Living with prostate cancer

Urinary problems and prostate cancer treatment

You may have some problems with controlling or passing urine as a result of certain treatments for prostate cancer like surgery, brachytherapy or external beam radiation.

Urinary problems may last from a few weeks to a number of months after the treatment has finished, and for some men a much longer length of time. 

See the Treatments for prostate cancer section for more detailed information on the specific urinary problems that might occur for each type of prostate cancer treatment and how to manage them.

You can speak with your doctor or nurse if you are having problems passing urine. The range of treatments may include pelvic floor exercises, bladder retraining, medications and sometimes surgery.

If you would like to read further information about urinary problems you can visit our section Urinary symptoms, catheters and prostate cancer treatment or call the Cancer Nurseline Freephone 1800 200 700 to speak to a cancer nurse. You can also email the nurses at cancernurseline@irishcancer.ie or visit a Daffodil Centre.

Sexual side effects and prostate cancer treatment

Prostate cancer or treatments for prostate cancer can cause side effects which can have an effect on your sex life. For example surgery will have an effect on ejaculation and may have an effect on the quality of a natural erection, while hormone therapies are likely to cause a reduced or loss of libido (desire for sex). 

Side-effects vary from person to person and depend on the treatment or combination of prostate cancer treatments you have. See the Treatments for prostate cancer section for more detailed information on the side effects of each type of prostate cancer treatment and how they may have an effect on you sex life.

Do not feel embarrassed to tell your doctor or nurse if you have any of these symptoms. There are treatments available that may be able to help which may include medications, injections, pellets, and vacuum pumps. 

For further information please visit our section sex, erectile dysfunction and prostate cancer. You can call our Cancer Nurseline on Freephone 1800 200 700 if you would like to talk to a cancer nurse. If you prefer, you can also visit a Daffodil Centre or email the nurses at cancernurseline@irishcancer.ieFind your nearest Daffodil Centre here.

You can also read further information about sex and prostate cancer here.

Communication and intimacy with your partner

A supportive partner who is sensitive to the changes you may be experiencing as a result of prostate cancer is a great comfort at a difficult time. However, the emotional and physical effects of a cancer diagnosis and of any treatments can be difficult for both you and your partner, and can cause stress and strain in some relationships.

Together as a couple you may experience changes in priorities as decisions have to be made and treatments planned. Changes may have to be made to plans and the future may feel uncertain. Tasks and roles may have to change hands temporarily, which may be difficult to get used to at first. You may have new financial pressures to cope with or you may experience intimacy issues and changes to your sex life.

Many men experience symptoms like fatigue, loss of libido, urinary incontinence and erectile dysfunction after treatment for prostate cancer. This might have an effect on your sense of yourself as a man, your self-esteem and your ability to feel confident in expressing and talking about the sexual aspects of your relationship with your partner. 

Talking about sex

Sex can mean different things to different men. Some men find that a change in their ability to have sex does not worry them a lot; other men find it a big problem. Having a natural erection is something that many men take for granted and so it can be difficult to imagine what life might be like without having sex or having to express intimacy in a different way to before.  

Trying to manage and contend with some or all these changes may discourage you from wanting to have sex or experience intimacy at all.

You may feel anxious about how issues to do with sex are affecting your partner too but you may be reluctant or embarrassed to talk about it.  Sometimes taking time with your partner to talk and stay close can unintentionally become less of a priority. However, not communicating well about the changes in the pattern of your physical relationship can have effects on other aspects of your relationship.

Often with the right advice, some patience and effort, many couples find ways to continue to have a satisfying sexual life, physical closeness, pleasure and fun together. There can often be a mutual sense of loss as you both try to get used to these changes but most couples adjust to expressing their love and closeness in a new way to before. 

Take time to talk and listen

Try to be open with your partner about how you think and feel. You may find you have similar concerns or worries, and sharing them can help you to feel better and find ways to cope. Recognise that your partner may have a different way of coping to you.

You may also have different feelings and expectations when it comes to sex and intimacy in your relationship. Talking about how you feel and listening to your partner’s feelings can give you both the opportunity to express your wishes, preferences and concerns and can help to avoid misunderstandings. 

