Locally-advanced Prostate Cancer

Support

Support for Locally-advanced Prostate Cancer

Getting diagnosed with cancer has a great impact on your life and the lives of your loved ones. Cancer can make you feel powerless. It can cause feelings of anxiety, anger, fear, or even depression. Undergoing treatment for cancer is intense and will affect your work, your social life, and your sexuality.

To find support, approach your doctor or nurse in the hospital, or ask your family doctor. They will be able to give you contact information about patient organizations or others who can help you with psychological support or practical matters such as financial advice.

Preparing for a consultation

Preparing for a consultation can be very useful. It will help you and your doctor better address your questions and concerns. It can also help you prepare for treatment and the possible side effects. Here are some things you can try:

  • Write down the questions you would like to ask the doctor. This will help you remember things that you want to ask. Writing down questions can also help you organize your thoughts
  • If you can, take someone with you to the visit. It is good to have someone to discuss what the doctor said and you probably remember different things
  • Ask for information about your specific type of prostate cancer
  • If the doctor uses words you do not understand, ask for an explanation
  • Tell your doctor what medicine you take and if you take any alternative medicine. Some of these medicines can affect the treatment

After the consultation you can:

  • Search the Internet or go to the library for more information about your type of cancer. Be aware that not all the information you see online is of good quality. Your doctor or health care team can point you to reliable websites
  • Contact a patient organization, they can offer support and information
  • Discuss with your health care team the possible financial consequences of your treatment. They might be able to direct you to people or places where you can get advice about your economic situation or even financial help
  • If you want, you should ask for a second opinion from another specialist

How to find a patient organization nearby

Patient organizations can be very helpful. To find one close to you, ask your family doctor, nurse, or doctor at the hospital. You can also search the Internet for a patient group.

Support after surgery

In the first days or weeks after surgery you may need help with everyday activities. If you can, ask family, friends, or neighbours to help you with things like buying and carrying home food, cooking, cleaning, washing, and gardening. You can also ask your health care team for information about professional home care.

After surgery, it is common that you experience fatigue. This means you feel more tired than usual, you are out of energy, have trouble concentrating, and it does not get better after you sleep. Most people experience fatigue for 1-2 months after the surgery. To deal with fatigue, you can:

  • Write down things that give you energy and give them priority during the day or week
  • Get help with household tasks like washing, cleaning, or gardening
  • Take short naps several times during the day
  • Try to be as active as you can. A short walk every day is better than a long walk once a week
  • When planning social activities like a trip or a visit, keep in mind you may need time to rest during the day. Discuss this with your family, friends, or caregiver so that you can plan ahead. It is important to tell them when you are feeling tired

Radical prostatectomy may cause stress urinary incontinence (SUI). This means that you lose urine during certain activities, for example coughing, laughing, running, or lifting. Here are some tips to help manage your symptoms:

  • Try to make sure you always know where the nearest toilet is. Never be afraid or embarrassed to ask where the toilet is when you are away from home
  • If you have problems with dribbles of urine you can use a drip collector, or a small pad. Drip collectors are worn over the penis and held in place by your underwear
  • Invest in odour preventers. Ask your pharmacist or family doctor about these
  • Wear dark-coloured clothes. Lighter-coloured clothes may show stains more easily
  • Wear loose clothes for comfort
  • Have an extra set of clothes at hand

You can read more about these in the section Living with Urinary Incontinence.

Another common risk of the surgery is erectile dysfunction. There are various options to treat this condition. The most common ones are pills, injections, or a prosthesis. Discuss with your doctor what is the best option for you.

Dealing with SUI or erectile dysfunction after radical prostatectomy can be difficult. They can have long-lasting psychological effects. Talk to your surgeon, nurse, or family doctor so they can help you find the support you need.

Support during radiation therapy

During the course of radiation therapy you can generally carry on with your daily activities.  The treatment may cause fatigue and can affect your lower urinary tract and bowel. Usually these symptoms go away a few months after treatment.

Your skin may be affected by the radiation. To care for your skin you can:

  • Avoid scratching or rubbing the radiated area
  • Ask your doctor or nurse which type of skin lotion you should use to deal with skin irritation
  • Avoid sun exposure
  • Use a high-factor sunscreen
  • Wear loose-fitting clothes in natural fabrics such as cotton or linen
  • Wash yourself daily with mild soap and lukewarm water
  • Gently pat your skin dry after washing
  • Avoid the sauna

Support during hormonal therapy

All types of hormonal therapy cause castration, to which your body can react in various ways. The most common side effect of castration is hot flushes. To manage this, your doctor will advise you to monitor your weight and avoid alcoholic drinks. If you experience hot flushes, you can:

  • Dress in layers
  • Wear natural fabrics like cotton or linen, which let the body breathe
  • Sleep under layers of light blankets so that you can remove some if you need to
  • Avoid hot baths, saunas, or whirlpools
  • Avoid hot or spicy food
  • Drink plenty of water, and carry a bottle with you when you leave the house

Discuss with your doctor possible treatments to manage hot flushes or any of the other consequences of castration and side effects of hormonal therapy.

