Managing your symptoms
Fatigue
What is it?
Fatigue is the most common symptom reported by people with cancer and it can be acute or chronic. Some of the common symptoms include:
- Sleeping more than usual, or still feeling exhausted after a good night’s sleep
- Tiring quickly during activities, or having lower energy all of the time
- Changes in your emotions (like irritability or mood swings), or a general loss of interest in life
- Trouble concentrating, thinking, or remembering
While feeling tired may seem like a minor inconvenience compared to some of the other issues you experience, it can have a serious impact on your day-to-day activities and quality of life.
Fatigue facts
Studies of prostate cancer patients have found that:
- As many as 74% of prostate cancer patients experienced cancer-related fatigue
- Fatigue is associated with all treatments for prostate cancer
What causes it?
There are many factors that can contribute to fatigue when someone is going through cancer treatment. Some of the common reasons include:
Cancer and cancer treatment
Cancer itself can cause changes in your body, like increasing its need for energy. Chemotherapy and radiation therapy may also cause fatigue as your body works to repair your damaged non-cancerous cells. Treatments that cause side effects like anemia and pain, or that affect your hormones, can also contribute to fatigue.
Poor nutrition
When you have cancer, your body’s need for nutrients and its ability to process those nutrients may change. However, side effects like low appetite, nausea and vomiting can make it difficult to meet your nutrient needs.
Lack of exercise
If you’re normally an active person, the effects of fatigue can feel more pronounced because you don’t have the energy to maintain your usual level of physical activity.
Tips for managing it
Get enough sleep
Keep a regular routine to help you get a good night’s sleep. Do things that relax you leading up to bed time, and make sure your bed, pillows and sheets are comfortable. Avoid sleeping too much during the day as this can make you feel more tired.
Save your energy
Note when your energy is high, and plan activities and appointments around those times of day. You may need to be active for shorter periods, and don’t forget to plan rests as well.
Ask for help
Your family and friends are there to support you, so don’t be shy about taking them up on offers to help. Cooking, chores, driving and helping with pets are just some of the simple ways they can help.
Exercise
Regular exercise (both aerobic and weight training) can help improve your energy levels and reduce fatigue – even something as simple as walking. Be sure to check with your doctor before starting or changing your exercise program.
Eat right
Eat a well-balanced diet and drink plenty of fluids, especially when your energy and appetite are good. In between, try to snack every 2-3 hours.
Manage your mood
Depression and anxiety can increase your feelings of fatigue. Consult our Side effect section on how to look after your emotional well-being.
Work with your healthcare team
If your fatigue has a specific cause, your healthcare team can take steps to treat it, such as nutritional supplements, medicines or blood transfusions, so always keep them up to date on how you’re feeling.
Erectile dysfunction
What is it?
Erectile dysfunction (ED), also called impotence, is the inability to get and keep an erection firm enough to have sex – even though you can still experience pleasure, have an orgasm and be fertile. ED is a common side effect of prostate cancer treatments, including surgery (radical prostatectomy), radiation and hormonal therapies. Depending on your type of treatment and your age, your ED may be permanent or only temporary.
Tips for managing it
If you have ED as the result of prostate cancer treatment, it can be yet another source of frustration in your life. But there are a few ways you can help gain control over your situation:
Don’t give up
Don’t assume you have a permanent problem and nothing can be done. Depending on your treatment you may recover your erectile function, but it can take a long time. In the meantime, try to control your anxiety around sexual encounters and activity, which can make ED worse.
Involve your partner
Honest and open communication can help make sure they know that this isn’t a sign of diminished interest in them, and can help you explore other ways to satisfy one another. Treatment is often more successful when a man involves his partner.
Manage your mood
Stress, anxiety and depression can seriously impact intimacy and erectile function. Be open with your healthcare team about all the issues surrounding your treatment and recovery.
Work with your healthcare team
Depending on the cause of your ED your healthcare team has several options to help you achieve erections, including:
- Medications (including pills, injections, and medicated urethral systems)
- Vacuum constriction devices
- Penile prosthesis
Pain
What is it?
People with advanced cancer may experience pain. It can impact you both physically and emotionally, affecting healing and contributing to fatigue, loss of appetite and difficulty sleeping. Depending on your cancer and the type of treatments your received, you may experience pain that is acute (short-term), chronic (long-term) or breakthrough (pain that occurs despite a regular dose of pain medicine).