Talking about sex can be difficult, even for couples who have been together for a long time. Sometimes it can be helpful to have professional support when you need to talk about relationships and sex.

Ask your medical team about relationship counsellors, psychologists and sex therapists who may be able to help. See the section below on sex therapy  for more information about the type of help available and where to get it.

Make time to be close and be together

There are many ways to feel close to your partner that don’t involve sex. These include sitting together, holding hands when out for a walk, making a special effort to cook something nice at home and to eat together as a couple, planning new activities or trips together to places you both enjoy or simply sharing a hug or a kiss together. Physical touch can send strong messages of love and care.

Take the focus off performance

It can help to try to change the way you think about sex. Taking the focus off erection and penetrative sex can help you to enjoy the whole act of lovemaking better and feel more fulfilled. You can still have orgasms without an erection or ejaculating.

Experiment a bit 

Make time to be physically close and be open to trying things differently, knowing they might not work so well at first. Introduce changes slowly. Try some mutual touch like massage focusing on the non-sexual parts of the body. Slowly progress to genital touching later or on another occasion. Being relaxed and experiencing touch with all your senses can lead to orgasm even with a soft penis by recognising previously undiscovered pleasure points or areas that are sensitive to touch. Other alternatives might include oral sex, mutual masturbation or sex toys.

Sex therapy

It may also help to get further advice from a therapist trained in sexual therapy. A sex therapist can advise you on ways to help maintain your sex life. They will have special training in the causes and treatment of sexual problems and are both knowledgeable and comfortable talking about sex. Therapy usually involves a number of counselling sessions to be attended by you and your partner. Some relationship counsellors may be trained in psychosexual therapy also.

Relationships counselling and sex therapy organisations

You can find further information about sexual therapy and what to expect when you attend a session from the Sexual Advice Association in the UK.

Below are organisations based in Ireland who offer services supporting couples around the area of relationships and sexual therapy.

  • Relationships Ireland
    Relationships Ireland offers couples counselling or psychosexual therapy for couples who are affected by cancer, as well as general relationships and sexuality counselling:  For more information see www.relationshipsireland.com, email info@relationshipsireland.com or Lo-Call 1890 380 380.
     
  • Accord
    Accord offers sex therapy for married couples who are experiencing problems in their sexual relationship. For more information see www.accord.ie, email info@accord.ie or call 01 505 3112.
     
  • Cosrt
    Cosrt, the College of Sexual and Relationship Therapists, has information on sexual issues and contact details of accredited therapists in Ireland. For more information see www.cosrt.org.uk, email info@cosrt.org.uk or call 00 44 20 8543 2707.

Additional reading

  • Intimacy with Impotence (The couples Guide to Better Sex after Prostate Disease)
    Ralph and Barbara Alterowitz
    ISBN:-13 978-7382-0789-6
     
  • Saving your sex life: A guide for men with prostate cancer (Kindle Format) 
    John Mulhall
    ISBN-13: 978-0980064964
     
  • The new male sexuality
    Bernie Zilbergeld, ph.D
    ISBN-13:978-00553380422

Intimacy and sexuality for cancer patients and their partners

This booklet can be downloaded from The Sexual Advice Association

For further information please visit our section Sex, erectile dysfunction and prostate cancer.

You can call our Cancer Nurseline Freephone 1800 200 700 or email cancernurseline@irishcancer.ie if you have any questions or need support. You can also visit a Daffodil Centre. Click here to find your nearest Daffodil Centre

Taking care of your mental wellbeing

Receiving a diagnosis of prostate cancer or finding out that it has returned may cause you to experience a variety of reactions and emotions. You may feel a range of mixed feelings at times like shock, fear, sadness, loss, anger and depression. You may also feel a loss of control or feelings of uncertainty. Remember these are all normal reactions to a difficult situation.

These feeling can come and go at different times as you progress through your treatments and indeed after treatment.  You might find it difficult to adjust to life after your treatment has finished, as you may be trying to live with or manage side-effects resulting from treatments such as erectile and urinary problems or fatigue.

The day-to-day impact of having to live with changes after a diagnosis of prostate cancer can have an effect upon how you feel about yourself as a man as well as how you relate to others around you. You may worry about the future and the possibility that the prostate cancer will come back or that you are not responding well enough to the current treatment. It may be more on your mind before your hospital follow-up visits or before PSA blood tests. 

