Ask CancerCare
September 2008 This Month's Topic: Prostate Cancer Featured Expert: Floyd Allen, LMSW |
Q. I've just been diagnosed with prostate cancer. What should I be asking my doctor?
A. A cancer diagnosis can be overwhelming and it's often challenging to understand what your "role" should be as a patient. You may wonder what you can do to help yourself as you begin treatment with your oncologist and urologist (your medical team).
First, it is important that you do not isolate yourself and attempt to cope with the diagnosis alone. Even if you find it difficult asking other people for help, reaching out for support from those you trust is critical in effectively managing the effects and impact of your diagnosis. Identify your primary caregiver—that is, the person who you want to assist and accompany you, if possible, on your visits to your physician.
Before speaking with your medical team, gather as much information as you can so that you can make more informed decisions about treatment.
The website of the American Society of Clinical Oncology (ASCO) offers useful information about prostate cancer. You may also find CancerCare's publications and podcasts about prostate cancer helpful:
- What's New on the Horizon: Treatment Choices for Men Living With Advanced Prostate Cancer
- Better Bone Health for Men Living with Prostate Cancer
- Medical Update on Metastatic Prostate Cancer (Podcast)
- Caring for Your Bones When You Have Prostate Cancer (Podcast)
Below is a list of some important questions to ask your physician:
- What is a Gleason Score and what is mine?
- What is the percentage of cancer present in my prostate?
- Is my prostate enlarged?
- What treatment would be best for my cancer and why?
- What potential physical effects can result from the treatment?
- How do I manage those effects?
- What are the anticipated long-term effects of the treatment?
Q. I have had radiation and hormonal treatments for my prostate cancer. My treatment has caused side effects which include erectile dysfunction. It has been difficult to talk about this, especially with my wife. I worry that my inability to be intimate with her is putting a strain on our relationship but I haven't been able to bring this up with her. Any advice?
A. Depending on how long they have had hormonal treatment, and what type or how many radiation treatments they have had, it is common for men with prostate cancer to experience either a loss of desire for sexual activity or difficulty having or maintaining an erection. It is important to discuss the specific side effects you are experiencing with your physician so together you can determine what the best options are for you.
It is also especially important that you communicate with your wife what is happening to you physically. That includes sharing how you feel emotionally about your body's physical response so that she can understand how you are being affected. It is common to have feelings of shame, guilt, anger and sadness. Some men believe that showing these emotions are a sign of weakness. Rather, opening up to your partner about what you are feeling demonstrates your strength and eventually will allow you to regain some measure of control over the situation as you seek and determine the assistance you need.
You also need to allow your partner to share with you how this is affecting her. Keep in mind that there is no right or wrong way to speak about this issue. Do not be embarrassed to discuss the details of your difficulties; it is not your fault or a failing, but a medical problem. Have your wife accompany you to your physician to discuss what options are available. In many cases, the medical help you receive can restore your functioning to satisfying levels for both of you.
Sharing your feelings with your partner is a very effective way to regain your strength together as a couple and summon the benefits of your mutual love and support to better cope with and manage your diagnosis.
For a compassionate and straight-talking guide on this topic, written by a prostate cancer survivor and his wife, read The Lovin Ain't Over: The Couple's Guide to Better Sex After Prostate Disease by Ralph and Barbara Alterowitz (Mandeville Press: 1999).
Another helpful resource online is The Center for Intimacy After Cancer Therapy, at www.renewintimacy.org.
Floyd Allen, LMSW, is the Director of Men's Cancers and a Senior Supervisor at CancerCare. He Directs the ICAN program and coordinates CancerCare's telephone group and wigs and prostheses programs. He works extensively with men affected by prostate, testicular and penile cancers and provides online, telephone and in-person counseling to those men and their loved ones. He is a frequent contributor to CancerCare's Telephone Education Workshops.
The questions and answers listed above are from the September 2008 Ask CancerCare feature. New Ask CancerCare topics are introduced every month.
If you have additional questions about prostate cancer, please contact CancerCare directly for information and guidance. CancerCare provides free professional support services, including counseling, education, financial assistance and practical help. These services are provided by professional oncology social workers. If you have a specific concern or question and would like to speak with an oncology social worker, please contact us at info@cancercare.org or 1-800-813-HOPE (4673).
For questions about medical issues, please visit Cancer.net, the patient information website of the American Society of Clinical Oncology (ASCO).
Ask CancerCare Archive (questions and answers from previous months)
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