Cancer is considered synonymous with pain, shame, embarrassment, suffering, stigma and finally death. Prostate cancer develops on an important gland in the male reproductive system, the prostate gland. The symptoms of this cancer include erectile dysfunction, loss of fertility, urinary dysfunction and bowel dysfunction. Treatment is often radiation followed by the surgical removal of the prostate gland known as prostatectomy. However, the surgery only seems to help prevent the cancer from metastasizing because its side-effects are the same as the symptoms of prostate cancer! Knowing these side effects in detail will be an important step of the process of convalescence.
Whatever might be the care taken during a prostate surgery to ensure that the nerves are not affected, it is simply impossible to prevent erectile dysfunction for at least some time after the treatment. The blood vessels and the nerves which control the physical aspects of erection are incredibly delicate and sensitive. The slightest trauma in that region will stop the penis from getting engorged with blood and thus erection reduces. Along with it, it results in a lowered sex drive too. However, although all men undergoing prostatectomy suffer from erectile dysfunction, they return to the pre-surgery performance within a year in 50 percent of the cases and within 2 years in 70 percent of the cases. All is not lost for 75 percent of the men have reported positive changes on using oral medications like Cialis and Viagra. For those that undergo radiation, only 20 percent show loss of erection but they never seem to recover from it.
Another side effect that occurs due to invasion of the area which houses sensitive muscles and nerves is retrograde ejaculation. This is an embarrassing condition in which the sperm or the man’s ejaculate does not proceed to the urethra as it is supposed to. Instead, on climax, it flows backward into the bladder. This detour is caused by the bladder sphincter which is supposed to shut tight during ejaculation to prevent this. Such a condition is not very common. However, when it occur, it increases the chances of urinary tract infection. Thus, it is vital that any person who suspects having this condition report it to the doctor.
Loss of fertility
Despite the greatest care and the best efforts of the surgeons or the radiotherapists, it is almost impossible for a man to become a father through sexual intercourse after prostate cancer surgery. This is because, during prostatectomy the prostate gland is removed along with the adjoining seminal vesicles. The seminal vesicles are important because they provide the semen which transports the sperms out of the penis during ejaculation. So, though a man is able to produce sperms, there is no way of transporting them to the woman’s egg by copulation. Even with radiation treatment, fertility gets impaired. This is because, the radiated seminal vesicles produce semen which is unable to carry the sperm. Thus, loss of fertility is a side-effect that cannot be treated and must be accepted. Wannabe fathers can go in for either sperm banking, sperm extraction from the testicles or even adoption.
An enlarged prostate leads to urinary dysfunction. However, when prostate surgery is done to treat this, it could aggravate the problem due to the damage to the muscles and the nerves that control the urinary process. Thus, men face a terrible side-effect of incontinence. This could range from leaking to complete loss of bladder control. The frequency of urination and its urgency goes up manifold. At the same time, there is pain while passing urine. There is also a burning sensation in the organs. Almost about 30-50 percent of the men undergoing prostatectomy report an increase in urinary symptoms. Similarly, brachytherapy and external beam radiotherapy to treat prostate cancer lead to irritating and painful voiding symptoms and men often need painkillers to save them from pain and pads to save them from embarrassment.
Non-urologic side effects
Not all the side-effects of a prostate surgery are urology-related. Some of them affect the heart too. The most common aftereffects that can happen during or after the prostate surgery are heart attacks or myocardial infractions, pulmonary embolisms, cerebrovascular accidents (strokes) or deep vein thromboses. Though there is less than 1 percent chance of patients contracting these conditions, it is important for the patients to consult the doctor for these side-effects are life threatening. When one undergoes radiation as part of the surgery, then side-effects of nausea and vomiting are common occurrences. General exhaustion and sleep problems also affect such patients. So, radiation therapy patients should eat well and nourish themselves.
Pain and depression
Having the prostate removed is sure to cause bleeding and pain like any other major surgery. Bleeding and the associated pain arise immediately after the surgery and in most cases, disappear a few weeks after that. However, in case the pain persists for a month or more, it is time to consult the doctor on whether there is some deeper problem. The prostate gland is also the seat of the liquid semen which is necessary for sperm-transport. The surgery can affect the levels of testosterone and associated hormones in the blood stream. This leads to several psychological side effects also. Many men have reported bouts of depression after the surgery. The pain can enhance this depression if not tended to.
Bowel dysfunction is a broad term that includes frequent stools, the inability to control and have proper bowel movements. However, this happens usually due to radiation therapy that may precede the surgery. Prostatectomy by itself causes no damage to the rectum. Once the prostate has been removed, there is extra abdominal space available in the bowels. It takes some time for the body to adjust to this increase in space and thus results in bowel dysfunction. In rare cases, there is bleeding from the rectum due to radiation damage but this can be arrested with laser treatment. Increasing the dietary fiber intake and taking anti-diarrhea medication also helps in making the bowel movement better.