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For Prostate Cancer
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Limited assistance from CancerCare is available to help with cancer-related costs.
Ask CancerCare
Every month, featured experts answer your questions about coping with cancer including specific answers to questions asked by caregivers.
For Prostate Cancer
- Q.
My father has prostate cancer and I keep seeing conflicting information about prostate cancer treatment. Are there updated treatments online anywhere?
A.I hear this question more and more from prostate cancer patients and families who want the best treatment available. It is not infrequent that people seeking a second or third opinion get different treatment suggestions. This often creates frustration and uncertainty by patients and families as to which route to pursue.
With continued research and increasing treatment options, oncologists have many treatment choices and make suggestions based on a number of factors. Some of the most important factors are:
Type of prostate cancer: Adenocarcinoma is the most common type and accounts for 95% of all prostate cancers. Other less common types account for the other 5%.
Stage of prostate cancer: A pathologist stages the cancer based on biopsy results. For prostate cancer stages are I, II, III and IV with IV being the most advanced.
Grade of prostate cancer: Additionally, pathologists grade prostate cancer according to the Gleason score, which assigns a grade from 1 to 5 based on how the cancerous cells look compared to normal prostate cells. The grade refers to how aggressive the type of prostate cancer is.
Once these factors are determined, the surgeon/radiologist/oncologist takes into account a patient’s age, other health issues, and lifestyle to determine the best treatment options for each individual. Potential short and long-term side effects will be discussed with the patient and family at this time, which can strongly impact patient’s quality of life post treatment.
With these factors in mind, patients and families determine what treatments to pursue. Some cancer doctors prefer to be more aggressive based on their experience and others see reason to be cautious, expecting to get similar results while avoiding difficult side effects.
This is often a good time for patients and families to meet with a social worker or nurse to explore their goals post treatment and make an informed decision. Along with the links above, for more information on prostate cancer treatment options and clinical trials it can be helpful to contact the National Cancer Institute at 1-800-4-CANCER (422-6237) and speak to a cancer information specialist who can assemble a packet of information that will help you make the best informed decision for you and your loved one.
And finally, the National Comprehensive Cancer Network (NCCN) provides prostate cancer treatment guidelines.
Answered by
Richard Dickens, MS, FAOSW, LCSW-R - Q.
I have just had a surgery for prostate cancer. When will I be able to be sexually active? Is there anything I should do and how do I explain things to my partner?
A.The first step is to talk to your urologist about your concerns. The most common problem following surgery for prostate cancer is erectile dysfunction (ED), or the inability to achieve an erection. ED does not affect your ability to reach orgasm, which is a separate but related process. You should begin to be intimate with your partner when your urologist feels you are appropriately healed. You and your partner’s ability to find other ways to be intimate that do not require an erection can help you on your road to recovery. In the meantime, you can ask to be referred to an urologist who specializes in ED. Some physicians have their patients use an ED medication to help in the recovery process.
Many partners need reassurance that the person with cancer still has an interest in being intimate, and vice versa. Interest is not only about physical attraction but in how you both feel and think about your relationship together. Your partner may be concerned that expressing a wish to be intimate again will be a source of stress and upset for both of you. Being open about these concerns is the best way to examine and explore these feelings together. Talking to other men who have similar concerns may also be helpful. Here are resources to find support group:
- CancerCare offers support groups for men coping with cancer.
- The American Cancer Society offers a supportive program, Man-to-Man for men who have prostate cancer.
- Us TOO International Prostate Cancer Education & Support Network has chapters and support groups.
You can find a counselor who specializes in intimacy issues, by contacting the American Association of Sexuality Educators, Counselors and Therapists.
Answered by
Wade Iwata, MSW, LMSW
For Breast Cancer
- Q.
I need information or possibly first hand knowledge of how Tamoxifen affects men. I am a male with breast cancer undergoing this treatment and I'm not sure how I'm supposed to feel but it doesn't feel normal. Can you help?
A.This is an important question and one that is not asked often, because of the rarity of male breast cancer. In fact, male breast cancer accounts for only 1% of all breast cancers. Men have a lifetime risk of about one-tenth of 1%, or one in 1,000, of developing breast cancer, according to the American Cancer Society. Most male breast cancers occur between the ages of 60 and 70, although a diagnosis can occur at any age.
All men have a small amount of breast tissue, which is located directly behind the nipples and produce a small amount of the female hormone, estrogen. Research has established that higher than normal levels of estrogen can result in gynecomastia, a condition in which the male breast is abnormally enlarged, or male breast cancer. Other risk factors that may lead to male breast cancer are: a family history of breast cancer, either male or female; overexposure to radiation of the chest area; cirrhosis of the liver; and obesity.
Male breast cancer can manifest as a firm, non-painful mass located just below the nipple or may cause skin changes on or around the tissue of the nipple such dimpling, redness, scaling, discharge or retraction. As with women with breast cancer, treatment depends on many factors, including the stage at diagnosis and the overall health of the patient.
Most male breast cancers are hormone-dependent, so estrogen-blocking treatments including Tamoxifen are often used. Possible side effects for men taking Tamoxifen include headaches, nausea, hot flashes, skin rash, fatigue, sexual dysfunction, and weight and mood changes. For more information about Tamoxifen and other hormonal therapies, read the National Cancer Institute’s, “Male Breast Cancer Treatment” and “Tamoxifen Questions and Answers”, and the American Cancer Society’s “Breast Cancer in Men”.
In addition to coping with treatment side effects, you may also be experiencing new feelings and emotions. From my research, most men state that having breast cancer doesn’t feel normal and this can create additional stress. I strongly suggest you talk to other men who have been diagnosed, both for support and also to learn new ways to cope with treatment side effects.
CancerCare offers publications about coping with treatment side effects, Connect Education Workshops, individual counseling, and support groups (online, telephone and face-to-face).
Finally, make sure you speak with your oncologist about any side effects or feelings you have, so that he or she can work with you to help you better manage your situation.
Answered by
William Anthony Goeren, MS, ACSW, SEP, LCSW-R, OSW-C
Specialized Programs
CancerCare offers specialized programs to address specific populations and concerns.
Coping Circle Workshops
Virtual educational and supportive workshops led by oncology social workers and qualified co-facilitators. These workshops cover numerous topics and are offered in English and Spanish.
Additional Resources
Organizations
American Urological Association Foundation
Malecare, Inc.
Prostate Cancer Education Council
Prostate Cancer Foundation
The Prostate Net
Us TOO International Prostate Cancer Education & Support Network
ZERO Prostate Cancer