Overview
Most people diagnosed with prostate cancer will live a good life beyond diagnosis and treatment. About 95% of them will survive at least 5 years and 91% 10 years. Survivorship is about making the most of life and dealing with the side effects and ongoing issues that may have been caused by an encounter with this disease. It is very important to let your doctor know if there are any changes to your health, or symptoms, or concerns about your wellbeing following treatment.
Follow-Up Appointments
Following diagnosis and treatment it is inevitable there will be ongoing medical appointments to monitor the condition of the disease. This will likely involve regular PSA tests and possibly further scans and examinations. Men receiving hormone treatment will have a regular (monthly or 3-monthly) appointment for their next treatment. It is normal to feel anxious about upcoming appointments. However if there are no ongoing problems these will usually reduce over time. It may be helpful to keep a notebook of the ongoing appointments, recording details such as PSA levels and any changes to the symptoms.
Prostate Cancer Patient Empowerment Programme
The Prostate Cancer Patient Empowerment Programme (PC-PEP) offers a comprehensive 6-month programme that delivers daily emails and videos to teach and encouage:
- Aerobic exercise and strength training: Guided videos using provided (free) elastic bands to enhance physical fitness;
- Pelvic floor muscle training: Exercises designed to improve urinary control and enhance sexual function;
- Stress reduction techniques: Utilizing a provided (free) heart rate coherence biofeedback device to manage stress effectively;
- Dietary advice:Weekly cooking videos and relationship guidance to promote intimacy and connection;
- Optional social support: Access to a mentor and buddy system, along with monthly video conferences with co-participants, extending beyond the initial 6 months; and
- Local support: Links to local support groups and resources to further assist you on your journey.
The Prostate Cancer Foundation is proud to have partnered with the programme developers to deliver PC-PEP in New Zealand. To register your interest in PC-PEP please email pcpep@prostate.org.nz
Urinary Problems
Surgery can affect the ability to control the bladder. It can lead to incontinence (inability to control urination) or leaking urine when coughing or with a sudden movement. Radiation treatment can lead to other problems with urination.
Sometimes men who have had surgery or radiation therapy can experience a slowing of their urine stream and a feeling they are not able to completely empty their bladder. In rare cases, men who have had radiation therapy may also experience blood in the urine. Sometimes it can be due to the prostate cancer treatment, but it can also be a sign of other health issues that should be investigated.
Pelvic floor exercises before and after treatment can reduce the risk of incontinence. A specialist continence nurse or pelvic floor physiotherapist can help men manage incontinence. If severe incontinence continues long term other surgical treatments such as a “sling” or artificial urinary sphincter can be inserted to assist with bladder control. In some cases the cost of this can be covered by ACC.
It is important to report any changes or concerns about your urinary symptoms to your healthcare team. You may also find it helpful to visit Continence NZ and watch the following video Continence and Prostate.
Bowel Problems
Bowel problems may result from radiation therapy treatment both during the treatment and also longer term following treatment. Often this occurs as a change in normal bowel function including diarrhoea, bloating and more flatulence (gas). It may also result in bowel incontinence and a lack of control over bowel function. Occasionally there may be bleeding from the rectum.
Any changes or concerns should be discussed with the treating clinicians as, while they are typical side effects from prostate cancer treatment, they can also be associated with other conditions that should be checked out, usually with a colonoscopy. Sometimes simply making lifestyle and dietary changes may provide relief to these side effects.
Incontinence
Incontinence refers to the accidental leaking of urine, which often happens during physical activity. The volume of urine leaking can vary from a small to a large amount. Understandably, most men find it highly embarrassing and difficult to talk about, even with their partners.
Bladder weakness, or urinary incontinence, is experienced by many men following surgery for prostate cancer. This is a common problem, however many men find this the biggest challenge they have to cope with during the recovery process.
Many think that they must manage their incontinence by themselves and feel frustrated and alone in trying to deal with the problem. Men are also often anxious about others knowing about their condition and may avoid social activities in case they risk being 'found out'.
It is important to report any changes or concerns about your urinary symptoms to your healthcare team.
You may also find it helpful to visit Continence NZ and watch the following video Continence and Prostate.
Urinary Problems
Surgery can affect the ability to control the bladder. It can lead to incontinence (inability to control urination) or leaking urine when coughing or with a sudden movement. Radiation treatment can lead to other problems with urination.
Sometimes men who have had surgery or radiation therapy can experience a slowing of their urine stream and a feeling they are not able to completely empty their bladder. In rare cases, men who have had radiation therapy may also experience blood in the urine. Sometimes it can be due to the prostate cancer treatment, but it can also be a sign of other health issues that should be investigated.
Pelvic floor exercises before and after treatment can reduce the risk of incontinence. A specialist continence nurse or pelvic floor physiotherapist can help men manage incontinence. If severe incontinence continues long term other surgical treatments such as a “sling” or artificial urinary sphincter can be inserted to assist with bladder control. In some cases, the cost of this can be covered by ACC.
