Prostate HEALTH WHAT YOU NEED TO KNOW TO

Prostate
HEALTH
W H AT YO U N E E D
TO K N OW TO
M A IN TA IN G O O D
P RO S TATE H E A LTH
Your Prostate
Health
P
roblems with the
prostate (a gland in
the male reproductive
system) become more
common as a man
ages. These problems
include prostate cancer,
a common cancer
in men. This cancer
can often be cured or
controlled, especially if
it is found and treated
early. Screening tests
help detect prostate
cancer before it causes
any symptoms.
Prostate Cancer
Cancer is an uncontrolled growth of
abnormal cells. These cells form in one area
and can spread through the body. Prostate
cancer causes no symptoms in its early
stages. In fact, urinary problems are more
likely to be symptoms of another condition.
The things that can increase a man’s
chance of developing prostate cancer
are called risk factors. These include: •Age. The risk of developing prostate
cancer increases as you grow older.
2
Screening for prostate cancer is done with a
physical exam and blood tests. These tests can
help determine whether it is likely that you have
cancer. The American Urological Association
recommends that men with risk factors begin
yearly screening at age 40. Men with no risk
factors are offered yearly screening at age 50.
Understanding
the Prostate
T
Risk Factors for Prostate
Cancer
This booklet is not intended as a
substitute for professional medical care.
Only your doctor can diagnose and
treat a medical problem.
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Screening for Cancer
•Family history. If your father or
brother has had prostate cancer, your
risk of developing it is higher.
•Race. African American men are more likely
than other men to develop prostate cancer.
They are also more likely to die of prostate
cancer than other men with this disease.
he prostate gland is part of the male reproductive system.
As a man ages, his prostate changes. Noncancerous
(benign) enlargements often form. And cancerous growths
(malignant tumors) can also develop inside the prostate.
What Is the Prostate?
The prostate is normally about the size and shape of a walnut. It’s located below
the bladder. It surrounds the urethra (the tube that carries urine and semen out
of the body). The function of the prostate is to produce a fluid. This fluid mixes
with fluid from the seminal vesicles and sperm from the testicles to form semen.
The testicles also make hormones called androgens (such as testosterone).
These hormones help the prostate to function.
Lymph
node
Bladder
Pubic
bone
Penis
Rectum
Seminal
vesicle
Prostate
Urethra
Testicle
3
W
ith age, the prostate changes. The prostate may become
enlarged, a condition called BPH (benign prostatic
hyperplasia), or it may become inflamed, a condition called
prostatitis. Unfortunately, cancer of the prostate is also
common. Unlike BPH and prostatitis, cancer can grow and
spread beyond the prostate, threatening health and life.
The Changing Prostate
Seminal
vesicle
Nerve
Urethra
Benign
enlargement
(BPH)
Normal
prostate tissue
4
Normal cells are
well organized. Cells
of about the same size
are arranged in regular
patterns. New cells form at
about the same rate as old
cells die.
Cancerous
tumor
Cancer cells are not well
organized. Cells may vary
in size and shape. Cancer
cells keep multiplying to
form more abnormal cells.
Prostate Cancer
Cancer develops as cells in
the body change abnormally.
•Atypical cells (prostatic
intraepithelial
neoplasia, or PIN). Some
cells don’t appear normal,
but they are not cancer.
These cells may indicate
that cancer is present
or is likely to form.
•Cancer. Abnormal
cells form a tumor
(a lump of cells that
grow uncontrolled).
Cancer may or may not
produce symptoms.
Some tumors can be
felt during a physical
exam, others can’t.
•Cancer spread. Prostate
cancer may spread to
nearby organs. In some
cases, the cancer spreads
further, to bones or
organs in distant parts
of the body. This is
called metastasis.
BPH
BPH (benign prostatic hyperplasia) develops when
changing hormone levels cause the prostate to grow
larger. This often begins around age 50. Excess tissue
can block the urethra, making it harder for urine to flow.
The enlarged prostate can also press on the bladder, so
you may need to urinate more often. Other symptoms
include straining during urination, a weak urine stream,
and feeling that the bladder isn’t emptying all the way.
