what cost does this happen?
Some healthcare providers are keen to downplay or overlook the long-term consequences of prostate cancer treatment in favour of becoming cancer free. Understanding what to expect from the side effects of prostate cancer treatment can help you to make an informed decision about which therapies you’d like to consider.
Treatments for prostate cancer
Cancer treatments continue to evolve, but at the current time, there are just three primary therapies for prostate cancer offered by the NHS.
What many people may not be aware of is that there are also several newer, more targeted prostate cancer therapies that are available privately and, in some cases, on limited NHS clinical trials around the country.
Let’s take a look at the different treatments available for prostate cancer and what side effects and longer-term consequences you can expect from each.
Radiation therapy
Radiation therapy is one of the most well-known types of cancer treatments and it can be used to treat many different types and stages of the disease, including prostate cancer.
Radiation therapy — or radiotherapy — is a non-invasive cancer therapy that works by damaging the DNA of cancer cells so that they either can’t divide and grow or die altogether. If they die, they are eventually metabolised by the body.
In prostate cancer, radiation therapy is either focused purely on the whole prostate, or in the case that the cancer has spread to nearby lymph nodes and bones, applied to a wider area of the pelvis. The wider the area radiation therapy is applied to, the more likely side effects are.
Some of the most debilitating side effects associated with radiation therapy include:
Urinary issues such as:
- Needing to urinate often, including at night
- Needing to pee without warning
- Burning when peeing
- Slow/poor urine flow
- Difficulty urinating
- Urinary leaking
- Blood in your urine
Bowel issues, caused by radiotherapy irritating the bowel and rectum, such as:
- Passing wind more often than usual
- Loose/watery bowel movements
- Needing to open your bowels without warning
- Abdominal pain
- Leaking from your back passage/bowel incontinence
- Bleeding from your back passage
Sexual dysfunction, which includes:
- Inability to obtain an erection
- Difficulty maintaining an erection
- Ejaculation becomes uncomfortable
- Dry orgasms (where you experience the sensation, but do not ejaculate)
If you have anal sex, you may be recommended to avoid this for some time, particularly if you also experience bowel issues after radiotherapy.
Fertility problems can also occur because radiotherapy can damage the cells that make semen. If you are looking at radiotherapy but would still like to have a family, you may wish to consider sperm freezing to increase the likelihood of this being an option in the future.
Hormone therapy
Hormone therapy is another non-invasive treatment option for men with prostate cancer. While hormone therapy alone won’t cure prostate cancer, it can slow or halt its progression and help you to manage your symptoms.
Prostate cancer cells are usually fuelled by testosterone — the male hormone that is responsible for other male characteristics like muscle mass, erections and more. Hormone therapy helps to treat prostate cancer by either stopping testosterone production completely, or by preventing testosterone from reaching cancer cells.
As you probably expect, there are many side effects associated with altering the way your body produces male hormones. Some of the consequences of hormone therapy for prostate cancer that have been reported include:
- Loss of muscle mass
- Increase in body fat
- Loss of sex drive
- Erectile dysfunction
- Thinner bones, which make broken bones more likely
- Hot flashes, similar to those experienced by menopausal women
- Decreased body hair
- Smaller genitalia
- Breast tissue growth
Since hormone therapy is typically taken for a prolonged period, if you choose this treatment option you are likely to experience side effects that persist for at least as long as the treatment is being taken.
Surgery (Radical prostatectomy)
Surgery is a very common recommendation for patients who have early to moderate-stage prostate cancer that is contained within the prostate itself.
The surgery, known as radical prostatectomy, focuses on the removal of the entire prostate and seminal vesicles (the tubes that carry semen out of the body). In some cases, lymph node removal may also be recommended.
Prostate cancer surgery is performed under general anaesthetic and can be carried out laparoscopically (though several smaller incisions through which a camera and instruments are inserted) or in traditional open surgery.
Surgery is typically fast and straightforward with a very high success rate. However, you will need to wear a catheter for up to a week following your procedure, even after you return home. There are also a higher number of risks with surgery than with other types of prostate cancer treatment — for example, bleeding following the surgery, blood clots and infections.
There are also a wide range of side effects associated with radical prostatectomy. Like the side effects of radiation therapy, they can be stressful, embarrassing and uncomfortable. They include:
- Urinary incontinence, including stress incontinence (leaking when coughing, laughing or sneezing), urge incontinence (the sudden need to pee) and overflow incontinence (struggling to empty your bladder).
