My Husband Has Prostate Cancer

Where Prostate Cancer Spreads

If left untreated, diagnosed prostate cancer can grow and possibly spread outside of the prostate to local tissues or distantly to other sites in the body. The first sites of spread are typically to the nearby tissues.

The cancer can spread down the blood vessels, lymphatic channels, or nerves that enter and exit the prostate, or cancer could erode directly through the capsule that surrounds the prostate.

The seminal vesicles are a site of particularly common early spread. More extensive local spread can occur with cancer invading the nearby bladder or rectum.

Further advancement of cancer can occur when cancer cells enter the blood vessels and lymphatic channels. Once cancer has entered into these vessels, prostate cancer cells can seed into virtually any other part of the body.

Prostate cancer is known to have a particular affinity for spreading or metastasizing to the bones especially the lower spine, pelvis, and femur. Other organs such as the liver, brain, or lungs can also be the sites of spread, but these are much rarer.

Questions To Ask About Having Hormonal Therapy

• What type of hormonal therapy do you recommend?

• What is the goal of this treatment?

• How will this treatment be given?

• Will I receive this treatment at a hospital or clinic? Or will I take it at home?

• How long will I need to continue this treatment?

• What side effects can I expect during treatment?

• Who should I contact about any side effects I experience? And how soon?

• What are the possible long-term effects of having this treatment?

• What can be done to relieve the side effects?

Questions To Ask About Having Radiation Therapy

• What type of treatment is recommended?

• Where will the radiation be focused?

• What is the goal of this treatment?

• How long will it take to give this treatment?

• What side effects can I expect during treatment?

• Who should I contact about any side effects I experience? And how soon?

• What are the possible long-term effects of having this treatment?

• What can be done to relieve the side effects?

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Will Treatment Cause Erectile Dysfunction

When youre sexually excited, nerves cause tissues in your penis to relax, allowing blood to flow into the organ. The nerves that control erection are very delicate. Surgery or radiation for prostate cancer may damage them enough to cause ED. When you have ED, you cant get or keep an erection.

Radical prostatectomy is a surgery to remove the prostate gland. When your surgeon removes the gland, they may damage the nerves and blood vessels that run along it. If theyre damaged enough, you wont be able to get an erection following the procedure.

Today, doctors can do nerve-sparing surgery, which helps prevent permanent ED. Your surgeon can still touch those nerves and blood vessels, causing ED as a temporary side effect. Many men have trouble getting an erection for a few weeks, months, or even years after their procedure.

Radiation therapy also damages blood vessels and the nerves that control erection. Up to half of men who have radiation for prostate cancer experience ED afterward. In some men, this symptom will improve with time. Sometimes radiation side effects dont appear until a few months after the treatment. If ED starts late, it may not be as likely to go away.

A few treatments can help with ED until youre able to have erections on your own again.

Additional treatments include the following:

What Happens Without Treatment

Physicians will sometimes talk about a particular diseases natural history or typical progression if it is left untreated indefinitely.

With regard to prostate cancer, most cases of the disease are discovered while the cancer is still confined to the prostate itself. This is called local disease or localized disease.

The disease is easiest to treat while it is confined to the prostate. At this stage, surgery and radiation are most likely to be curative and completely kill or remove whatever cancer cells are present.

If left untreated, however, prostate cancer can proceed on a number of different paths.

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So Why Are We Talking About This Now

My husband and I know a lot more about prostate cancer than we did a couple of years ago. For one thing, we know that it is one of the most common male cancers. We also know that while this is his cancer, going through this experience has had an impact on our life as a couple.

Im writing about this now because the chances of a Beyond 50 woman learning that her beloved has been diagnosed with prostate cancer are significant. We hope our experience will be of help to others who will be facing the same situation.

Questions To Ask About Having Therapy Using Medication

• What type of treatment do you recommend?

• What is the goal of this treatment?

• How will this treatment be given?

• How long will it take to give this treatment?

• Will I receive this treatment at a hospital or clinic? Or will I take it at home?

• What side effects can I expect during treatment?

• Who should I contact about any side effects I experience? And how soon?

• What are the possible long-term effects of having this treatment?

• What can be done to relieve the side effects?

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Our Lives Have Changed Forever

Cancer has changed our lives forever. In some ways, our lives have changed for the better. You wouldnt think a person with a loved one who has terminal cancer would say that, huh? Well, for this moment it is true. We are eating healthier, most of the time. Occasionally, we still eat junk food but, trust me we are much more aware what goes into our bodies. We planted a garden! I do not have a green thumb but, I am trying! It is kind of nice to go out there every day and water the garden. We also planted pear trees! hehe I planted four! My husband is like, What are we going to do with all those pears?! I told him not to worry, I am sure I will kill at least three of the trees.