Follow-up

After treatment you will meet with your doctor. In this visit, both the results of the treatment and the follow-up schedule will be discussed. Ask for a care plan so you can see how often you will need to see your doctor, and what kind of tests could be needed before each visit. This depends on the characteristics of the disease.

Write down questions you may have before the visit. Examples of questions you can ask are:

  • Is the cancer gone?
  • Do I need additional treatment? If so, what options are relevant for me?
  • What tests do I need before the follow-up visits?
  • How will the treatment and the prostate cancer affect my quality of life?

It is important that you continue to attend these visits. During these, the doctor monitors your health and can detect possible tumour recurrence on time. It is also important to tell your doctor if you notice any new symptoms that may be related to prostate cancer. If you notice any symptoms before the visit, do not hesitate to contact your health care team.

Lifestyle advice

It is important to maintain a healthy lifestyle during and after treatment. Try to get physical exercise regularly. Find an activity that you enjoy doing. If you have doubts about what you can do, ask your doctor to refer you to a physiotherapist.

Try to eat a balanced diet with a mix of vegetables, fruit, and dairy. Also include starchy food like bread and potatoes, rice or pasta, and protein-rich food like meat, fish, eggs, or legumes. Try to eat less sugar, salt, and fatty food. If you have any questions, ask your doctor to refer you to a dietician.

Try to stop smoking. It may help you recover faster after treatment.

Psychological support

After the surgery you may worry about your prognosis, the impact of cancer on your social or financial situation, or other issues.

It is common to worry about the cancer coming back. Most people who have been diagnosed with cancer, or their loved ones, will probably have these worries and thoughts. If you feel worried, contact your doctor and find out the risk of cancer recurrence. You can also ask the doctor about psychological support if you feel you need to have someone to talk to. A patient organization can also offer support.

During treatment you will be away from your work. Talk to your boss about the best way for you to get back to work. Perhaps you could work part time, or in a different function.

Discuss the possible financial consequences of your treatment with your health care team. They might be able to direct you to people or places where you can get advice about your economic situation or even financial help.

The side effects of the treatment can make it difficult to fully participate in social and economic life. Changes in your daily life as a result of the disease or the treatment can lead to isolation. Talk to your doctor or nurse. They can help you find the support and treatment you need.

A cancer diagnosis can make you look at life in a different way and you may realise you now have different priorities. This can affect your work or relationships and can make you feel disoriented and uncertain. Talk to family and friends and take all the time you need for this process. If you do not feel comfortable addressing these issues with those close to you, you can ask your health care team for a referral to a psychologist. The psychologist can give you the tools to deal with these feelings and help you to realise the changes you want or need.

Cancer treatment can affect your sexuality. Feelings of depression and fatigue can also have a negative effect on your sex life. It is important that you talk to your partner about your feelings. There are many ways in which you can be intimate. If it is difficult for you to be sexually active, be near each other, touch each other, give and take hugs, and just sit or lay down close to each other.

Support for family and friends

A cancer diagnosis not only affects the patient, but also the people around them. As a loved one, you can offer support in many different ways. Sometimes you can help with practical things like laundry, gardening, or grocery shopping.

It may also be helpful to go to the doctor together. You could offer to drive to the visit or help formulate questions to ask during consultation. Being there for the consult can also be good. You may remember different things or focus on other details, which you can later discuss together. You could also ask the doctor how the treatment may impact your lives in terms of caregiving and psychological effects.

The diagnosis and treatment can be very emotional for everybody involved. Cancer treatment is intense and your life may change suddenly. Questions about prognosis, effects of the treatment, and even the possibility of dying may come up. As a friend or loved one you can be there and listen. You don’t need to have the answers.

If you feel you need somebody to talk to, approach your family doctor or the medical team to get support. Patient organizations also offer support for family members or friends of people who have been diagnosed with cancer.

Support for partners

A cancer diagnosis can put pressure on your relationship. Often talking to each other becomes more difficult because of the time and energy spent on treatment. You could decide to discuss any difficulties with a therapist.

You may experience a similar degree of stress, anger, and depression as your partner. You could feel exhausted, both physically and emotionally. This can be a result of the responsibilities of caring for your partner, and taking on extra tasks around the house. Be sure to make time for yourself and think about your own needs and wishes.

Your partner’s cancer treatment can affect your sex life. Try to talk to your partner about your feelings. There are many ways in which you can be intimate. Be near each other, touch each other, give and take hugs, and just sit or lay down close to each other.

It is normal to worry about being left alone. If you feel you need somebody to talk to, approach your family doctor or your spiritual advisor. Patient organizations also offer support for partners.

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