- Erectile dysfunction, which means that you can no longer obtain or maintain an erection that is sufficient for sexual penetration and satisfaction. For many men, this is a significant side effect that can severely affect their quality of life even after their cancer is treated.
- Decrease in penis length isn’t a side effect that is commonly talked about, but can occur due to the shortening of the urethra if some of this is removed along with the prostate.
- Loss of fertility is another common side effect. Since the surgery cuts the pathways between the testicles (where sperm is made) and the urethra (the tube used to carry sperm out of the body), you will no longer produce semen when you ejaculate. Many men choose to freeze their sperm before they undergo prostate cancer surgery.
Every patient is different, and so the severity of side effects after prostate cancer surgery — and the length of time for which you experience them — can vary considerably and not be guaranteed.
High-Intensity Focused Ultrasound (HIFU)
High-Intensity Focused Ultrasound, or HIFU for short, is the first of the prostate cancer treatments we are looking at that isn’t available on the NHS.
It’s referred to as a type of focal therapy because it is extremely targeted. And although it isn’t well known, it is very popular and well-evidenced, having been in use for more than 20 years and used to treat more than 50,000 patients.
HIFU is recommended when prostate cancer is contained within the organ and within the lower part of the prostate (which is where more than 75% of prostate cancers occur).
It uses high-intensity ultrasound waves to heat up and destroy cancer cells within the prostate. However, the targeted nature of this therapy means that only the cancer cells are affected, and surrounding sensitive tissues and body structures are left untouched.
This is something that helps to dramatically reduce the risk of complications and side effects. For example, men who choose HIFU over radiotherapy and/or surgery are less likely to experience issues with bladder/bowel incontinence.
98% of patients who have had HIFU treatment are fully continent at two weeks post-procedure.
Similarly, studies have found that erectile dysfunction is far less common, and where it does occur, is much shorter-lived in patients who have had HIFU than in other types of prostate cancer treatment.
95% of patients who have had HIFU treatment maintain erectile dysfunction after their initial recovery period.
You’ll need to wear a catheter for a few days, and may experience a few very mild side effects, such as blood in your urine while cancer cells pass out of your body.
Unsurprisingly, the reduction in some of the most severe and debilitating side effects helps to make HIFU a very popular treatment here at The Focal Therapy Clinic.
NanoKnife
Also known as Irreversible Electroporation (IRE) or NanoKnife is another cutting-edge prostate cancer not currently available on the NHS, but that also has far fewer side effects associated with it than conventional treatments.
NanoKnife treatment is recommended for patients with early to mid-stage prostate cancer which is located in difficult-to-reach parts of the prostate gland. Like HIFU treatment, NanoKnife is a form of focal therapy that specifically targets the cancerous cells within the prostate to ensure that healthy cells are left untouched.
The treatment itself uses ultra-fine needles placed into the tumour, through which a series of short, electrical pulses are passed. These pulses destroy the cancerous cells which are then metabolised by the body.
Clinical evidence shows that surgeons who use NanoKnife can achieve a 97% eradication of prostate cancer tissue within the target area, with virtually zero impact on healthy tissue.
Again, the focal nature of NanoKnife helps to drastically reduce the risk of long-term side effects. You will still need to wear a catheter for a few days, and you may experience a small amount of blood and seminal fluid in your urine after surgery. Decreased/absent ejaculatory fluid is a rare side effect, as is erectile dysfunction.
In fact, patients who undergo NanoKnife treatment have a minimal risk of erectile problems compared to those who had prostate cancer surgery.
Many men choose NanoKnife treatment, safe in the knowledge that the risks associated with long-term side effects are very slow.
In terms of side effects, what is the best treatment for prostate cancer?
Unsurprisingly, HIFU and NanoKnife treatment both offer patients the lowest risk of experiencing long-term consequences from their prostate cancer treatment, without compromising on the overall outcome for the patient.
However, it’s important to always speak to your doctor to make sure that the prostate cancer you choose is the best one for you based on your personal prognosis.
Focal therapies are an effective way of treating early to moderate-stage prostate cancer. Contact our team today for a no-obligation consultation.
Sources
- https://prostatecanceruk.org/prostate-information/treatments/external-beam-radiotherapy
- https://www.mayoclinic.org/tests-procedures/hormone-therapy-for-prostate-cancer/about/pac-20384737#
- https://www.cancer.org/cancer/prostate-cancer/treating/surgery.html
- https://www.thefocaltherapyclinic.com/NanoKnife-ire-focal-therapy/
- https://www.thefocaltherapyclinic.com/focal-therapy-precision-prostate-cancer-treatment/