Often men manage their reactions to living with prostate cancer in different ways: Some men may feel empowered by becoming very knowledgeable about their prostate cancer and research it and ask lots of questions and talk openly; other men may prefer to have less information and may choose to cope with their cancer in a more private and low-key way. There is no one right way to cope, but it is important that you have whatever level of support is right for you.  Help is available, whatever level of support you need, and you do not have to deal with this alone. Call the Cancer Nurseline Freephone 1800 200 700 for details of support services or to discuss any questions or concerns.

How can I take care of my mental wellbeing?

  • Talk to someone close
    It can help to talk through your concerns if you have a partner or family. They too are affected by what is happening to you. Talking through things together can bring you closer at a time when you might be all be feeling worried. 
     
  • Share your concerns with a health professional
    It can help to share your concerns with your doctor or nurse. They can also refer you to other professionals who will help you find ways to cope in a supported way, if you need them. You could ask to be referred to a psycho-oncology service, if one is available in the hospital you are attending. These specialise in dealing with how you feel about your cancer and how you can live well with cancer.
     
  • Visit a community cancer support centre
    Local, community-based cancer support centres give you the opportunity to meet others, join groups, receive complementary therapies and/or arrange a ‘one-to-one’ appointment with a professional counsellor. Contact our Cancer Nurseline on 1800 200 700 for advice on finding a group near you.
     
  • Join structured educational and support programmes
    Some cancer support centres run specific men’s cancer support groups or prostate cancer educational support groups where you can meet other men to learn more and share experiences about treating and living with prostate cancer. For information on your nearest cancer support centre click here
     
  • Speak with a volunteer
    Some men find it helpful to speak one-to-one with another man who has gone through a diagnosis of prostate cancer.

    For example, Survivor Support is a programme set up to help and support people who have been diagnosed with cancer. It involves personal phone contact between you and a volunteer who has had treatment for prostate cancer. Volunteers are carefully selected and fully trained to provide support and reassurance at a time when you are most in need of both.  A referral to a Survivor Support volunteer can be arranged for you by calling our Cancer Nurseline Freephone 1800 200 700 or visiting a Daffodil Centre.
     
  • Use stress management techniques
    Some therapies available in many cancer support centres like relaxation therapy, meditation or yoga might help you to cope and feel supported and to develop skills to help you cope with the stress. 
     
  • Write things down
    It can often help to keep a journal. Writing down your thoughts may help you to identify what it is that you are feeling. If your head feels cluttered with too many thoughts, writing things down may help to clear it so you feel less overwhelmed.
     
  • Take regular exercise
    Exercise isn’t just good for your body – it can also help your mind. Chemical hormones called endorphins are released during exercise. These help to lift your mood and help you to feel better able to cope. As well as the mental benefits, exercise may help you to feel less tired and keep your heart and lungs healthy and your bones strong. Exercise may also reduce the risk of your prostate cancer coming back.
     
  • Feel the feeling
    Recognise in yourself that you may experience different feelings at different times and that this is normal. Try not to worry if you do feel sad or afraid at times. Remember that these feelings are normal and that they usually pass after a time. Identify your inner strengths by thinking about ways you have coped with life’s challenges in the past and try to use these to help yourself cope now. 
     
  • Recognise when you need further help
    Most men experience some level of emotional distress (feelings of shock, fear, sadness, anger) when initially diagnosed with prostate cancer and at various times during and after treatment.

    Feelings of distress can be more intense at certain times, such as while you are waiting for test results or before your hospital visits.  Some men report that the period after treatment ends can be a difficult time, as you might feel more isolated or start to experience the impact of possible side-effects. 

Most men adjust to living with a prostate cancer diagnosis and learn how to deal with its emotional effects. However, if you are experiencing persistent distress with feelings of anxiety, low mood or possibly depression which is having an impact upon your daily life and relationships you should inform your urology doctor, prostate nurse or your GP. 

Feeling low all the time, losing motivation, isolating yourself and losing the ability to enjoy life may indicate the onset of depression.  Depression can have an impact on all aspects of your life so it is important to seek the appropriate help as soon as you can. 