Thickened
bladder wall
Excess tissue
How BPH Affects the Bladder
Pushing to urinate through a narrowed urethra can cause the bladder walls
to thicken or stretch out of shape. A stretched bladder may have problems
emptying all the way. If the bladder doesn’t empty, infections or bladder stones
can occur. Also, the kidneys can’t drain properly into a bladder that doesn’t
empty completely. If not treated, this can lead to kidney failure. Pressure from
urine buildup can also cause leaking of urine (called overflow incontinence).
Prostatitis
Prostatitis is an infection or inflammation that
causes the prostate to become painful and swollen.
This narrows the urethra and can block the bladder
neck. Prostatitis can cause a burning sensation
during urination. You may also feel pressure or
pain in the genital area. In some cases, prostatitis
can cause fever and chills, and can make you very
sick. Prostatitis is most common in younger men.
Inflamed
tissue
5
T
Understanding
The Screening
Process
o evaluate the
problem, your doctor
will ask questions
about the urinary
symptoms you’ve
been having. He or
she will also examine
the prostate and order
tests. Tests help find
the cause of your
symptoms. They also
help rule out other
health problems
that can cause
urinary symptoms.
Who Should Be Screened?
The American Cancer Society recommends
yearly screening if you are over 50.
African American men or men with a
family history of prostate problems
may need to start screening at a
younger age. Talk to your doctor
about when you should start
screening, and be sure to
review the pros and cons
of yearly screening
on page 9 of this
booklet.
Your evaluation will start with a health history and DRE (digital rectal exam).
•During the DRE, your
doctor will insert a
lubricated gloved finger
into the rectum to feel
6
the prostate’s size, shape,
and texture. Your doctor
may also gently massage
the prostate. This causes
a few drops of fluid to
come out through the
urethra. The fluid is
collected and checked
for signs of prostatitis.
A DRE may cause a little
discomfort, but it takes
less than a minute.
Prostate specific antigen (PSA) is a chemical made
by prostate tissue. The PSA level (amount of PSA in
the blood) is tested to evaluate a man’s risk of prostate
cancer. In general, a high or rising PSA level may
mean an increased cancer risk. PSA testing is also
used to evaluate the success of cancer treatments. For
example, a falling PSA level can mean that treatment
is working. Keep in mind that PSA levels can vary for
many reasons. Discuss your PSA test results with your
doctor and ask what they mean for your situation.
Evaluating the PSA
A high or rising PSA level suggests that prostate
cancer may have formed. A lower PSA level
indicates that cancer is less likely. In addition
to the PSA level, your doctor may look at:
•The ratio of free PSA
(PSA that is not bound
to a certain protein in
the blood) to total PSA.
•The PSA velocity
(how fast the PSA
level is rising).
•The PSA density
(the relation of the
PSA level to the size
of the prostate).
Health History and Exam
•During the health
history, you will be
asked about your health
and your symptoms. Tell
your doctor if you take
any prescription or overthe-counter medications,
supplements, or herbs.
The PSA Test
Rectum
A DRE lets your doctor feel
for changes in the prostate.
Factors That Affect
PSA
Many factors can affect
PSA levels. Some,
such as age, BPH, and
prostate cancer, are
ongoing. Others, such
as prostatitis or recent
sexual activity, have
only a temporary effect
on PSA. Your healthcare
provider can explain how
these factors may affect
the timing of the PSA
test and your results.
Further Testing
Abnormalities found
with DRE may not be
tumors. And a high PSA
level doesn’t always
mean cancer. More tests
may need to be done.
After looking at the
results of your screening
tests, your doctor may
recommend other tests.
7
To Screen or
Not to Screen?
Core
Needle
Biopsy
S
I
f the results of your exam and tests lead
your doctor to suspect cancer, tissue
samples will be taken from the prostate
(a core needle biopsy). This can provide
more information about prostate cells.