Tips for managing it
The most important thing to know about cancer pain is that you don’t have to accept living with it. Your healthcare team has many ways to help you manage pain, and there are a few things you can do to help them:
Speak up
Nobody is expecting you to “just deal with it” and nobody will think you’re weak for admitting you’re in pain. The more your healthcare team knows, the better equipped they are to help get your pain under control.
Track your pain
Note when pain happens, what triggered it, where it is, how strong it is (try a simple scale from 1 to 10) and what you did to try and make it better. This kind of information is very helpful to your healthcare team as they try to get your pain under control.
Stick with it
It may take hours or days to get your pain under control. In the meantime, many strong pain medications can have side effects like confusion, lethargy and sleepiness. Don’t let these stop you from sticking with your pain medication regimen! After the first few doses, these side effects usually resolve and you’ll feel more like yourself again.
Work with your healthcare team
You and your healthcare team can put together a pain management plan. This may include:
- Over the counter medication
- Prescription medication
- Treatments that remove the source of the pain e.g. radiation
Hot flashes
What is it?
About 50-80% of men on hormonal therapies for prostate cancer will experience some sort of hot flashes. They usually start as a sudden feeling of warmth in the face and chest that then spreads to the rest of the body in waves, lasting anywhere from 2 to 30 minutes. You may also experience sweating, reddening of your skin, a racing heart or feelings of anxiousness. The exact cause of hot flashes is unknown, but it may be related to how hormones interact with a part of your brain called the hypothalamus, which controls body temperature.
Tips for managing them
Hot flashes usually get better as your body gets used to treatment or if medication is stopped, but there are a number of things you can do on a daily basis to help manage them:
- Dress in layers so that you can remove them when you get hot, and wear looser clothing in lighter fabrics (e.g. clothes made with cotton).
- Stick to air conditioned or cool areas with lots of air circulation (e.g. from a fan or open window).
- Avoid hot drinks, caffeine, spicy foods, tobacco and alcohol.
- Practice taking slow, deep breaths when you feel a hot flash coming on, or try relaxing activities like yoga or meditation.
Incontinence
What is it?
Many men who have radiation, TURP (transurethral resection of the prostate) or radical prostatectomy will experience incontinence – the involuntary leakage of urine. The good news is that it’s usually only temporary, and by 6 months after surgery most men will only lose a few drops of urine when lifting, sneezing or coughing (also called stress incontinence). Some men may also experience urge incontinence (also called overactive bladder) – a strong, sudden urge to urinate.
Tips for managing it
Incontinence can make you feel self-conscious and embarrassed, leading to a decreased enjoyment of life. If you’re older, it can also increase your risk of falling as you rush to the toilet. But there are many lifestyle changes you can make to minimize its impact on you as you heal:
- Drink less, especially before bed. Try to avoid alcohol, caffeine, carbonated and sweet drinks, and spicy and acidic foods.
- Schedule regular trips to the bathroom every few hours, and train your bladder by gradually increasing the time.
- Work out your pelvic floor muscles (which help hold in urine) with Kegel exercises. Your doctor can give you advice on how to get started.
Work with your healthcare team
In addition to lifestyle modifications, there are a few ways your healthcare team can further help you get incontinence under control:
- Medications that reduce bladder irritability, decrease bladder spasms or improve bladder emptying
- Surgical procedures to eliminate blockages in the urethra
- Implants to help close off the flow of urine
By looking after your own mental, emotional and physical well-being, you’ll be better equipped to deal with the changes that come from living with advanced cancer and its treatment. The role you play in looking after yourself is just as important as any medicine or treatment.
We are here for you
You have questions or concerns? Don’t hesitate. Contact us at 1-855-899-2873 to discuss with one of our nurses specialized in uro-oncology. They are there to listen, support and answer your questions, and those of your family or your loved ones. It’s simple and free, like all of our other services.
Also take the time to visit each of our pages on this website, as well as our YouTube channel, in order to get familiar with the disease, our expert lectures, our section on available resources, the support that is offered to you, our events and ways to get involved to advance the cause.
Last medical and editorial review: September 2023
Written by PROCURE. © All rights reserved
Managing your symptoms
Managing your symptoms
In this section on managing your symptoms, we explore the various manifestations and possible complications related to prostate cancer and its treatments. We provide you with advice and information to help you better understand and cope with these symptoms, as well as strategies to alleviate them and improve your quality of life.
What is it?
