Cancer and its treatment can cause a variety of side effects. However, doctors have made major strides in recent years in reducing pain, nausea and vomiting, and other physical side effects of cancer treatments. Many treatments used today are less intensive but just as effective as treatments used in the past. Doctors also have many ways to provide relief to patients when side effects do occur.

Fear of treatment side effects is common after a diagnosis of cancer, but it may be helpful to know that preventing and controlling side effects is a major focus of your health-care team. The specific side effects that can occur depend on a variety of factors, including the cancer's location, the individual treatment plan (including the length and dosage of treatment), and the person's overall health.

Before treatment begins, talk to your doctor about possible side effects of the treatments you will be receiving. Ask your doctor which side effects are most likely to happen (and which are not), when they are likely to occur, and how they will be addressed by your health-care team if they do happen. Also, be sure to communicate with the doctor about any side effects you experience during and after treatments.

Possible General Side Effects of Prostate Cancer Treatment

Incontinence — the inability to control the urine stream, resulting in leakage or dribbling of urine.

Despite some embarrassment in discussing incontinence, it is a common medical problem. Depending on your situation, there are several ways to improve this condition, including surgery, medicine, and Kegel exercises to strengthen the muscles of the pelvis. There are three types of incontinence:

• Stress Incontinence is the most common type of incontinence after prostate surgery and is usually caused by problems with the bladder sphincter (the muscular valve that keeps urine in the bladder). It causes urine leakage when coughing, laughing, sneezing or exercising.
• Overflow Incontinence is usually caused by cancer or scar tissue blocking or narrowing the bladder outlet, making it difficult to urinate and causing a dribbling stream of urine with little force.
• Urge Incontinence is marked by sudden urges to pass urine because the bladder has become overly sensitive to stretching as urine fills it. This is the most common type of incontinence after radiation therapy and may occur after external radiation or brachytherapy.

Erectile Dysfunction (ED) — the inability to get an erection of the penis sufficient for sexual intercourse, also known as impotence.

The nerves that allow men to get erections are often damaged by radical prostatectomy or radiation therapy. Other treatments may also damage these nerves or the blood vessels that supply blood to the penis to cause an erection.

For men with ED, several solutions are available.

• Phosphodiesterase (PDF) inhibitors such as sildenafil (Viagara ®), vardenafil (Levitra ®), or tadalafil (Cialis ®) do not cause erections, but can improve erections by increasing blood flow to the penis.
• Vacuum devices can create an erection. These mechanical pumps are placed around the entire penis before intercourse.
• Prostaglandin E1 is a substance naturally made in the body that can produce erections. It can be injected almost painlessly into the base of the penis 5 to 10 minutes before intercourse or put into the urethra as a suppository.
• Prostheses (penile implants) can restore the ability to have erections.

In addition to physical side effects, there may be psychological (emotional and social) effects as well. These are normal for many men and you can ask your doctor about the variety of support groups and services that are available to you through Roswell Park and throughout the Western New York.