We are traveling and doing more. You quickly realize that tomorrow is really not guaranteed in any way. I know, this is true for everybody. Any of us can die in a car wreck, heart attack, stroke, robbery, bad weather, and so on. But, when a doctor tells you there are only 8 years left, it makes it so much more real! Travis loves kayaking and I try to encourage him to go as often as he wants. We have started hanging out with friends more often and going down to the beaches close to us every chance we get. We are currently planning a family vacation. Travis and I are actually going somewhere for our anniversary this year! We never had a honeymoon.

How To Make The Right Treatment Decision

Current expert guidelines for treatment of localized prostate carcinoma recommend potentially curative therapy for patients whose life expectancy is at least 10 years., Patients with limited life expectancy are more likely to die from health conditions other than prostate cancer. Men with a life expectancy of more than 10 years are more likely to die from progressive prostate cancer. This 10-year rule enjoys broad acceptance among urologists and radiation oncologists.,

Conservative management proved to be an acceptable treatment option for men with low-grade Gleason scores, clinically localized disease, and life expectancies of less than 10 years. Increasing age was described as a risk factor for receiving inadequate treatment for prostate cancer. Thus, older men have been shown to receive potentially curative therapy less often than younger men., Radical prostatectomy is preferred treatment in men younger than 70 years, whereas radiation therapy is applied predominantly in patients older than 70 years. Conservative therapy such as watchful waiting or androgen deprivation by luteinizing hormone-releasing hormone analogs is preferentially applied in men older than 80 years. Watchful waiting or hormonal therapy is used to treat 82% of men older than 80 years.

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Soreness In The Groin

When prostate cancer spreads, its common for cancer cells to go to your lymph nodes and then move to more areas of your body. The lymph nodes are a network of glands that help your body filter fluids and fight infections.

There are several lymph nodes in your groin. These are the ones closest to your prostate, so its common for the cancer to spread to them first. Cancer cells prevent your lymph nodes from draining fluid and working properly. When this happens, your lymph nodes swell. As a result, you might experience pain or soreness in the area.

What Kind Of Treatment Will I Need

There are many ways to treat prostate cancer. The main kinds of treatment are observation, active surveillance, surgery, radiation, hormone therapy, and chemo. Sometimes more than one kind of treatment is used.

The treatment thats best for you will depend on:

• Your age
• Any other health problems you might have
• The stage and grade of the cancer
• Your feelings about the need to treat the cancer
• The chance that treatment will cure the cancer or help in some way
• Your feelings about the side effects that might come with treatment

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Watchful Waiting And Active Surveillance

Watchful waiting is an adequate approach in patients who are at low risk of death from prostate cancer because of their limited life expectancy due to severe comorbidities., Watchful waiting resulted in similar overall survival when compared with radical prostatectomy, but disease-specific survival was better in patients who had undergone surgery. For some patients it turns out to be hard to persist on a watchful waiting policy, and many men drop out and seek active treatment within several years, mostly when PSA elevation is noted.

Active surveillance is a novel and fascinating approach to distinguish between patients who are at higher risk and need active therapy and patients who are at low risk for disease progression., This approach avoids the risks of therapy while allowing early detection of those patients who are prone to progress. In these high-risk individuals, delayed active treatment is offered. Periodic monitoring of the PSA serum level, digital rectal exam, and repeated prostate biopsies are performed in patients who are on active surveillance, and active therapy is started when predefined threshold values are reached. This concept makes it possible to offer curative treatment to individuals who are at high risk for disease progression as indicated by active surveillance parameters.

Nurturing Your Relationship And Sex Life

Prostate cancer can touch some of the most private areas of your life. Treatment often involves hormone therapy, which is designed to interfere with the hormones that can fuel the growth of prostate cancer. Side effects of this treatment can include a decline in sexual performance, libido, and erectile function.

At this most difficult time for you as a couple, theres a sense of robbery, that the illness has taken away intimacy, and specifically, sexual intimacy, says Morris. Theres a real struggle to recover the sense of a life together, and how to be intimate without having sex. Even if you find a way to regain erections, libido is still lower on hormone therapy than without hormone therapy.

Morris suggests that couples find other ways to express intimacy if, for example, intercourse is no longer possible. Physical contact hugging and caressing can help you and your partner feel close even in the absence of the sex life you may once have had. Working with a sex therapist or couples counselor can also help you and your partner find ways to address sexual or relationship problems you may be facing.

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How Can You Talk To Your Partner About Prostate Cancer Risk

Theres really only one thing you can do: equip your husband with the knowledge you now know about risk factors. Hopefully, this can help convince him to see the doctor.

