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Living with Prostate Cancer

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Some prostate cancers grow very slowly and have few symptoms, but even when the prostate cancer has already passed to other organs, it can often be well controlled with anti-cancer drugs and the person can have a good quality of life for years.

Once diagnosed with prostate cancer, the patient is assigned to a multidisciplinary team, in other words, various professionals (oncologists, radiation oncologists, oncology and urology nurses, dieticians, pharmacists, and psychologists) who work together as a team to provide the best treatment and support during the period of illness and treatment.

The treatments may cause side effects, so care and supportive treatments will be used to eliminate or lessen these. The most common are:

Medications to regulate urinary frequency and discomfort, and rehabilitation to improve urination habits.
Analgesics to relieve pain.
Bowel regulators in addition to recommendations on diet and moderate daily physical activity.
Cognitive rehabilitation to improve any memory and concentration issues caused by the treatments.
Recommendations on how to maintain good oral hygiene and avoid a dry mouth.
Treatments that help decrease fatigue and recommendations for daily habits and strategies, such as yoga and mindfulness, that increase personal energy.
Treatments to avoid osteoporosis or bone wear that may be caused by anti-cancer drugs. Calcium and vitamin D supplements to improve bone health.
Dietary recommendations, daily habits and physical activity for maintaining an adequate weight and reducing the risk of falls and bone fractures.
Treatments to improve peripheral neuropathy or decreased tactile sensitivity in the hands and feet. Recommendations on including vitamins, folic acid and antioxidants in the diet, as well as physical rehabilitation to regain sensitivity.
Keeping the skin well hydrated and protected from the sun.
Medicines and techniques that enable a good night’s rest and a restful sleep.

Healthy habits

Nutrition. Diet and obesity are related to the development and progression of prostate cancer. Both factors can be favourably modified with diet and lifestyle.

An adequate intake of protein, an optimal body mass index, increased physical activity, and eating fruits and vegetables can be very beneficial.

Dietary recommendations:

A varied and moderate diet is the best way to avoid being continuously exposed to harmful substances that some foods may contain.
Increased fibre intake: a diet rich in vegetable products including whole grains, legumes, vegetables and fresh fruits.
Preferential consumption of raw vegetables (salads, smoothies, shakes, shoots, gazpachos, fruit), several servings a day.
Increased consumption of legumes, three to five times a week.
Limited red meat intake. Do not eat this more than twice a week.
Restricted consumption of processed meats: sausages, black pudding and processed foods containing industrially processed meat.
Consumption of healthy fats (olive oil and linseed, and nuts) on a daily basis. Avoidance of saturated fats (sausages, bacon).
Reduced salt intake, in addition to less salt-preserved foods. The carcinogenic potential of salt increases with the frequency of consumption.
Eating oily fish a couple of times a week.
Eating low-fat dairy products, primarily yoghurt and fresh (unripened) cheeses.
Decreased alcohol intake.
Reduced consumption of sugars, in general.
It is important to drink five to six glasses of water a day.
Simple, low temperature preparation of food (simmering, steaming). Avoid barbecues, smoked foods, and grilled dishes, as these cooking methods increase the carcinogenic substances in food.
Take care to conserve food correctly.
Wash food well before use to remove any chemicals that it may contain.

Avoid:

Burned food (meat, toast).
Coffee.
Sugar and carbonated drinks.
Industrial pastries.
Cold meats in general.
Processed foods.

Exercise. Physical exercise is desirable and effective for the majority of men affected by prostate cancer. Various scientific studies have shown that physical exercise improves the situation and contributes very positively to achieving an overall improvement in the physical symptoms and psychosocial factors related to cancer and its different treatments.

It is an important part of the disease control, because physical exercise improves autonomy and well-being. It is also a useful complement for improving the side effects of cancer treatments.

Some activity is very beneficial, but it must always be adapted to the patient’s state of health. To carry out the exercise safely, it is important to agree on this with the healthcare team, from the earliest stages of treatment. Often, different treatments are combined that cause conditions which can be improved with personalised exercise.