Once depression has been identified there are many effective treatments that can help, such as talking therapies and medication.

If you are finding it hard to understand or to talk to others about how you might be feeling at the moment it might be helpful to read these two books: Emotional Effects of Cancer and Who Can Ever Understand?

If you have any questions or concerns about your cancer diagnosis or if you would like more information about  where you can get further support from a cancer support centre, call our Cancer Nurseline Freephone 1800 200 700 and talk to one of our cancer nurses in confidence. You can also visit a Daffodil Centre. Click here to find your nearest Daffodil Centre.

Eating a balanced diet

The evidence about diet and prostate cancer is limited, but following a healthy diet may help with side-effects of treatment, and can lower your risk of other cancers and heart disease.

You may find it easier to make gradual changes to your diet, such as eating more fruit and vegetables.

If you are not sure how healthy your diet is you can have a look at our booklet: Diet and Cancer.  

Click here for some easy-to-follow tips on how to improve your diet. Call our Cancer Nurseline on 1800 200 700 or visit a Daffodil Centre if you would like a printed copy.

There is some evidence that certain foods may be helpful for men with prostate cancer, although there is no firm evidence that any food or dietary supplement has a proven effect. At present many research studies find it difficult to draw definitive conclusions.

It is thought that maybe eating foods like tomatoes rich in lycopene may slow down the growth of prostate cancer. This includes eating fresh tomatoes but also cooked and processed (tomato soup, tomato sauces, tomato puree/paste) too as they are a better source of lycopene. Eating green leafy vegetables (cabbage, broccoli, cauliflower, brussels sprouts, kale, soya products and drinking green tea and possibly pomegranate juice may lower the risk of prostate cancer coming back after treatment. There is no real evidence to show that these can help but equally there is no evidence to show that they are harmful when eaten as part of a healthy well-balanced diet. 

Should I be taking supplements?

Most people do not need food supplements like vitamin pills, as a balanced diet will usually give your body all the nutrients it needs. If you are thinking about taking supplements and have prostate cancer it is important to discuss this with your doctor or nurse first. 

If you are taking hormone therapy your doctor may advise you to increase the amount of calcium in your diet and to take calcium and vitamin D supplements to help strengthen your bones. Calcium-rich foods include dairy products like milk and cheese, oily tinned fish with soft bones, such as sardines, tofu and green leafy vegetables like cabbage.  

Alcohol

We do not know if alcohol has a specific effect on prostate cancer but it is still important to drink in moderation so as to lower the risk of getting other cancers and to help control your weight and keep your bones healthy. If you have had prostate cancer treatments and have bladder problems such as bladder irritability, then taking alcohol may make these symptoms worse. Click here for more information on alcohol and cancer.  

Eating a healthy balanced diet may help you to reduce excess weight or keep your weight within the expected range for your height. It is important to eat healthy foods and not to over-eat – keep portion sizes small if you are trying to lose weight.  

Your body mass index (BMI) is a way of finding out if you are a healthy weight. You can calculate your own BMI here.  

If you are overweight, eating a balanced diet, reducing fatty and sugary foods and getting more exercise will help you to lose weight gradually. Click here for information on healthy weight habits and tips to help you lose excess weight or keep it under good control.  

If you are underweight consider steps to improve this by making sure that you are eating enough. Being underweight can have an influence on your health, especially if you are on hormone therapy as there is an increased risk of bone thinning. If you are concerned that you are overweight or underweight you could discuss this with your family doctor and also get further advice from a dietitian.

Keeping a healthy heart

Keeping a healthy heart is important for everyone, but it’s particularly important if you are taking hormonal therapies for prostate cancer. Hormone therapy may increase body fat and raise low density lipoprotein (LDL) cholesterol and cause blood sugar abnormalities, which can increase your risk of getting heart problems, having a stroke or developing diabetes. 

You can help to keep your heart healthy by maintaining an active healthy lifestyle and eating a healthy diet. Simple measures like reducing your salt intake and cutting down on alcohol are helpful. It’s also important to avoid smoking and to maintain a healthy weight.

