Prostate cancer is the most common cancer among men. As the caregiver, often a wife, you’ll probably be helping your man manage his treatment and take care of insurance paperwork. Be sure that if you haven’t done so already, you both have healthcare proxies, a durable power of attorney, and a living will. To navigate the process through each phase, the Prostate Cancer Foundation has partnered with a group called My Bridge 4 Life, which offers online guidance by coaches for $75 a session.
You may be involved in medical decisions. After a diagnosis, patients typically choose among three main treatment options: “watchful waiting,” surgery to remove the prostate, or radiation. Doctors may also offer hormone therapy in combination with other treatments.
Survival rates are similar across these options, but the possible side effects differ. Three years after treatment, up to 15 percent of men who had their prostates removed suffer from urinary incontinence. Similar portions of men who have radiation develop bleeding or incontinence of the bowels. Sexual problems are also common. These include having trouble getting an erection, losing urine during orgasm, or low desire and a less pleasurable orgasm.
Hormones are most likely to cause sexual problems and can lead to weight gain, fatigue, loss of muscle mass and body hair, smaller genitals, depression, or mood swings. No surprise — all of those changes are rough on sexual relationships, and men sometimes find that their sexual fantasy life declines too.
Wives are often less judgmental than their husbands suspect. Be open to direct conversation and show him clearly that you’re not angry or humiliated by changes in your sex life together. You might nudge him to see a counsellor or find other men to confide in. Frank Talk forums cover erectile dysfunction and other sexual issues.
You’ll need to take care of your own health and emotions as well. If your sex life has faded away, ask yourself if you’re okay with that situation before you give up.
A relatively small group of men have tougher cancer cases. Prostate cancer usually responds to hormone treatments, but cancer cells may learn how to grow without testosterone — this is called “castrate-resistant prostate cancer.”
Prostate cancer is “metastatic” if it has spread to the bones, lungs, liver, brain, lymph nodes outside the pelvis, or other organs. It’s uncommon to hear that a prostate cancer is metastatic at the first diagnosis, but it happens. The news may come after completing a round of treatment or many years later.
Men may develop cancers that are both castrate-resistant and metastatic.
New treatments are in the works. You may hear about the vaccine sipuleucel-T (Provenge), which uses a man’s own white blood cells to destroy prostate cancer cells. Research is underway to see if radiation, hormone therapy, or another experimental cancer vaccine called pTVG-HP helps Provenge work better. Scientists are also looking for viruses that could put the immune system to work fighting advanced prostate cancer.
Two relatively new drugs, abiraterone acetate (Zytiga) and enzalutamide (Xtandi) bring testosterone levels down to almost zero, starving the prostate cancer cells. They are approved for men with advanced prostate cancer that resists the ordinary hormone therapy. Blood tests may help doctors predict who will benefit from these drugs.
June 08, 2016
Janet O’Dell, RN