Improved prostate cancer treatments are enabling physicians to cure most of the one in nine American men diagnosed with prostate cancer. But even with lifesaving medical care available, men still worry about how the possible side-effects of their prostate cancer treatment - from sexual dysfunction to temporary incontinence and rectal problems - will affect their overall quality of life and the intimate relationship they have with their partner. To offer men recovering from prostate cancer a better understanding of what they may face, physicians at the University of Michigan Health System are leading a national study to examine how prostate cancer treatments may affect a couple's intimacy and quality of life.
For Leo Maguire, his diagnosis of prostate cancer and subsequent treatment earlier this year left him cancer-free and did not compromise the physical intimacy he shares with his wife, Elva. But even with a positive outcome, Maguire admits he was initially concerned about what his life would be like following surgery.
"You hear the word 'cancer' and chills go right up and down your back," says Maguire. He wondered if he was "going to be one of those studs turned out to pasture" following treatment and if he would still have a chance at a normal, active life with his wife, he recalls.
Maguire's concerns are often shared by many of the patients who have been diagnosed with prostate cancer and must make a difficult choice between various surgery options, radiation therapy, radioactive seed implants or watchful waiting explains Martin Sanda, associate director for the UMHS Prostate Cancer Program.
"When men are diagnosed with prostate cancer, they often are concerned or become somewhat anxious about the possible side-effects of prostate cancer treatments," says Sanda. "The side-effects men often fear involve their sexuality, urinary functioning or possible rectum symptoms. And these are concerns that weigh heavily on a man who's been diagnosed with prostate cancer."
Misconceptions about the severity and longevity of those side effects, too, may prevent a man from proceeding with appropriate treatment, says Sanda.
"In some cases, men may turn to new and untested prostate cancer treatments under the erroneous assumption that something new will be better than refined surgical or radiation techniques that have been improved through years of experience," he says.
For example, surgery side-effects like urinary leakage or incontinence can be common initially following the procedure. However, those side-effects are usually only temporary, and how long they last may vary from one individual to another. In fact, the majority of men do recover their urinary control several months after surgery.
In contrast, radiation side-effects on sexuality or bowel functioning can develop over several months or years. Seed implants, once touted as symptom-free when they were first introduced, are now known to be associated with similar side-effects as those seen after either external radiation or surgery, says Sanda.
Sanda hopes that by conducting a national study on quality of life after prostate cancer treatment with several leading medical centers, they will be able to correct some of the misinformation about refined existing treatments, and place the untested promises of newer treatments in the appropriate context.
The study will monitor the men and their partners' quality of life following treatment, and carefully measure how the patients are doing at the time they started their prostate cancer treatment, from the perspective of other health concerns.
The information gathered from the study will help better inform patients who are facing prostate cancer treatment about what outcomes they can expect in terms of their sexuality and urinary, bowel and rectal functioning following treatment.
"After prostate cancer treatment, men and their partners can certainly look forward to resuming their sexuality, to having fulfillment and pleasure in their sex life, and having other aspects of their quality of life aside from sexuality, returned to the same levels before their treatment," says Sanda.
"In terms of their sexuality, men may need to make some adjustments or accommodations," he continues. "But the ability to get some pleasure out of sex and to enjoy each other certainly is something that most men can look forward to after their prostate cancer treatment."
Setting quality of life goals and having a positive attitude following treatment can also make living with and overcoming side effects much easier, says Maguire, who experienced incontinence for a short time after his surgery. Within a few days after his surgery, Maguire was able to return to work and even attended a horse show because he learned how to manage his incontinence. Three months later, he was riding a horse again and driving cattle in Montana.
"I've found that after surgery, life goes on, and that desire and capability are still there too," says Maguire. "You've got to take a positive attitude and handle the situation the best you can."
