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Ask An Expert

Doctor

At the Doctor's OfficeQ I’ve been having sex with my husband who was just diagnosed with prostate cancer. Am I at risk in any way?

There is no risk to you in continuing to have sexual relations with your husband, because cancer is not transmitted sexually.

Q How common is a recurrence of the cancer after treatment?

Cancer can recur after surgery, but it depends upon a number of factors. The most important is the nature and extent of the disease at the beginning. That information is predicted by the biopsy report and preoperative PSA. After removal, the specimen will be submitted to pathology for analysis. If the cancer is deemed to be contained at a microscopic level to the prostate, and within the margins of surgical removal, the odds for a successful outcome are extremely high. Features that predict recurrence include extension outside of the prostate or to other organs such as the seminal vesicles or lymph nodes. Your surgeon will go over this pathology report with you in the post-operative period.

Q If he has surgery how long will his incontinence last?

While the risk of permanent, significant incontinence is small, most men will experience some leaking after the catheter is removed. Recovery is hard to predict and can range from several days to a few months. In general, as long as there is an ongoing trend towards dryness, as much time as needed will be given.

Q My husband is overweight. Would losing weight help (with surgical risks, post-op incontinence)?

Reducing weight can definitely affect recovery. It may lead to an easier procedure and therefore less blood loss and quicker anesthetic. It is possible that continence will also recover more quickly.

Nurse Practitioner

Q Is it important for me to attend his doctor’s appointments?

Yes, it is recommended that a partner/spouse attend doctor’s appointments, as there will be a lot of information given. Offering moral support and being an extra set of ears is important. Intimate details will be discussed and this is a good time for you to ask questions.

Q Even after reading about all the treatment options available, how do we decide which one is best? There are so many to consider!

Not all treatment options are available to everyone. Factors such as the stage and grade of the cancer will most often eliminate a few of the options available. Once your doctor reviews which options are available to your husband it is important to look at what option best fits. There are risks and benefits to all treatment options and careful consideration of these, and how they will impact your life, are important to consider.

Q I’d still like to have an active sex life but my partner is avoiding the issue since surgery. What can I do?

Opening up the lines of communication is the single most important thing a couple can do. This process should start at the very beginning (before treatment). Verbalizing fears and anxieties to each other is very important because each person is bringing something different to the table.

As well, couples usually try to protect each other. Many men will shy away from intimacy; “why start something you can’t finish” is a common theme. The answer is maintaining intimacy and communicating often. It is not about penetration as much as it is about maintaining the relationship. It is also important to note that treatment options, with the exception of hormone therapy, will never affect sexual drives, desires, libidos, or orgasms. Only the nerves that are responsible for erections are possibly traumatized by some of the treatment options. The good news is there are many different treatment options available to deal with erectile dysfunction and they vary in intensity.

Q Are there support groups for women whose partners have had prostate cancer?

Most cities do have support groups for female partners/spouses. For example, Side by Side, in collaboration with Prostate Cancer Canada, provides an opportunity for conversation and support from a woman’s perspective. You can go to the PCCN website for more information on meeting times and locations.

Q How do I talk to my kids about their dad’s prostate cancer?

This conversation will be dependent on the age of the children. Children are very perceptive and usually are aware when something is amiss. Speaking to them together as a couple is usually the best option as it allows them to ask questions directly. Try to encourage them to ask as many questions as they need to.

Q What healthy lifestyle changes can I make for our family to reduce the chances of a recurrence?

Exercise is one of the best prescriptions. Even mild exercise strengthens your heart and blood vessels. If you have strong healthy tissue you heal quicker, have more energy and a stronger immune system, you can sleep better and it even helps you deal with stress better. A healthy diet is also important and probably the easiest one to follow is the healthy heart diet.