Fatigue is the most common symptom reported by people with cancer and it can be acute or chronic. Some of the common symptoms include:
- Sleeping more than usual, or still feeling exhausted after a good night’s sleep
- Tiring quickly during activities, or having lower energy all of the time
- Changes in your emotions (like irritability or mood swings), or a general loss of interest in life
- Trouble concentrating, thinking, or remembering
While feeling tired may seem like a minor inconvenience compared to some of the other issues you experience, it can have a serious impact on your day-to-day activities and quality of life.
Fatigue facts
Studies of prostate cancer patients have found that:
- As many as 74% of prostate cancer patients experienced cancer-related fatigue
- Fatigue is associated with all treatments for prostate cancer
What causes it?
There are many factors that can contribute to fatigue when someone is going through cancer treatment. Some of the common reasons include:
Cancer and cancer treatment
Cancer itself can cause changes in your body, like increasing its need for energy. Chemotherapy and radiation therapy may also cause fatigue as your body works to repair your damaged non-cancerous cells. Treatments that cause side effects like anemia and pain, or that affect your hormones, can also contribute to fatigue.
Poor nutrition
When you have cancer, your body’s need for nutrients and its ability to process those nutrients may change. However, side effects like low appetite, nausea and vomiting can make it difficult to meet your nutrient needs.
Lack of exercise
If you’re normally an active person, the effects of fatigue can feel more pronounced because you don’t have the energy to maintain your usual level of physical activity.
Tips for managing it
Get enough sleep
Keep a regular routine to help you get a good night’s sleep. Do things that relax you leading up to bed time, and make sure your bed, pillows and sheets are comfortable. Avoid sleeping too much during the day as this can make you feel more tired.
Save your energy
Note when your energy is high, and plan activities and appointments around those times of day. You may need to be active for shorter periods, and don’t forget to plan rests as well.
Ask for help
Your family and friends are there to support you, so don’t be shy about taking them up on offers to help. Cooking, chores, driving and helping with pets are just some of the simple ways they can help.
Exercise
Regular exercise (both aerobic and weight training) can help improve your energy levels and reduce fatigue – even something as simple as walking. Be sure to check with your doctor before starting or changing your exercise program.
Eat right
Eat a well-balanced diet and drink plenty of fluids, especially when your energy and appetite are good. In between, try to snack every 2-3 hours.
Manage your mood
Depression and anxiety can increase your feelings of fatigue. Consult our Side effect section on how to look after your emotional well-being.
Work with your healthcare team
If your fatigue has a specific cause, your healthcare team can take steps to treat it, such as nutritional supplements, medicines or blood transfusions, so always keep them up to date on how you’re feeling.
What is it?
Erectile dysfunction (ED) is the inability to get and keep an erection firm enough to have sexual intercourse – even though you can still experience pleasure and have an orgasm. ED is a common side effect of prostate cancer treatments, including surgery (radical prostatectomy), radiation therapy and hormone therapy. Depending on your type of treatment and your age, your ED may be permanent or temporary.
Tips for managing it
If you have ED as the result of prostate cancer treatment, it can be yet another source of frustration in your life. But there are a few ways you can help gain control over your situation:
Don’t give up
Don’t assume you have a permanent problem and nothing can be done. Depending on your treatment you may recover your erectile function, but it can take a long time. In the meantime, try to control your anxiety around sexual encounters and activity, which can make ED worse.
Involve your partner
Honest and open communication can help make sure they know that this isn’t a sign of diminished interest in them, and can help you explore other ways to satisfy one another. Treatment is often more successful when a man involves his partner.
Manage your mood
Stress, anxiety and depression can seriously impact intimacy and erectile function. Be open with your healthcare team about all the issues surrounding your treatment and recovery.
Work with your healthcare team
Depending on the cause of your ED your healthcare team has several options to help you achieve erections, including:
- Medications (including pills, injections, and medicated urethral systems)
- Vacuum constriction devices
- Penile prosthesis
What is it?
People with advanced cancer may experience pain. It can impact you both physically and emotionally, affecting healing and contributing to fatigue, loss of appetite and difficulty sleeping. Depending on your cancer and the type of treatments your received, you may experience pain that is acute (short-term), chronic (long-term) or breakthrough (pain that occurs despite a regular dose of pain medicine).
