Prostate Cancer

Frequently Asked Questions about Prostate Cancer

This text has been adapted from the Oncology Interactive Education Series. Click here for a demo of this unique and innovation series.

1. What is prostate cancer?
2. Why does prostate cancer occur?
3. Can prostate cancer be cured?
4. What is the PSA test?
5. What treatment options are available to me?
6. What are the side effects of each type of treatment?
7. Will I be impotent following treatment?
8. Will I experience pain from my cancer or its treatments?
9. Will I be able to work during my treatments? Following my treatments?
10. How long will I be in hospital?
11. I’ve heard about a complementary therapy called “Saw Palmetto”, is this an effective treatment?
12. If I don’t have treatment now, can I have it when the cancer gets worse?
13. How do I choose a physician for my treatment and ongoing care?
14. When should I contact my physician?
15. Are my children at risk?
16. Can prostate cancer be transmitted through sexual activity?
17. How will my cancer affect my sex life?
18. How important is nutrition?
19. Where should I go for additional information?
20. How can I assess the quality of health information in the Internet?
21. What To Ask Your Health Care Team

1. What is prostate cancer?
Prostate cancer is the uncontrolled growth of cells that make up a man’s prostate gland.

2. Why does prostate cancer occur?
A number of changes must happen to a cell before it becomes cancerous. With prostate cancer, no one knows exactly what causes these changes, but there are several factors that can increase your risk of developing prostate cancer.

These risk factors include:

• Age: Prostate cancer is rare in men under 50 years of age, but it is the most common form of cancer in men over 65.
• Family History: Prostate cancer is more common in some families than in others. It may have a genetic basis.
• Diet: Several dietary factors have been linked with prostate cancer, including a high fat diet.
• Race: The risk of developing prostate cancer is highest among black men.

3. Can prostate cancer be cured?
Prostate cancer is a potentially life-threatening disease. When the cancer is localized (has not spread beyond the prostate), successful treatment is possible, allowing long-term survival and a good quality of life. In other cases, where the cancer spreads to other parts of the body, the outlook is not as favorable. Your own prognosis will depend on your individual case.

4. What is the PSA test?
The PSA test is a blood test to measure the levels of Prostate Specific Antigen in your bloodstream. When prostate cancer is present, PSA levels tend to be high. However, the PSA test is not a test to diagnose prostate cancer, since other factors may cause your PSA levels to rise. Your PSA level is an indicator that is used by your doctor to determine if further investigations should be conducted.

5. What treatment options are available to me?
There are several treatment options available for prostate cancer. The treatment that is best for you will depend on your case and your personal preference.

6. What are the side effects of each type of treatment?
Each treatment has side effects. The severity and type of side effects depend on the type of treatment and your individual case.

7. Will I be impotent following treatment?
Impotence (the inability to have satisfactory erections) is a common side effect of treatments for prostate cancer. Whether you become impotent following treatment will depend on several factors, including:

• Which treatment you receive
• Whether you were potent before treatment
• The extent of your cancer

Remember that there is a lot you can do to manage impotence. Many couples go on to enjoy fulfilling sexual activity (including intercourse) in spite of impotence.

8. Will I experience pain from my cancer or its treatments?
Pain is a common symptom of prostate cancer and its treatments. Your doctors and nurses will help you find the method of pain control that works best for you and ensure that your pain is managed effectively.

9. Will I be able to work during my treatments? Following my treatments?
Your ability to continue to work during your treatments will depend on a number of factors:

• Which treatment you receive
  If you have major surgery, you will want to take several weeks off from work. This will give you time to recover. You may find that you are able to continue working while undergoing Radiation Therapy, Chemotherapy or Hormonal Therapy treatments, although fatigue is a side effect of these treatments.
• Your flexibility at work and where you work
  If you work close to the treatment centre, and if your work schedule is flexible, you may be able to work in between treatments. For example, if you are receiving radiation therapy, you will have to come to the hospital for daily visits. For some people, it is possible to work part of each day. For others, this is not an option and they must take several weeks off work.
• Your health
  Many people are able to remain active despite having prostate cancer. In more severe cases, the cancer or its treatments may require you to alter your lifestyle.

In general, whether or not you can work during or after your treatments depends on your individual circumstances. You may have to wait and see how you feel. If you feel fit and willing to work, you may wish to continue working. If you do not feel physically, or emotionally, “up to it”, you may wish to take a leave of absence.

10. How long will I be in hospital?
The length of time you must spend in the hospital depends on the treatment approach that is used.

• If you receive Radiation Therapy, you will be treated on an outpatient basis. You will not stay overnight in the hospital, but you will come to the hospital for treatment every weekday for several weeks.
• If you receive Hormonal Therapy or Chemotherapy, you will most likely be treated on an outpatient basis.
• If you receive Surgery, the length of time you will be in the hospital depends on the type of surgery you receive. It may be as little as a few hours to as much as a week.