Physical activity and exercise play a fundamental role in all stages of cancer and a sedentary lifestyle and inactivity are associated with worse results.

Sleep. Resting well helps you face the day and improves your mood. Poor sleep, on the other hand, can make a person feel tired and irritable. The need for rest is different for each person, but it is important that everyone sleeps the number of hours they need and that this is good quality rest. Being diagnosed with prostate cancer can lead to sleep disturbance as a result of stress and anxiety.

Recommendations that can help you sleep better:

Make your sleep schedule a routine: go to bed and wake up at the same time each day.
Lie down when you start to get sleepy.
Avoid sleeping during the day if you have insomnia problems. It is better not to take naps, but if you really need to, they should last no longer than 20 minutes.
Do something relaxing until you get sleepy, like reading, listening to music, relaxation techniques, having a hot bath, drinking a glass of warm milk, and so on.
Favourable conditions: a comfortable bed, a dark room, no noise, and a pleasant temperature (between 18-22ºC).
Eat a light supper.
Avoid stimulants, like alcohol, coffee and nicotine, three or four hours before you go to bed.
Exercise regularly during the first half of the day.
Do not watch the clock when you cannot sleep because this can increase your anxiety.
Try not to think about the problems, now is not the time to solve them.
If you cannot sleep, try to face the situation calmly.

If you stick to these habits but still do not get enough sleep to feel rested, you will need to ask the healthcare team for help.

Sexuality. Sexual dysfunction is a well-known side effect of prostate cancer. The adverse sexual effects from the treatments have a negative impact on a man’s sex life.

The different treatments can lead to various disorders: sexual desire problems, sexual dissatisfaction and erectile dysfunction. These disorders have a big physical, emotional and sexual impact that negatively affects quality of life.

In this sense, the dysfunction affects the man’s self-esteem, aspects of his private life, and his relationship with his partner.

These disorders indicate the need to offer counselling to patients, based on all the dimensions of their masculinity and identity. In addition, strategies will be offered that allow them to communicate openly with their partner. In the same way, it is important that the patient understands that they can achieve a full and satisfying sex life.

A methodical and evolutionary evaluation by the doctor is required to adjust the appropriate therapeutic measures, as there may be drugs and procedures that will produce a favourable response to the dysfunction.

Professional advice is provided so that the advantages and disadvantages of the possible therapeutic options are understood, and the most suitable can be found in each case.

It is fundamental to establish a healthcare climate where the patient can approach the subject with complete confidence, with open language and with no reservations.

It is advisable to discuss the subject openly with health professionals to find the necessary support and advice. There are strategies for dealing with the situation, as well as building and maintaining satisfying intimate relationships.

Travel. It is recommended to talk to healthcare team when planning a trip.

Recommendations for travelling:

Plan your trip in advance and obtain all the medicines you need.
Start with short trips and plan time for resting. It is important to listen to your body.
If you have problems with urinary incontinence, you should take into account the length of the journey, plan stops, and know where toilets are located.
Chemotherapy and radiation treatments affect the immune system. To prevent sunburn and insect bites, wear sunscreen and insect repellent.
An optimistic attitude is always important.

Social and emotional support. A diagnosis of prostate cancer is a stressful event for anyone, and can have a significant impact on their quality of life. The appearance of anxiety, fear, mood swings and depression, as well as other issues, add to the physical problems related to treatment side effects, like urinary incontinence and erectile dysfunction.

The perception of the loss of masculinity can affect relationships and self-esteem. Prostate cancer can affect many aspects of life, including the man’s personal, social and working life. It is therefore important to receive psychological support, as an individual or couple, when life’s usual resources are not enough.

One way of trying to avoid increased feelings of discomfort and anxiety is to obtain as much information about the illness, treatment and side effects as possible.

Good communication with healthcare staff, your partner and family, can be the key to staying calm and in control.