It is important to report any changes or concerns about your urinary symptoms to your healthcare team. You may also find it helpful to visit Continence NZ and watch the following video Continence and Prostate.
Bowel Problems
Bowel problems may result from radiation therapy treatment both during the treatment and also longer term following treatment. Often this occurs as a change in normal bowel function including diarrhoea, bloating and more flatulence (gas). It may also result in bowel incontinence and a lack of control over bowel function. Occasionally there may be bleeding from the rectum.
Any changes or concerns should be discussed with the treating clinicians as, while they are typical side effects from prostate cancer treatment, they can also be associated with other conditions that should be checked out, usually with a colonoscopy. Sometimes simply making lifestyle and dietary changes may provide relief to these side effects.
Living Well
Emotional Distress
Being diagnosed with prostate cancer is a major stress for men and those close to them and inevitably leads to a range of emotions such as anxiety, anger, fear and frustration. A sudden diagnosis can threaten a man’s emotional equilibrium and cause a re-think of plans for the future. This can also result in physical symptoms such as trouble sleeping, nausea and feeling irritable.
It is important to recognise these as a normal reaction that many men have experienced going through a similar journey. Each person has their own way of dealing with these issues but it is important to share those struggles with family and close and trusted friends. Discuss this also with those in the healthcare team so they can provide help, and if necessary make referrals for professional help.
Living with prostate cancer doesn’t stop when the treatment is finished. Being a cancer survivor comes with its own challenges. Men might feel sad, worried that the cancer will come back, or pressured to return to their normal life. These emotions are normal. It will take time to adjust to the “new normal” of living beyond a cancer diagnosis.
Support groups organised by the Prostate Cancer Foundation can provide a good opportunity for men, and their partners, to meet others and share their concerns in a supporting environment.
Diet and Nutrition
Publications and the web are overflowing with stories about how this food, or that, can prevent or cure. There is growing evidence that eating a healthy, balanced diet can help in the recovery and enhance the effectiveness of the treatments for prostate cancer. A healthy, balanced diet will keep men strong and along with good physical activity can achieve and maintain a healthy weight.
The following general dietary guidelines are valuable for healthy survivorship:
- eat plenty of vegetables incl. cruciferous, legumes, beans and fruit
- eat wholegrain foods such as bread, pasta, rice and noodles
- eat lean meat, fish and poultry as well as other protein sources such as tofu, milk, yoghurt and cheese
- avoid diets high in animal fats
- drink plenty of water
- limit saturated fat such as biscuits, cakes, pies and processed meats
- limit added salt
- limit added sugars such as confectionery and sugar-sweetened soft drinks
- limit alcohol
- cease smoking.
Useful Links:
- The Mediterranean Diet Information Sheet is a helpful resource from the School of Medical and Health Sciences, University of Auckland . It outlines the main features and dietary patterns of people living in countries bordering the Mediterranean Sea, populations which have a lower incidence of prostate cancer. If also contains a summary of research and references which may be useful for further reading.
- You may also like to visit The Manual: Diet and prostate cancer at Prostate Cancer UK’s website
- The role of diet in prostate cancer - a PCFNZ National Conference 2023 Presentation
Among the line up of expert speakers running the full spectrum of important issues in the prostate cancer landscape at National Conference 2023 was Professor Richard Mithen, Interim Director and Professor of Nutrition at the Liggins Institute of the University of Auckland, and Chief Scientist for the New Zealand High Value Nutrition National Challenge. Professor Mithen's research is focused on plant chemistry and human health, with a specific focus on the role of diet in the prevention of aggressive prostate cancer and neurodegenerative disease. View Professor Mithen's presentation here
Fatigue
Fatigue (feeling very tired) can be caused by hormone therapy or chemotherapy drugs. Bladder problems after surgery or radiation therapy may mean men keep getting up to go to the toilet at night, which can lead to ongoing tiredness.
Having a fatigue management plan can help men cope. This might include getting more rest during the day, adjusting activities so important things are done when energy levels are higher, doing some exercise, and accepting help from others.
Physical Activity and Exercise
Physical activity and exercise are very important as part of the recovery and ongoing wellbeing of men with prostate cancer. It is important to exercise most, or if possible, every day. Exercise can enhance survivorship and improve quality of life and help with anxiety and depression.
The most effective forms of exercise are fast walking, swimming, jogging and cycling as they workout the cardiorespiratory system. Resistance exercise such as lifting weights, climbing stairs and high intensity resistance workouts are also very valuable for building and maintaining muscle conditioning.
Prost-FIT is an exercise programme supported by the Foundation and designed specifically for men living with prostate cancer, at any stage of diagnosis or treatment. There is evidence that targeted exercise may slow the progression of the disease and reduce the side effects of treatment such as hormone therapy.