11. I’ve heard about a complementary therapy called “Saw Palmetto”, is this an effective treatment?
Saw Palmetto is an herbal extract from a type of palm tree (Serenoa repens). It commonly used as a complementary or alternative therapy for prostate cancer and benign prostatic hyperplasia (BPH).

Complementary therapies are used in addition to conventional treatments. They are used to help improve symptoms, well-being and recovery. Alternative therapies, or alternative medicines, are used by some people instead of conventional treatments. Although some alternative therapies claim to cure cancer, there is no scientific proof that any alternative therapies (including Saw Palmetto) cure or shrink cancer. If you are considering taking any complementary or alternative therapy, you should first consult your doctor.

12. If I don’t have treatment now, can I have it when the cancer gets worse?
In some cases, when a prostate tumour is small and is not thought to be aggressive, it may be possible to opt for “Observation as Treatment”. This means that your cancer will be closely monitored, but no active treatment will be given.

For some men, observation can be an alternative to active treatment. However, it does carry with it some risk. Eventually, the cancer will progress. Once the cancer has spread, it may be harder to treat and some treatment options may no longer be available. The chance for cure may be lost by waiting.

13. How do I choose a physician for my treatment and ongoing care?
It is important to choose a physician with whom you are comfortable and can develop a rapport. This will ensure that you feel comfortable asking the questions that are concerning you and that you receive answers which you can understand and which help to address your concerns.

14. When should I contact my physician?
You should contact your physician when your situation changes in a way that you did not anticipate or do not understand. For example, you may be uncertain about the development of recurrent or new symptoms.

Also, your situation will need to be closely followed by your family physician, who will help you deal with your cancer treatment and other medical problems that are not cancer-related.

15. Are my children at risk?
With many types of cancer, certain families are at higher risk than others. This is sometimes due to genetic factors that make members of those families susceptible to developing cancer. Research suggests that there may be prostate cancer susceptibility genes.

If you have a family history of prostate cancer, it may mean that your sons or other male relatives are at higher risk of developing prostate cancer.

16. Can prostate cancer be transmitted through sexual activity?
Prostate cancer CANNOT be transmitted through sexual activity. You are free to engage in sexual activity whenever you are able. However, prostate cancer and its treatments can impact your feelings of sexuality and body image.

17. How will my cancer affect my sex life?
For some people, prostate cancer has little or no effect on their sex lives. For others, there can be a great deal of adjustment. The impact of prostate cancer on your sex life will depend on the extent of your disease and the type of treatment you receive.

18. How important is nutrition?
For any cancer patient, it is important that you eat a healthy diet. Eating well can promote recovery and improve your outcome. Also, diet may play a role in the development of prostate cancer.

19. Where should I go for additional information?
The best source of information on prostate cancer is your treatment team. Each member of your treatment team has received specific training on the subject of prostate cancer and can answer many of your questions.

You may wish to consult additional sources as well. Bookstores, the Internet and the patient library at your local hospital are all good resources.

20. How can I assess the quality of health information in the Internet?
There is a lot of health information on the Internet. The difficulty is deciding which Internet sites you should trust. Since anyone can post information on the Internet, there is a great potential for misleading or erroneous information.

The best thing you can do to ensure that the information you are receiving is credible is to check the source. If you do not trust the source, you should not trust the information. Web sites developed by major healthcare centres and recognized medical journals are more likely to provide reliable information than websites developed by individuals or unnamed sources. Corporate websites often have high-quality reliable information, but there is always the potential for bias. For example, a website of a pharmaceutical company may provide information which favors a treatment which uses a drug produced by that company.

To help you find more information on finding and evlauating cancer information on the Internet, we have developed a practical Internet Guide to cancer information, as well as a list of Internet Links that will help you get started.

21. What To Ask Your Health Care Team
You should ask your health care team whatever questions are necessary to make sure that you are comfortable with what is happening to you during the course of your diagnosis, staging, treatment and follow-up.

Here are some examples of questions you may wish to ask your health care team:

1. What is my PSA level?
2. What is my Gleason Score?
3. What stage is my cancer?
4. What are my treatment options?
5. Is there anyone else with whom I should speak?
6. Where can I find more information?
7. Where should I be treated?

This text has been adapted from the Oncology Interactive™ Education Series. Each title in this series contains between 15 and 20 hours of interactive, graphically rich and comprehensive content for patients, their families and health care professionals. You can use this series at any one of the Resource Centres at Princess Margaret Hospital, borrow a copy from the PMH Patient and Family Library, or purchase your own personal copy from http://www.OncologyInteractive.com.