What to Consider
Making a choice about whether to screen depends on how
you feel about the pros and cons of screening:
Taking Tissue Samples
The procedure takes about 20 minutes. Before it starts, you may be
given an enema to clear the bowels. When the procedure begins:
•You will be given antibiotics
to prevent infection.
•You may be given a
sedative, local anesthetic,
or pain medication.
•A small probe is then inserted
into the rectum as you lie on
your side. An image of your
prostate can then be seen on a
video monitor. This is called a
trans­­rectal ultrasound (TRUS).
Risks and Complications
of Core Needle Biopsy
• Infection
• Blood in urine, stool, or semen
hould you be screened yearly for prostate problems, even
if you have no symptoms? Experts disagree. Below are
some factors to think about as you make a decision.
•With this image as a
guide, your doctor uses a
thin needle to remove tiny
tissue samples from several
sites in the prostate.
Pros
Cons
•Many experts believe that screening
saves lives. Prostate cancer is the
second leading cause of cancer death
in men. Screening is the best way to
find prostate cancer in its early stages.
•Screening tests show how likely cancer
is. But they are not perfect. So some of
the biopsies done based on these tests
will be unnecessary. Doing a biopsy has
risks, such as bleeding and infection.
•When found early, prostate cancer can
nearly always be successfully treated.
When it is found at a more advanced
stage, the outlook often is not as good.
•Prostate cancers are often slow-growing.
Many never become life-threatening
and never need treatment. If you find
out you have cancer, you may feel you
need to treat it, even if tests show that
it’s not a dangerous cancer. Prostate
cancer treatments have side effects
that can affect quality of life, such as
incontinence and erectile dysfunction.
•The side effects of prostate cancer
therapies are often temporary and
can be treated.
Weighing Your Options
Before making a decision about screening, talk to
your doctor. Ask any questions you have about testing.
Talking to your partner, friends, or family members
may also be helpful. Things to consider include:
•Whether you have risk factors.
•Your age, overall health, and life expectancy.
•Your feelings about treatment. If you found out that you
had prostate cancer, would you want to have it treated?
8
9
Your Diagnosis: What Happens
Next?
Y
our doctor will form a
diagnosis based on
your health history,
DRE, and test results.
Your treatment
options depend on
the severity of your
symptoms and their
underlying cause.
Work with your
doctor to choose
the best treatment
plan for your needs.
Thinking About Your Treatment Options
There are many ways to treat prostate cancer. Treatments
include surgery, radiation, and medications. In some cases,
watchful waiting (monitoring the cancer without treating it)
is a choice. The treatment your healthcare team will suggest
depends on many factors. These include your age, your overall
health, how fast the cancer is growing, and whether it has
spread. Discuss your options with your healthcare team.
❑ Diagnosis of BPH
There are a number of treatments for BPH. One or more may be chosen based
on how much your symptoms affect your daily life. Your treatment plan may
include behavioral changes, such as changing your diet, medication, or surgery.
❑ Diagnosis of Prostatitis
Some cases of prostatitis are caused by bacterial infection. These cases
are treated with antibiotic pills, which are taken for up to 3 months.
Other cases of prostatitis require different medications or treatments. Your
doctor will tell you more. He or she may also suggest ways to relieve your
symptoms, such as relaxing during urination and taking warm baths.
❑ Diagnosis of Cancer
Many treatments for prostate cancer are available. Which one will be most effective
depends on many factors, including your age, overall health, and biopsy results.
First, tests will be done to learn more about the cancer. This helps determine
the best treatment. In many cases, prostate cancer can be cured or controlled.
Although prostate cancer is common in older men, most men don’t die of it.
10
Your Healthcare Team
The team of professionals who will assist in your care may include:
•A urologist, a doctor who
treats and performs surgery
on the urinary system and the
male reproductive system.
•A radiation oncologist, a
doctor who uses radiation
to treat cancer.
•A medical oncologist, a
doctor who treats cancer
with medications.
•A nurse practitioner, who
may perform exams and
manage follow-up care.
•Your primary care physician,
who refers you to the
appropriate specialists.
He or she also monitors
your overall health.