You could see your GP for further advice and to discuss how often you may require health check-ups to monitor your heart health and have your blood cholesterol levels checked. Keeping active is important for your general health. Exercise has also been shown to help with the side-effects of prostate cancer treatments and to improve your sense of wellbeing. This is especially true if you are taking hormone therapy, as exercise may help with fatigue and help to prevent bone thinning and weight gain. For more information on hormone therapy side-effects visit our section Hormone therapy and prostate cancer.

Being physically active

Keeping active is important for your general health. Exercise has also been shown to help with the side-effects of prostate cancer treatments and to improve your sense of wellbeing. This is especially true if you are taking hormone therapy, as exercise may help with fatigue and help to prevent bone thinning and weight gain. For more information on hormone therapy side-effects see our factsheet Hormone Therapy and Prostate Cancer.

Getting started with exercise

Try to remain active and exercise a little both during and after prostate cancer treatment, even if you do not feel like it. Remember to get a good balance between being active and taking time to rest. This allows your muscles time to recover after activity. If exercise is impossible, try to remain active in your daily routine.

Research has shown that there are many benefits to exercise:

  • It helps to reduce the symptoms of fatigue, the side-effects of cancer treatments, and improves your overall well-being and heart health.

  • It keeps and improves your physical abilities and prevents your muscles wasting due to inactivity.

  • Regular exercise builds up your physical fitness level, improves your energy, strength, balance, stamina and co-ordination.

  • Regular exercise, along with a healthy diet, can help lower the risk of prostate cancer coming back or some other types of cancer developing. 

  • Light exercise encourages your body to release endorphins. These are often called ‘feel-good hormones’. When released, they can lift your mood and sense of well-being.

Remember a little exercise is better than none. Even a short walk is a good place to start.

Physical activity programmes

You might be able to take part in a supervised, group physical activity programme. Experienced fitness trainers run these groups over a number of weeks. The programmes can be a good source of support from other people who have had cancer as well as being sociable. It can be fun to exercise with other people and being in a structured group can keep you motivated. Before you start, your trainer will explain the benefits and risks of increasing your physical activity. After that, you may be asked to give your written consent. The fitness trainer will match the types of exercises to your individual needs, bearing in mind your current fitness level. He or she will then support you throughout the programme.

Some cancer support centres run physical activity programmes, including the 15-week fitness programme called Strides for Life, which is supported by the Irish Cancer Society. Call or visit your local cancer support centre to see if any fitness programmes are running in your area. Click here to find details of your nearest cancer support centre.

Some sports centres may also run specially supervised physical activity programmes for people after cancer. To take part you will need to be referred by your medical team and you may have an assessment first.

Ask your medical team for advice about specialist exercise programmes in your area.

How to get started

Start gradually if you have not been taking regular exercise before your cancer diagnosis. Regular exercise usually means 30 minutes of moderate activity at least 3–5 times a week. At this level, your heart rate will increase but you can still talk. You can build up to this gradually and also break up the 30 minutes into three 10-minute sessions.

A simple and free activity like walking is excellent. Set yourself some achievable goals, and try and increase the distance you walk every day or every week, while pacing yourself and listening to how your body feels. Your muscles will tell you when you need to ease back or rest.

Doing an activity such as swimming, gardening or cycling for a few minutes every day can help. Recording your achievements in a diary every day can also help you to check your progress. Overall, make sure the exercises are safe, work well and are enjoyable.

Simple ways to keep active:

  • Go for a walk during the day

  • Ride your bike

  • Do some gardening

  • Take the stairs instead of the lift

  • Park your car in the farthest parking space at work and walk to the building

  • Get off the bus a few stops before your destination and walk the rest of the way

Hints & Tips – Exercise safely

  • Exercise on a flat surface and avoid exercises that might increase your risk of falling or injuring yourself.

  • Make sure you drink enough water during and after exercise to prevent dehydration.

  • Wear well-fitting supportive shoes like laced, flat shoes or trainers

  • If you are having chemotherapy, it is best to avoid swimming pools. Consider using the gym. If you are just starting to exercise regularly you may feel more comfortable during off-peak times, when the gym is quieter.

  • If you are having radiotherapy and have a skin reaction, avoid swimming pools until after your skin has healed. The chemicals in the water may cause an irritation.

  • If you get chest pain, dizziness, nausea, difficulty breathing or a racing heart, do stop the exercise and tell your doctor.

