Prostate Cancer Treatments
Deciding the best prostate cancer treatment is a challenge. Prostatectomy is the removal of the prostate by surgical incisions in abdomen or perineum, or small incisions and laparoscope use. Radical prostatectomy is the removal of the entire prostate gland and possibly the seminal vesicles and surrounding nerves and veins. Although technically well done, radiation therapy may not be the answer or at least the whole answer to prostate cancer treatment and survival.
All prostate cancer treatments affect sexual potency. Complications from prostate cancer are related to both the disease and its treatment. Many men may feel depressed after a diagnosis of prostate cancer or after trying to cope with the side effects of treatment.
Prostate Cancer Treatment
Treatment options include radiation therapy (either through an external beam or radioactive seed implants), surgery, hormone therapy and watchful waiting. Selecting the right treatment for prostate cancer depends on many factors, including your husband's overall health, his age, the aggressiveness of his prostate cancer, and how he feels about the potential side effects. One of the biggest fears of many men who have prostate cancer is that treatment may leave them incontinent or unable to maintain an erection firm enough for sex (erectile dysfunction).
Male Urinary Incontinence
Male incontinence is relatively unusual, and is always associated with some sort of bladder or prostate disease. Yes, more than 330,000 men are diagnosed with prostate cancer each year, and many will require prostate surgery, the leading cause of incontinence in men. Stress incontinence may develop when a man's prostate gland is removed and there has been dysfunction of or damage to the nerves or the sphincter, resulting in inadequate support for the lower bladder (bladder neck). Most men do not have trouble with incontinence for more than a few days or a few weeks after a transurethral resection of the prostate (TURP). When a radical prostatectomy is performed to remove a cancerous prostate, the possibility of incontinence is greater.
Muscle-strengthening Exercises
The ability to fill and store urine properly requires a functional sphincter (the circular muscles around the opening of the bladder) and a stable, expandable bladder wall muscle (detrusor). Stress incontinence is a bladder storage problem in which the strength of the muscles (urethral sphincter) that help control urination is reduced. Exercises to strengthen the muscles which support your bladder neck (with or without the help of devices like electrical stimulation, biofeedback, or exercise cones) may be prescribed if your symptoms point to stress urinary incontinence. Muscle-strengthening exercises (called Kegel exercises or pelvic floor exercises) can be very helpful in treating bowel incontinence. These are performed by contracting the large muscles that make up the pelvic floor. When the pelvic muscles are contracted they send a message to the bladder muscle to relax.
Biofeedback And Electrical Stimulation
Biofeedback and electrical stimulation may be helpful for those who have trouble doing pelvic muscle training exercises. Biofeedback uses electrodes placed on the pelvic floor muscles, giving you feedback about when they are contracted and when they are not. Biofeedback and electrical stimulation will no longer be necessary once you have identified the pelvic floor muscles and mastered the exercises on your own. Newer techniques are being investigated, including one that uses a specially designed electromagnetic chair that causes the pelvic floor muscles to contract when the patient is seated.
Medications
Medications that may be prescribed include drugs that relax the bladder, increase bladder muscle tone, or strengthen the sphincter. Other medications such as diuretics, muscle relaxants, and blood pressure medication can also affect bladder function. Other medications, including flurbiprofen, capsaicin and botulinum toxin, are sometimes prescribed to relax the bladder muscles or to tighten the urethral sphincter. One of these drugs, duloxetine, differs from present medications in targeting the central nervous system's control of the urge to urinate rather than the smooth muscle of the bladder itself.