11
T
Evaluating the Cancer
o form your treatment
plan, your healthcare
team must learn more
about your cancer.
What do the cancer
cells look like? Has
the cancer spread
beyond the prostate?
Cells removed
during biopsy will
be viewed under
the microscope.
Treatment will
depend on how the
cells look (grade)
and where they are
located (stage).
The Gleason Score
Often there is more
than one cancer grade
within a tumor. The two
most common grades
found in the tumor are
added together to get the
Gleason score (or sum), a
number between 2 and 10.
12
Grading the Cancer
Staging the Cancer
Choosing the
Best Treatment
A cancer is graded using tissue removed during
a biopsy. A pathologist (a doctor who identifies
diseases by studying cells and tissues) looks
at this tissue under a microscope. He or she
then determines the cancer’s grade, from 1
to 5. Low-grade cancers are similar to normal
tissue. High-grade cancers differ from normal
tissue in the way cells are organized, and in
cell size and shape. The higher the grade, the
faster the cancer is likely to be growing. The
pathologist will give a report to your urologist.
Your urologist will assign your cancer a stage
based on PSA, DRE, and imaging tests. Lower-stage
cancers are confined to the prostate. Higher-stage
cancers have spread from the prostate to nearby
organs, bone, or other body tissues.
Knowing the cancer’s
grade and stage
helps with forming a
treatment plan. Your
plan may be based on:
Grade 1 or 2
Seen under a microscope, grade
1 or 2 cells are abnormal but
still appear to be organized in
rings. This may indicate a slowgrowing cancer.
Stage T1: A tumor that is
completely inside the prostate.
It can’t be felt during DRE.
Grade 3 or 4
Grade 3 or 4 cells vary more in
size and shape. Fewer rings are
visible. These cancer cells may
grow more rapidly.
Grade 5
Grade 5 cells don’t form rings.
They vary even more in size and
shape than lower-grade cells.
This indicates a fast-growing
cancer.
Stage T2: A tumor that can
be felt during DRE but is still
completely inside the prostate.
Cancer
Stage T3 or T4: Cancer that
has spread to the outside of
the prostate or to the seminal
vesicles.
Stage N+, M+: Cancer
that has spread to the lymph
nodes (N+), or to the bones or
other organs (M+).
• Watchful waiting.
Depending on the
cancer’s grade and
stage, your age, and
your overall health,
you may not need
treatment. Your PSA
will be monitored,
and you’ll have
frequent follow-up
exams to watch for
changes.
• Treating to cure.
Low- or mid-stage
cancer can often be
cured with surgery or
radiation.
• Treating to control.
High-grade or
high-stage cancer
often can’t be
cured but may be
controlled using
surgery, radiation,
hormone therapy, or
chemotherapy.
13
Radiation Therapy
R
adiation therapy is used
to destroy cancer cells.
Cancer cells continue to
die for months after the
therapy ends. Radiation
(x-rays) can be delivered
from outside the body,
or from material placed
inside the prostate.
Radiation therapy also
damages some normal
cells. This damage
causes side effects, which
can be controlled.
Risks and Complications
of External Radiation
• Mild to moderate diarrhea
• Frequent urination, possibly with a
burning feeling
• Erectile dysfunction
• Some loss of pubic hair
• Fatigue
• Bloating or gas pains
• Bleeding or scarring of the bladder
or rectum
• Urinary retention
• Irritation or inflammation of the
rectum with diarrhea, an urgent
need to pass stool, or rectal
discomfort
14
Targeting Cancer Cells from Inside the Body
Interstitial brachytherapy is radiation treatment
done from inside the body. “Seeds” (tiny pieces of
radioactive material) are implanted into the prostate.
These seeds may be either permanent or temporary.
•Permanent seeds release decreasing amounts of
radiation over a period of months. You can most
likely go home soon after the seeds are implanted.
Targeting Cancer Cells
From Outside the Body
•Temporary seeds release a single high dose of
radiation. They are implanted and removed. You
may stay in the hospital for a day or more after the
first dose. One or more doses may be given during
the next day.
