What are the side effects of treatment?
It is hard to limit the effects of therapy so that only cancer cells are removed
or destroyed. Because treatment also damages healthy cells and tissues, it often
causes unwanted side effects.
The side effects of cancer treatment depend mainly on the type and extent of the
treatment. Also, each patient reacts differently. Doctors and nurses can explain
the possible side effects of treatment, and they can often suggest ways to help
relieve symptoms that may occur during and after treatment. It is important to
let the doctor know if any side effects occur.
Surgery
Although patients are often uncomfortable during the first few days after
surgery, their pain can be controlled with medicine. Patients should feel free
to discuss pain relief with the doctor or nurse. It is also common for patients
to feel tired or weak for a while. The length of time it takes to recover from
an operation varies for each patient.
Radical prostatectomy may cause urinary incontinence in 10-20% of cases. Severe
incontinence is usually quite rare. Permanent erectile dysfunction (impotence)
is not uncommon after radical prostatectomy and occurs in approximately seventy
percent of the patients. These side effects are somewhat less common than in the
past after the induction of the new surgical technique, the nerve-sparing
surgery. Potency can be preserved by a skilled urologist in more than 50% of
young patients. When this surgery is fully successful, impotence and urinary
incontinence are only temporary. However, men who have a prostatectomy no longer
produce semen, so they have dry orgasms only.
Radiation Therapy
Radiation therapy may cause patients to become very tired as treatment
continues. Resting is important, but doctors usually advise patients to try to
stay as active as they can. Patients may have diarrhea or frequent and
uncomfortable urination. In addition, when patients receive external radiation
therapy, it is common for the skin in the treated area to become red, dry, and
tender. Radiation therapy can also cause hair loss in the pelvic area. The loss
may be temporary or permanent, depending on the amount of radiation used.
Radiation therapy causes impotence in some men. This does not occur as often
with radioactive seed implant (brachytherapy) as with external radiation
therapy; brachytherapy is not as likely to damage the nerves that control
erection.
Hormone Therapy
Orchiectomy, LHRH agonists, and estrogen often cause side effects such as loss
of sexual desire, impotence, and hot flashes. When first taken, an LHRH agonist
tends to increase tumor growth and may make the patient's symptoms worse. This
temporary problem is called "tumor flare." Gradually, however, the
drug causes a man's testosterone level to fall. Without testosterone, tumor
growth slows down and the patient's condition improves.
Prostate cancer patients who receive estrogen or an antiandrogen may have
nausea, vomiting, or tenderness and swelling of the breasts. (Estrogen is used
less now than in the past because it increases a man's risk of heart problems.
This form of treatment is not appropriate for men who have a history of heart
disease.)
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