WHAT IS PROSTATE CANCER SURVIVORSHIP?
Most men affected are still in the prime of their life. Fortunately, for them there is now help available. Life after treatment for cancer is termed “cancer survivorship”. Cancer survivorship is often under-recognized. It can also be an undertreated issue for men after their treatment for prostate cancer. Long term survival is vitally important for a man’s return to normal daily life, returning to be a contributing member of society and sense of self-worth.
WHY DO MEN GET URINARY INCONTINENCE OR LEAKS AFTER TREATMENT FOR PROSTATE CANCER?
Fortunately, most patients with urine leaks or incontinence continue to improve up to 1 year after their prostate cancer treatment. This group includes those who have had a radical prostatectomy and/or radiotherapy. A small proportion however do have long-term and severe leaks that they require the use of pads. Radical surgery to remove the prostate and the cancer itself can result in a loss of control. This is related to a loss of sphincter muscle strength (the muscle that guards the bladder door).
SYMPTOMS OF URINARY INCONTINENCE
Activities that are strenuous such as walking, running, coughing, laughing sometimes brings on the leaks. Men have also reported that leaks occur especially at night when they sleep. In addition, those that have had radiation may find that they experience an increase in frequency of trips to the toilet. This is due to increased bladder sensitivity.
DIAGNOSING MALE INCONTINENCE
Assessment with the doctor includes pad tests, a cystoscopy and a urodynamic study. This confirms the diagnosis and assesses the severity.
TREATMENTS OF MALE INCONTINENCE
Treatment options depend on the severity. Mild incontinence can be managed with Physiotherapy (pelvic floor exercises and biofeedback). Surgery is the best option for those with moderate to severe incontinence. They can be treated with either a male sling or Artificial Urinary Sphincter (AUS). The male sling is suitable for those with moderate incontinence, whereas the AUS is reserved for those with severe incontinence or those who have had radiation. The success rate is high if selected appropriately. Side effects are rare but can include infection, device failure and erosion.