Radioactive
seeds
Radioactive “seeds” are
implanted throughout
the prostate.
External-beam radiation is
done using a machine that sends
beams of radiation from outside
your body to the cancer.
Before, During, and After Treatment
•Before treatment. Your
radiation oncologist designs
your treatment plan. This may
include hormone therapy to
shrink the prostate. The radiation
therapy team locates the exact
areas that will be treated.
•During treatment. You are given anesthesia to keep you free
from pain during the procedure. Needles are then inserted
behind the scrotum. These needles are used to implant
the seeds. The procedure takes about 1 to 2 hours.
•During treatment. A radiation
therapist positions you on a
table. Radiation is aimed at the
tumor from different angles. Each
treatment lasts a few minutes.
It is done once a day, 5 days
a week, for 5 to 7 weeks.
•After each treatment. You will
most likely be able to follow
your normal routine. Discuss
with your team how to manage
side effects of treatment.
•Before treatment. You may be given hormone therapy
to shrink the prostate. Ultrasound or a CT scan is then
used to map the size and shape of the prostate.
•After treatment. Soon after treatment, you can resume normal
activities. Your healthcare team will help you to manage any side
effects. With permanent seeds, you may need to restrict contact
with young children and pregnant women for a period of time.
Discuss these precautions with your healthcare team.
Risks and Complications of Interstitial Brachytherapy
• Erectile dysfunction
• Incontinence
• Frequent urination, possibly
with a burning feeling
• Pain in the perineal region
• Bleeding or inflammation
of the bladder or rectum
• Urinary obstruction
15
Removing the
Prostate
R
adical (total) prostatectomy is surgery to remove the
entire prostate. It may be done if diagnostic tests show
that the cancer is confined to the prostate. The surgery will
be performed in one of four ways. Your healthcare team
will help you decide which one might be best for you.
The prostate,
Seminal
vesicle the seminal
vesicles, and
a portion of
the urethra are
removed.
Radical Prostatectomy
•You will be given medication that
blocks pain. This is called anesthesia.
•During surgery, one or several cuts
are made. This will depend on the
kind of prostatectomy performed.
•The urologist may remove and check
the lymph nodes near the prostate
to see if the cancer has spread. If the
cancer has spread, the urologist may
decide not to remove the prostate.
Urethra
Prostate
Bladder
•The prostate, the seminal vesicles,
and a portion of the urethra will
then be removed.
•Nerve-sparing techniques may be used
to help preserve erectile function
(the ability to achieve and maintain
an erection).
Balloon
Catheter
Urethra
Risks and Complications of Prostatectomy
16
• Erectile dysfunction (difficulty
achieving or maintaining an erection)
• Incontinence (loss of bladder control)
• Infection
• Excessive bleeding
• Difficulty urinating
• Pneumonia
• Blood clots
• Bowel perforation
The urethra
is reattached
to the bladder.
A catheter is
inserted to
drain urine
while you heal.
A balloon holds
the catheter in
place.
The Techniques
Open Surgery
Open surgery may be performed through an
incision in the abdomen. This is known as the
retropubic approach. It is the open surgery most
commonly performed. The other open surgery
technique is called the perineal approach. This is
done through an incision behind the scrotum.
Laparoscopic Surgery
During laparoscopic surgery, several incisions are
made in the abdomen. These are smaller than the
one made in open surgery. Long, thin tools are
placed inside each incision. These tools include:
•Laparoscope. This is a long, thin tube
with a video camera inside. The camera
sends images to a video screen next to the
operating table. This allows the surgeon a
clear view of the area around your prostate.
•Surgical tools allow the surgeon to remove
the prostate and seminal vesicles, stanch
bleeding, and sew wounds closed.
•Graspers to grasp fat, tissue, or the prostate.
Robot-assisted Surgery
With robot-assisted surgery, which is also known
as Da Vinci surgery, four robotic arms are
stationed beside the operating table. These arms
hold the surgical instruments. The surgeon sits
at a computer console away from the operating
table. The console gives the surgeon a larger,
three-dimensional view of the surgery site. This
view is not attainable with the other techniques.
