Survivorship: Living with prostate cancer

Most men diagnosed with prostate cancer will live a good life beyond their diagnosis and treatment. About 95% will survive at least 5 years and 91% will survive 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 the doctor know if there are any changes to your health or symptoms, or concerns about your wellbeing following treatment.

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.

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.

Diet and Nutrition

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 dietary guidelines are valuable for healthy survivorship:

  • eat plenty of vegetables, 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.

Prostate Cancer and Diet is a very helpful resource at the School of Medical and Health Sciences, University of Auckland website. It contains Prostate Cancer and Diet fact sheets, an extensive recipe collection for the Modified Mediterranean Diet, and numerous publications on nutrition and exercise for men with prostate cancer.

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.

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.