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Prostate Cancer Complications

Overview

Prostate cancer occurs when cells in the prostate gland become abnormal and multiply. The accumulation of these cells then forms a tumor. The tumor can lead to a variety of complications, such as erectile dysfunction, urinary incontinence, and severe pain if the cancer spreads to the bones.

Treatments such as surgery and radiation can successfully eliminate the disease. In fact, most men diagnosed with prostate cancer can still live full, productive lives. However, these treatments can also lead to unwanted side effects.

Erectile dysfunction

The nerves that control a man’s erectile response are located very close to the prostate gland. A tumor on the prostate gland or certain treatments such as surgery and radiation can damage these delicate nerves. This can cause problems with achieving or maintaining an erection.

Several effective drugs are available for erectile dysfunction. Oral medications include:

A vacuum pump, also called a vacuum constriction device, can help men who don’t want to take medication. The device mechanically creates an erection by forcing blood into the penis with a vacuum seal.

Incontinence

Prostatic tumors and surgical treatments for prostate cancer can also lead to urinary incontinence. Someone with urinary incontinence loses control of their bladder and may leak urine or not be able to control when they urinate. The primary cause is damage to the nerves and the muscles that control urinary function.

Men with prostate cancer may need to use absorbent pads to catch leaking urine. Medications can also help relieve irritation of the bladder. In more severe cases, an injection of a protein called collagen into the urethra can help tighten the pathway and prevent leaking.

Metastasis

Metastasis occurs when tumor cells from one body region spread to other parts of the body. The cancer can spread through tissue and the lymph system as well as through the blood. Prostate cancer cells can move to other organs, like the bladder. They can travel even further and affect other parts of the body, such as the bones and spinal cord.

Prostate cancer that metastasizes often spreads to the bones. This can lead to the following complications:

  • severe pain
  • fractures or broken bones
  • stiffness in the hip, thighs, or back
  • weakness in the arms and legs
  • higher-than-normal levels of calcium in the blood (hypercalcemia), which can lead to nausea, vomiting, and confusion
  • compression of the spinal cord, which can lead to muscle weakness and urinary or bowel incontinence

These complications can be treated with drugs called bisphosphonates, or an injectable medication called denosumab (Xgeva).

Long-term outlook

Prostate cancer is the second most common type of cancer in men after non-melanoma cancer of the skin, according to the Centers for Disease Control and Prevention.

Deaths due to prostate cancer have declined dramatically. They continue to drop as new treatments become available. This may be due to the development of diagnostic tests for prostate cancer in the 1980s.

Men with prostate cancer have a good chance of living for a long time even after their diagnosis. According to the American Cancer Society, the five-year relative survival rate for prostate cancer that hasn’t spread is close to 100 percent. The 10-year survival rate is close to 99 percent and the 15-year survival rate is 94 percent.

The majority of prostate cancers are slow growing and harmless. This has led some men to consider using a strategy called active surveillance or “watchful waiting.” Doctors carefully monitor the prostate cancer for signs of growth and progression using blood tests and other exams. This helps avoid the urinary and erectile complications associated with certain treatments. A 2013 study suggests that people diagnosed with low-risk cancers may want to consider receiving treatment only when the disease looks like it may spread.

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