Advanced Prostate Cancer Treatment: Side Effects

The medicines you take to treat advanced prostate cancer are strong. They can cause side effects, but there are lots of ways to manage them.
Remember, you need to let your doctor know what's going on with you. He may be able to adjust your doses or switch your treatments, and that can make a difference.

Incontinence

When you laugh, cough, or sneeze, you may leak urine or find that you can't control its flow. This can happen after you have surgery to remove your prostate, as well as from radiation therapy.
Try these tips:

• Cut back on or avoid alcohol and caffeine.
• Do Kegel exercises to strengthen the muscles that control the flow of urine.

Infertility

This may happen after some treatments for prostate cancer, such as:

• Surgery to remove your prostate gland
• Radiation of your pelvis
• Chemotherapy

Because infertility may be permanent, if you want to have children in the future you should talk to your doctor about banking your sperm.

Hormonal Changes

You may need to take medicines to lower your levels of testosterone and other male sex hormones because those hormones can fuel the growth of your cancer. There are side effects, but also ways to deal with these problems.
During treatment, you may:

• Gain weight
• Develop breasts or have tenderness
• Feel depressed
• Lose muscle mass
• Develop weaker bones
• Have hot flashes

When your testosterone levels are low, you may also be more likely than other men to have:

• Diabetes
• Heart attack
• High blood pressure

You can control many of the symptoms with medication and lifestyle changes. Dietary supplements, such as calcium and vitamin D, along with exercise and weight training, can help boost bone strength.
Those hormonal changes are reversible. So if you don't like how it makes you feel, let your doctor know in case you could switch medicines.

Erectile Dysfunction (ED)

Several treatments for advanced prostate cancer can cause ED, including:

• Surgery
• Hormone therapy
• Radiation to the prostate

You can take care of your ED with medicine and other treatments:

• Sildenafil (Viagra)
• Tadalafil (Cialis)
• Vardenafil (Levitra)
• Penile injectable medications such as alprostadil (Caverject Impulse, Edex)
• Vacuum pump. It's a device that uses suction to achieve an erection and an elastic ring to maintain it.
• Penile implants

Diarrhea

You can get this from:

• Hormone therapy, especially the combination of luteinizing hormone-releasing hormone (LHRH) agonists and anti-androgen therapies
• Chemotherapy
• Radiation to the prostate. This is less common with newer, focused techniques.

To ease the symptoms, drink 8 to 12 cups of clear liquids every day, such as:

• Water
• Apple juice
• Sports drinks

Also, change your diet. Eat five to six small meals a day rather than three large ones. And try foods that are easy on the stomach, such as:

• Skinless broiled or baked chicken
• Rice
• Boiled potatoes

Avoid things that can irritate your intestines, such as:

• Milk and dairy products
• Spicy foods
• Caffeine
• High-fiber foods
• Greasy foods

Ask your doctor if you need any supplements.

Fatigue

The cancer or some treatments for it, like radiation, hormone therapy, chemo, or vaccines, can make you feel wiped out. You can get some energy back if you:

• Exercise every day.
• Eat nutritious food and stay hydrated.
• Get enough rest.
• Focus on your most important tasks and delegate the rest to friends and family.

If your cancer treatment gives you anemia (low red blood cell counts), you may also feel tired. Your doctor may suggest supplements, drugs, or blood transfusions to help.

Nausea and Vomiting

This often happens during chemotherapy and may also be a side effect of vaccine therapy. Try these tips:

• Eat a light meal on treatment days.
• Stick to foods and drinks that are easy on the stomach.
• Wear loose-fitting clothes.
• Talk to your doctor about drugs you can take before your treatment to help prevent and control nausea and vomiting. If one doesn't work, try another.

Also, ask your doctor about complementary treatments, such as:

• Acupuncture
• Hypnosis
• Biofeedback
• Guided imagery

They may also help manage side effects.

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