From the console, the surgeon controls the
robotic arms. They are thought to allow for
more precise movement. Other advantages
of Da Vinci surgery are that it may cause less
blood loss and allow for a quicker recovery.
17
Your Surgical Experience
Y
our surgeon will give you detailed instructions on
preparing for surgery. After surgery, you’ll be told how to
care for yourself at home as you recover. Be sure to ask any
questions you have about the procedure and recovery.
After Surgery
•You may have to stay in bed for a
while after surgery. But you'll be
encouraged to walk as soon as you
can. This will help prevent blood clots
from forming in your legs. You'll also
be shown exercises that help keep your
blood flowing while you're in bed.
•Urine will drain through the catheter
into a sterile bag. The urine may
be bloody or cloudy at first.
•You may be able to have a regular
diet 24 hours after surgery.
•You may return home in 1 to 3 days.
Before surgery, you may
donate blood to be used
in case you need a blood
transfusion.
Before Surgery
•Lab tests. Your surgeon may instruct
you to have these done before surgery.
•Medications. Your surgeon will tell you
which medications you shouldn't take
in the weeks before surgery. These tend
to be medications that thin the blood.
•Bowel prep. This may include a
laxative the day before surgery and
an enema the morning of surgery.
Preparing the bowels for surgery is
important because it decreases their
size. This allows your surgeon to
see more of the surgery site. It also
decreases the chance of infection if
the bowel were to be nicked during
18 surgery (Note: This is uncommon).
•Fasting. You'll be asked not
to eat or drink after midnight
the night before surgery.
•You will discuss anesthesia with the
anesthesiologist. You might be given
local anesthesia. This means the area
around the surgery site will be numb,
but you'll be awake. Or, you may be
given general anesthesia. This means
you'll be asleep during the procedure.
•Medications to control pain will
be prescribed.
Catheter
bag
•The catheter will be left in place
when you go home. You’ll be given
instructions on how to manage it.
•The catheter and stitches will be removed
at a follow-up visit. This is often 1 to
2 weeks after surgery. At this point
in your recovery, you may be able to
partake in activities you did before
surgery. But don't push yourself too
hard. Try to avoid strenuous activity
even after your catheter is removed.
Walking as soon as possible
after surgery helps prevent
blood clots in your legs.
•Bladder control often takes a few weeks
to several months to return. Improvement
can continue for up to a year.
Call Your Doctor If
• You have fever or chills.
• An incision is draining or increasingly
painful or red.
• Your leg or ankle begins to swell.
• Urine isn’t draining from the catheter.
• You can’t urinate after the catheter has
been removed.
19
Controlling Spread and Symptoms
C
ancer that has spread beyond
the prostate can often be treated.
Hormone therapy can slow the
growth and spread of the cancer.
Chemotherapy may help relieve
symptoms and control the
cancer. Cancer pain can be
managed with medications.
Chemotherapy (chemo) uses medications
to destroy cancer cells anywhere in
the body. Chemo may be given by pill,
injection, or IV infusion (through a tube
placed in a vein). It may slow the growth
of cancer, and may relieve pain and
other symptoms. Chemotherapy is given
in cycles so your body has a chance to
recover. Your doctor will determine how
you receive chemo and for how long.
Hormone Therapy
Before treatment
Testosterone can cause cancer cells to
grow. Treatments can include:
Since chemotherapy can affect your blood cells, your
doctor is likely to order blood tests. It is important
to carefully follow instructions you are given
before treatment. Always tell your healthcare team
which medications you are taking, including herbal
medicines or supplements. Make sure you contact
your medical team if you have any questions.
•Luteinizing hormone-releasing hormone
(LHRH) agonists. These medications
reduce the amount of testosterone made by
the testicles. LHRH agonists are injected
monthly every 2, 3, 4, or 6 months.
•Antiandrogens. These medications block the
body’s ability to use testosterone. They are
given by pill.
•Orchiectomy. This surgery removes the
testicles, the main source of testosterone.
