Men with prostate cancer who have their prostate removed cite sexual dysfunction as the most common side effect after surgery, but urinary dysfunction troubles these patients most, reports a University of Florida researcher. What's more, many aren't emotionally prepared to face these complications.
The study findings, published in a recent issue of Urologic Nursing, underscore the need for health-care practitioners to educate their patients about the physical and psychological effects the surgery will have on their everyday lives.
“The effects of this treatment are quite immediate and can lead to depression and frustration,” said Bryan Weber, Ph.D., A.R.N.P., an assistant professor in the UF College of Nursing and the study's lead author. “After an initial diagnosis of prostate cancer, men may be so focused on eradicating the disease that they don't realize the effects the treatment will have on their quality of life, both for them and their families.”
Prostate cancer is the No. 1 cancer among men, excluding skin cancer, and with more baby boomers reaching their 50s and 60s, it's expected to grow even more prevalent, with more than 200,000 cases diagnosed in 2007. Given the various treatment options for prostate cancer, men who undergo radical prostatectomy may initially decide that the risk of physical dysfunction is worth the benefit of improved likelihood of survival. But many don't know what to expect in the months after surgery, Weber said.
Physical side effects of prostate cancer treatment limit daily activities and may interfere with a man's sense of masculinity and self-confidence. Urinary incontinence, for example, requires the use of pads that add considerable bulkiness to clothing and create concern about leakage and odor. Sexual dysfunction interferes with a man's sense of self and may limit the relationship he has with his significant other, Weber said.
In the study, UF researchers evaluated 72 men six weeks after they underwent prostatectomy. In addition to measuring participants' physical function and assessing whether they had urinary and bowel symptoms and sexual dysfunction, the researchers also evaluated measures of self-confidence, social support and uncertainty about the disease and treatment. Most participants were white, married and employed full-time or retired, and most had some college education.
Fifty-seven percent of the men reported low to moderate social support, indicating that many of the topics proved embarrassing for them to discuss with others, Weber said. The level of social support was significantly related to urinary problems, revealing that men with urinary incontinence may need more support than those with more control.
“Within the first 100 days of diagnosis, men may be so distressed and so focused on curing their cancer that they don't focus on these side effects, which is what makes it imperative for health-care professionals to educate them on ways that their lives will change and how they can cope,” Weber said. “Almost immediately after treatment, men may experience depression, awkwardness and emasculation, which will have a great effect on their quality of life.”