Ask CancerCare

You should first begin by having a discussion with your oncologist, and then your internist, to rule out any medically related issues that may be the cause or source. Barring no surprises, I would suggest that you speak with a registered dietician (RD) who can help you identify healthy ways of eating and products that may assist you with meeting your weight goals and set weight goals that are best suited to your individual needs. To find a registered dietician in your area, please consult the American Dietetic Association's online database.

Additional resources you might find useful include:

• The National Cancer Institute's publication, Eating Hints for Cancer Patients: Before, During, and After Treatment
• CancerCare's podcast, Nutrition and Cancer: Beyond Calories: Building Lean Body Mass
• The National Coalition for Cancer Survivorship's Nutrition web section
• The American Institute for Cancer Research offers a Nutrition Hotline

This question will require an in-depth conversation with your physician to fully determine what treatment options are available to you. Another surgical procedure may be possible, but further surgery will depend on scar tissue present at the site, location and size of the new tumor and whether or not your prostate tissue present is enlarged, as well as any other factors that may complicate some of the treatment choices. Depending on the Gleason score, the percentage of the prostate affected and the size of the tumor your physician may decide that "watchful waiting" may be an option that is possible.

Other treatment options such as radiation, both external beam and brachytherapy, should be discussed with your physician. I would advise you to consult with your urologist and oncologist to determine what the course of action would be, taking into account your specific situation.

For information about the types of treatment for prostate cancer, please visit The National Cancer Institute's website or The American Society of Clinical Oncology's (ASCO) website.

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?

CancerCare's professional oncology social workers assist men with prostate cancer, family members and caregivers by providing emotional and practical support, free of charge. To speak with a CancerCare social worker, call 1-800-813-HOPE (4673) or email info@cancercare.org.

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.