In helping patients choose the best prostate cancer treatment, several factors are taken by doctors into consideration. These factors include the patient’s age, his health condition, the stage and grade of the cancer, other diseases that the patient might have and possible side effects.
It is a sad reality that even the best prostate cancer treatment can have side effects. For each therapeutic option, there usually exists a corresponding side effect. It is important for every patient and doctor to know the possible ramifications of treatment procedures, be it surgical, radiation-based, chemotherapy, hormonal or cryosurgery.
Surgical procedures for treating prostate cancer include radical retropubic prostatectomy, radical perineal prostatectomy, laparoscopic radical prostatectomy and transurethral resection. The risks associated with radical prostatectomy include anesthetic risks, heart attack, stroke, blood clots in the legs and lungs and infection at the incision site. Major side effects of surgical procedures can also include urinary incontinence, impotence, sterility and lymphadema. Lymphadema is a rare complication characterized by swelling and pain particularly in the legs and the genital area. This is caused by fluid collection due to the removal of lymph nodes.
When it comes to external beam radiation therapy (EBRT), the most notable side effects reported by researchers are bowel problems, bladder problems, incontinence, impotence, and in some cases, fatigue. Lymphadema is also possible after EBRT. Brachytherapy, or internal radiation therapy, carries some of the side effects also associated with EBRT; with bowel problems and frequent urination as the most common. Impotence can also occur although this is not as common with brachytherapy compared with other treatment methods.
The side effects associated with cryosurgery or cryoablation are often worse if the procedure is done on a patient who has already undergone radiation therapy. Men who have had radiation therapy and cryosurgery can sometimes have blood in their urine and experience soreness in the areas where the needles were placed. Swelling of the scrotum and the penis is also possible, and so are impotence and urinary incontinence. In some cases, a fistula or abnormal opening or connection between the rectum and the bladder may occur. This could result to urine leaking into the rectum and may require surgery to repair.
The debate on whether hormone therapy should be started early or used only at the advanced stage has yet to be resolved. The primary problem with the use of hormones is that over time, majority of patients become resistant to this treatment. Aside from this, hormone therapy can also cause impotence, hot flashes and loss of sex drive.
Chemotherapy, just like hormone therapy, is unlikely to result in a cure but is primarily used to slow the growth of the cancer. The main problem with chemotherapy is that it could also damage normal cells. Some of the temporary side effects associated with this procedure include nausea and vomiting, loss of appetite, hair loss, mouth sores, increased risk of infection, bleeding or bruising and blood clots.
Side effects can exist even in the best prostate cancer treatment. The best thing for a patient to do is to discuss these possible risks with his doctor before deciding on the type of treatment or maintenance method.