Pain Control
Prostate cancer that has spread
may cause pain. This pain can
be treated. Pain medications
can improve your quality of life.
Using them can relieve stress,
helping you to better withstand
the cancer. Discuss the side
effects of these medications,
and any other concerns you
have, with your doctor.
20
Chemotherapy
Risks and Complications of
Hormone Therapy
• Hot flashes
• Breast enlargement or tenderness
• Sexual dysfunction
• Osteoporosis (bone loss)
• Diarrhea
• Loss of energy
During treatment
Each chemotherapy session may take an hour or
more. Most chemotherapy medications are given
intravenously, through a needle inserted into a vein.
Your dose will depend on your weight and height,
plus other factors. There may be a few medications
given together. And the schedule may vary to ensure
you’re getting the most effective treatment possible.
After treatment
Your progress will be monitored, and you may
be given medications to take at home after your
treatments. After chemotherapy you may experience
side effects, but most are temporary and your
body will recover once the treatment finishes.
Because your immune system is not as strong
as normal, you should try to avoid contact with
people who have infections. Also, you shouldn’t
get any new immunizations for several months.
Risks and
Complications
of
Chemotherapy
• Infection
• Hair loss
• Fatigue
• Muscle Pain
• Diarrhea
• Nausea/Vomiting
21
Living Your Life
N
o matter what type
of treatment you
choose, life with
prostate cancer
can be a challenge.
Your goal should
be to live as normal
a life as possible.
Your healthcare
team can help
you to cope with
any physical and
emotional issues
that result from
treatment. The
support of your
family and friends
can help, too.
Dietary Changes
Eating smart can result in better
overall health. Fish high in
omega-3 may help protect against
prostate cancer. Try to eat 5 to 9
servings of fruit and vegetables
daily. Tomatoes, and products
containing cooked tomatoes such
as pizza, have been linked to
a reduction in prostate cancer.
You should work to eliminate
dairy and meats from your diet.
Avoid tobacco products and
excessive alcohol. Choosing
organic produce and drinking 3
to 5 cups of decaffeinated green
tea daily are good ideas, too.
Exercise
Exercise can result in better
prostate health. Try exercising
30 minutes or longer at least
three times weekly. Find an
exercise that works for you. Good
choices include walking or hiking
outdoors, jogging, bicycling,
and swimming. It’s also a good
idea to practice stress reduction
and relaxation techniques.
The Future
22
Sexuality
Urinary Problems
Treatment for prostate cancer
may affect your sexuality. It can
result in erectile dysfunction or
a lowered sex drive. Often, these
problems can be treated. Ask your
urologist for help. And talk to
your partner about ways to nurture
your relationship so that it will
be satisfying for both of you.
Incontinence or other
urinary problems can
occur due to treatment for
prostate cancer. Effective
treatments exist for
most urinary problems.
Talk to your urologist or
radiation oncologist about
what may help you.
During and after treatment, your urologist will monitor
your prostate health. Your healthcare team will also
help you control any ongoing symptoms resulting
from treatment. Keep in mind that each man responds
differently to prostate cancer treatment. Continue working
with your team throughout treatment. Mention any
concerns you have, and be sure to get your questions
answered. Above all, think about how best to live your life.
Prostate cancer may or may not shorten your life. But
living life to the fullest is a good goal for anyone.
23
Reaching
Out for
Support
Cancer Information Service
(National Cancer Institute)
800-422-6237
www.cancer.gov/cancertopics/types/prostate
American Cancer Society
800-227-2345 | www.cancer.org
Us TOO International, Inc.
(Prostate cancer support groups)
800-808-7866 | www.ustoo.org
H
aving prostate
cancer can be
hard to cope with.
But you don’t
have to keep
your feelings to
yourself. Talk with
friends and family.
Try a prostate
cancer support
group. Sharing
your concerns can
help you get the
emotional support
you need. Check
out the resources
on this page for
more information.
www.kramesstaywell.com 800.333.3032
Compliments of
65662US.LEU.12.03.003 1204