  • Do not exercise if you feel unwell, are breathless, in pain, or have any symptom that worries you. Discuss it with your doctor.

  • Avoid high-impact exercises or contact activities if you have bone cancer or osteoporosis (bone-thinning)

Bone health

Taking hormone therapy can increase the risk of your bones thinning. Being physically active can help to keep you strong and less likely to have falls which can lead to bone fractures (breaks). Doing gentle resistance exercises such as fast-paced walking, swimming and using light weights will help to strengthen your bones and prevent muscle loss.

Talk to your doctor or nurse if you have bone-thinning or prostate cancer present on the bone before thinking about higher impact sports like running or contact sports. You may be referred to a physiotherapist who can give you advice about exercising safely and tailor a specific exercise programme to your needs.

For more information visit our section on bone health and cancer.

Fatigue

Many people suffer from fatigue from time to time, even if they are not ill. Fatigue is often described as an overwhelming tiredness. Sometimes fatigue is nature’s way of telling us to slow down and take some rest. Fatigue can be caused as a result of prostate cancer symptoms. It can also be a side-effect of treatment. The reason for the fatigue can be hard to identify. You may find it difficult to concentrate or make decisions when you are suffering from fatigue. There are ways to cope with fatigue, even if you don’t know what is causing it. See our booklet Coping with Fatigue for information and advice.

Quick tips to manage fatigue

  • Treatment: Pain or urinary problems can drain your energy or prevent you from sleeping, which can make you feel fatigued. Always tell your doctor about your symptoms so he or she can advise you about treatments that may help.
  • Sharing worries: Worries and anxiety because of a cancer diagnosis can affect your mood or sleep and cause you to feel fatigued. Talk to family and friends. If you find this difficult ask to see a counsellor. He or she will help you to find ways to relax.
  • Exercise:  Taking exercise can boost energy levels and combat fatigue. If your illness allows you to take part in physical exercise, do some on a regular basis. For example, gradually increasing to a 30 minute walk 3 days a week might be a realistic goal and will boost your morale when you achieve it.
  • Eating and drinking: Sometimes when you are feeling weak and fatigued you may lose interest in your food. You may notice that you have lost weight. This may be due to the cancer or the treatment you are getting. Ask for help in preparing your meals. Eat your favourite types of food. Drink lots of clear fluids such as water and fruit juice.
  • Involve others: Get others to help you around the house, with travelling to hospital, at work, with the children or with shopping. Use the extra free time to do something that you especially enjoy.

Hot flushes

Hot flushes and sweating happen because the lack of testosterone affects the part of your brain that regulates heat when you take hormone therapy for prostate cancer. Speak to your doctor if they are troubling you, as medication may be prescribed. 

Hints and tips on coping with hot flushes

  • Cut down on alcohol and drinks with caffeine, such as coffee, tea and cola.

  • Some men choose cotton clothing rather than synthetic fabric as it absorbs moisture better, others may find newer fabrics such as those with wicking technology help to keep them more comfortable. These can be bought online and come in t shirts and sleepwear.

  •  Wear layers of clothes or bedclothes to allow you to remove layers as needed. Sheets which wick away moisture may help if excessive sweating at night is a problem. These can be bought online.

  • Note when the hot flushes occur to see if there is a pattern or if certain things like hot drinks or spicy food trigger them off.

  • Avoid warm areas and use moist wipes, sprays or an electric fan to help you to feel cooler.

  • Avoid smoking.

  • Cut down on spicy foods.

  • Drink plenty of cool fluids and stay a healthy weight for your height.

  • Try relaxation therapy to see if it helps to reduce the hot flush.

  • Keep a cool gel pack under your pillow at night for a cooling effect when you need it.

  • Regular exercise, such as going for a walk, may help reduce your symptoms.

  • If you are overweight, losing weight can help to reduce your symptoms.

Our section Hormone therapy and prostate cancer has more information on managing hot flushes and other side-effects of hormone treatments.

Note: There are links to external websites on this page. The Irish Cancer Society is not responsible for the contents of external websites

Date Last Reviewed: 
Wednesday, August 26, 2015
Date Last Revised: 
Wednesday, April 15, 2015