Frequently Asked Questions About Prostate Cancer


General Q&A

Q: How common is prostate cancer?
Prostate cancer affects 1 in 6 men. About 241,740 new cases of prostate cancer were diagnosed in 2012-on par with breast cancer. It is estimated that there are more than 2 million American men currently living with prostate cancer.

Q: Are some men more likely to be diagnosed with prostate cancer?
Older age, African American race, and a family history of the disease can all increase the likelihood of a man being diagnosed with the disease. In fact, African-American men have the highest rate of prostate cancer in the world: 1 in 4 men. Further, as men increase in age, their risk of developing prostate cancer increases exponentially.

Q: How much does family history of prostate cancer increase the risk for it?
For men with a primary relative with prostate cancer (a brother or a father), the risk is two-fold higher. Men with familial prostate cancer may develop the disease at an earlier age, so screening should be considered as early as age 35-40.

Q: How curable is prostate cancer?
In general, the earlier the cancer is caught, the more likely it is for the patient to remain disease-free. Because approximately 90% of all prostate cancers are detected in the local and regional stages, the cure rate for prostate cancer is very high-nearly 100% of men diagnosed at this stage will be disease-free after five years.

Q: What are the symptoms of prostate cancer?
If the cancer is caught at its earliest stages, most men will not experience any symptoms. Some men, however, will experience symptoms such as frequent, hesitant, or burning urination, difficulty in having an erection, or pain or stiffness in the lower back, hips or upper thighs.

Q: What are the screening recommendations for men at risk for developing prostate cancer?

The prostate cancer specialists at Chesapeake Urology have put together a recommendation for PSA screening for men - click here to read Chesapeake Urology's PSA screening recommendation.

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Recovery after treatment

Q: Is it normal for a patient to feel anxious or depressed after prostate cancer surgery?
It's natural for a man to feel anxious and/or depressed. However, these feelings pass with time, as men resume their regular activities and lives.

Q: What are some of the side effects from removing a prostate?
The two most feared side effects of radical prostatectomy are loss of erections and urinary incontinence. These side effects can occur but there are successful treatment options available. Also, after total removal of the prostate, there is little, if any, ejaculate, although there is the sensation of climax and orgasm.

Q: Will I still be able to exercise after discharge from the hospital?
During the first month or two of recovery, the body is repairing the physical trauma caused by the surgery and the incision(s) is also healing. You should refrain from physical activities that place a stress or strain on the abdominal and pelvic regions of the body. Your physician will instruct you as to when it's safe to return to your normal exercise routine.

Q: Are there any exercises that can be done before and after prostate surgery?
In addition to Kegel exercises; walking, biking, and swimming are beneficial to cardiovascular and general health. Good physical conditioning is helpful in recovery from prostate cancer surgery.

Q: Once a prostate gland has been removed because of cancer, can diet help prevent the cancer from recurring?
Nobody knows for certain, but good nutrition is important to overall health and well being.

Q: What kind of follow-up is recommended after a radical prostatectomy?
With any cancer, not only prostate cancer, there's always a possibility that the cancer can come back. Your doctor will let you know how often you should be seen following your prostatectomy.
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Incontinence

Q: It's been 6 months since my prostatectomy and I still have no control of my bladder. What can I do?
Although some patients continue to have improvement in continence for up to 12 months after surgery, the general consensus is that if there is no return of urine control after one year, further intervention is needed. While it has not been 12 months since your surgery an artificial urinary sphincter (AUS) or AdVance® Male Sling could dramatically improve the quality of your life. You may want to see a surgeon who specializes in these types of restorative surgeries.

Q: Is urinary incontinence an inevitable part of life after prostate cancer?
While many men experience some form of urinary incontinence following prostate cancer treatment, the good news is, 90 to 95% of men do regain their continence with time without the need for additional surgery. 
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Sexual health

Q; When will erections return after a nerve-sparing prostatectomy?
Erections usually begin to return as partial erections 3 to 6 months after surgery and then continue to improve for about 12 months after surgery, as the nerves recover from the trauma of surgery. Despite expert application of the nerve-sparing prostatectomy technique, early recovery of natural erectile function is uncommon. Even when the nerve-sparing surgery is performed with meticulous technique, patients generally do not recover erectile function as quickly as they do urinary continence.

Q: Why does it take so long to recover potency?
A number of explanations have been proposed for this phenomenon of delayed recovery, including mechanically induced nerve stretching that may occur (during the operation), thermal damage to nerve tissue caused by cauterization during surgical dissection, injury to nerve tissue amid attempts to control surgical bleeding, and local inflammatory affects associated with surgical trauma.

Q: Why don't all men recover erectile function after nerve-sparing surgery?
The most obvious determinant of post-operative erectile function is how potent the man was prior to the operation. Post-operative erectile dysfunction is compounded in some patients by preexisting risk factors that include: older age, cardiovascular disease, diabetes, cigarette smoking, alcohol abuse, physical inactivity and certain medications such as anti-hypertensive drugs.

Q: What is penile reconditioning or penile rehabilitation?
The relatively new strategy of rehabilitation in clinical management after prostate cancer treatment comes from the idea that early-induced sexual stimulation and blood flow in the penis may facilitate the return of natural erectile function and resumption o normal spontaneous sexual activity. Some experts in erectile dysfunction now believe that taking agents such as Viagra,® Levitra,® or Cialis® will hasten the return of erections. Alternatively, vacuum erection devices, MUSE suppositories, or penile injections can produce good erections in some patients.

Q: When is it safe for a man to resume sexual activity after a prostate cancer surgery?
Sexual activity can generally be resumed within 4 to 6 weeks after prostate cancer surgery, but check with your doctor. Most patients tend to resume sexual activity as soon as they feel an interest and when their urinary control is adequate for sexual activity. For those men who have return of erections, it is a gradual process. Many men, however, do experience improvement over the first year after the operation. The stimuli for erection during the first year will also be different. Visual stimuli will be less effective, and physical stimulation will be more effective. For this reason, do not be afraid to experiment with sexual activity. Re-familiarize yourself with your body. You can do no harm. Do not wait until you have the "perfect erection" before attempting intercourse. In addition, you should be able to have an orgasm even if you do not have an erection. With orgasm, there will not be ejaculation because the prostate and seminal vesicles have been removed. There are many successful erectile dysfunction treatment options available. Become familiar with them and let your health care provider know you would like to begin treatment as soon as possible.

Q: Is it normal to have pain with return of sexual activity?
It is not uncommon to have pain with orgasm after a radical prostatectomy. This pain occurs because the deep pelvic muscles have not completely recovered from the trauma of surgery.

Q: Will I still be fertile after a radical prostatectomy?
There is no seminal fluid after the prostatectomy, so you will no longer be fertile or able to father children.

Q: I've tried the "pills," vacuum device, suppositories and injections and nothing worked for my erectile dysfunction. Is there anything else available for me?
Penile implants are an excellent, safe, surgical treatment option, have a high degree of patient satisfaction and provide a very natural erection. Ask your doctor to provide you with more information about this option.
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