You can start by telling him some of these prostate cancer statistics:

• Prostate cancer is thethird leading cause of cancer death in American men, and nearly 1 in 39 men die of prostate cancer.
• There were161,360 new estimated cases of prostate cancer in 2017.
• In 2017, there were approximately26,730 prostate cancer deaths. This accounts for about 4.4% of all cancer deaths in 2017.
• Theres a12.9% probability of developing prostate cancer.

Thats the scare tactic.

But what if now hes too scared to go to the doctor and face the facts. Its not uncommon for men to avoid going to the doctor if they think something is wrong, because they dont want to deal with the negative consequences of it.

Your husband doesnt want to hear he has cancer.

So you could also try the encouraging tactic:

• Between 2007 and 2013,the average survival rate of prostate cancer was 98.6%.
• Even though theres a 12.9% probability of developing prostate cancer, theres only a2.5% chance of dying from it.

Maybe hes more willing to go now. He wont die! But hes still a little fearful of the tests.

The preliminary tests for prostate cancer are easy peasy.

Its important to track PSA over time. Consistent tests can track how fast the level is increasing or changing. The change in PSA is often more important than the number.

How Often Do Men Get Diagnosed With Prostate Cancer

What can happen? About 1 out of every 7 men will be diagnosed with prostate cancer in his lifetime, making it the most common cancer in men. Prostate cancer affects the walnut-shaped gland that wraps around a mans urethra. Treatments like surgery, radiation, and hormone therapy remove or destroy the cancer.

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Why Does Prostate Cancer Happen

The causes of prostate cancer are largely unknown. But certain things can increase your risk of developing the condition.

The chances of developing prostate cancer increase as you get older. Most cases develop in men aged 50 or older.

For reasons not yet understood, prostate cancer is more common in men of African-Caribbean or African descent, and less common in Asian men.

Men whose father or brother were affected by prostate cancer are at slightly increased risk themselves.

Recent research also suggests that obesity increases the risk of prostate cancer.

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Second Cancers After Prostate Cancer

Prostate cancer survivors can be affected by a number of health problems, but often a major concern is facing cancer again. Cancer that comes back after treatment is called a recurrence. But some cancer survivors may develop a new, unrelated cancer later. This is called a second cancer.

Unfortunately, being treated for prostate cancer doesnt mean you cant get another cancer. Men who have had prostate cancer can still get the same types of cancers that other men get. In fact, they might be at higher risk for certain types of cancer.

Men who have had prostate cancer can get any type of second cancer, but they have an increased risk of certain cancers, including:

• Acute myeloid leukemia

This risk is probably related to the dose of radiation. Newer methods of giving radiation therapy may have different effects on the risks of a second cancer. Because these methods are newer, the long-term effects have not been studied as well.

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How Serious Is My Cancer

If you have prostate cancer, the doctor will want to find out how far it has spread. This is called the stage of the cancer. You may have heard other people say that their cancer was stage 1 or stage 2. Your doctor will want to find out the stage of your cancer to help decide what types of treatment might be best for you.

The stage is based on the growth or spread of the cancer through the prostate, and if it has spread to other parts of your body. It also includes your blood PSA level and the grade of the cancer. The prostate cancer cells are given a grade, based on how they look under a microscope. Those that look very different from normal cells are given a higher grade and are likely to grow faster. The grade of your cancer might be given as a Gleason score or a Grade Group . Ask your doctor to explain the grade of your cancer. The grade also can helpdecide which treatments might be best for you.

Your cancer can be stage 1, 2, 3, or 4. The lower the number, the less the cancer has spread. A higher number, like stage 4, means a more serious cancer that has spread outside the prostate.

If your cancer hasn’t spread to other parts of the body, it might also be given a risk group. The risk group is based on the extent of the cancer in the prostate, your PSA level, and the results of the prostate biopsy. The risk group can help tell if other tests should be done, and what the best treatment options might be.

Quality Of Life With Advanced Stage Prostate Cancer

Since Huggins and Hodges won a Nobel Prize in 1966 for their work describing the relationship between testosterone and prostate cancer, androgen deprivation has continued to be an important component in the treatment of advanced prostate cancer. It is associated, however, with significant cost in terms of morbidity as well as economics. Side effects of androgen deprivation therapy include hot flashes, osteoporosis, loss of libido or impotence, and psychological effects such as depression, memory difficulties, or emotional lability. Recently Harle and colleagues reported insulin resistance, hyperglycemia, metabolic syndrome, and metabolic complications being associated with castration and thus being responsible for increased cardiovascular mortality in this population.

Because of the palliative nature of androgen ablation, quality of life is an important component of evaluating competing therapies. Intermittent androgen deprivation is one approach to hormonal therapy that has been developed with the aim of minimizing the negative effects of therapy while maximizing clinical benefits and the patients quality of life. It can be used in any clinical situation where continuous androgen deprivation treatment could be applied.

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