Tips for managing it
The most important thing to know about cancer pain is that you don’t have to accept living with it. Your healthcare team has many ways to help you manage pain, and there are a few things you can do to help them:
Speak up
Nobody is expecting you to “just deal with it” and nobody will think you’re weak for admitting you’re in pain. The more your healthcare team knows, the better equipped they are to help get your pain under control.
Track your pain
Note when pain happens, what triggered it, where it is, how strong it is (try a simple scale from 1 to 10) and what you did to try and make it better. This kind of information is very helpful to your healthcare team as they try to get your pain under control.
Stick with it
It may take hours or days to get your pain under control. In the meantime, many strong pain medications can have side effects like confusion, lethargy and sleepiness. Don’t let these stop you from sticking with your pain medication regimen! After the first few doses, these side effects usually resolve and you’ll feel more like yourself again.
Work with your healthcare team
You and your healthcare team can put together a pain management plan. This may include:
- Over the counter medication
- Prescription medication
- Treatments that remove the source of the pain e.g. radiation treatments
What is it?
About 50-80% of men on hormonal therapies for prostate cancer will experience some sort of hot flashes. They usually start as a sudden feeling of warmth in the face and chest that then spreads to the rest of the body in waves, lasting anywhere from 2 to 30 minutes. You may also experience sweating, reddening of your skin, a racing heart or feelings of anxiousness. The exact cause of hot flashes is unknown, but it may be related to how hormones interact with a part of your brain called the hypothalamus, which controls body temperature.
Tips for managing them
Hot flashes usually get better as your body gets used to treatment or if medication is stopped, but there are a number of things you can do on a daily basis to help manage them:
- Dress in layers so that you can remove them when you get hot, and wear looser clothing in lighter fabrics (e.g. clothes made with cotton).
- Stick to air conditioned or cool areas with lots of air circulation (e.g. from a fan or open window).
- Avoid hot drinks, caffeine, spicy foods, tobacco and alcohol.
- Practice taking slow, deep breaths when you feel a hot flash coming on, or try relaxing activities like yoga or meditation.
What is it?
Many men who have radiation, TURP (transurethral resection of the prostate) or radical prostatectomy will experience incontinence – the involuntary leakage of urine. The good news is that it’s usually only temporary, and by 6 months after surgery most men will only lose a few drops of urine when lifting, sneezing or coughing (also called stress incontinence). Some men may also experience urge incontinence (also called overactive bladder) – a strong, sudden urge to urinate.
Tips for managing it
Incontinence can make you feel self-conscious and embarrassed, leading to a decreased enjoyment of life. If you’re older, it can also increase your risk of falling as you rush to the toilet. But there are many lifestyle changes you can make to minimize its impact on you as you heal:
- Drink less, especially before bed. Try to avoid alcohol, caffeine, carbonated and sweet drinks, and spicy and acidic foods.
- Schedule regular trips to the bathroom every few hours, and train your bladder by gradually increasing the time.
- Work out your pelvic floor muscles (which help hold in urine) with Kegel exercises. Your doctor can give you advice on how to get started.
Work with your healthcare team
In addition to lifestyle modifications, there are a few ways your healthcare team can further help you get incontinence under control:
- Medications that reduce bladder irritability, decrease bladder spasms or improve bladder emptying
- Surgical procedures to eliminate blockages in the urethra
- Implants to help close off the flow of urine
By looking after your own mental, emotional and physical well-being, you’ll be better equipped to deal with the changes that come from living with advanced cancer and its treatment. The role you play in looking after yourself is just as important as any medicine or treatment.
Additional Information - Managing your symptoms
How I coped with prostate cancer
A man with prostate cancer shares the challenges of his cancer experience.
Urologist’s advice: Treatments and information on prostate cancer
Learn more about the role of the urologist and the importance for a patient to gather adequate information after receiving a prostate cancer diagnosis.
Prostate cancer: Tests, imaging and biomarkers
Discussion about the variety of approaches available to monitor this disease before, during, or after treatment.
Is prostate cancer hereditary?
Understanding the hereditary and genetic aspects of this disease can provide valuable information to both individuals affected and their families.
Symptoms, risk and screening
Are you over 50 or experiencing urinary problems? Discover why early screening for prostate diseases is important.
Diagnosis and treatment
Recently diagnosed with cancer? Educate yourself to fully understand your situation.
The role of hormone therapy
Has your doctor recommended hormone therapy? This video is for you!
States of prostate cancer following treatment
Do your recent tests show an increase in PSA levels? It could indicate a recurrence.
External radiation or Brachytherapy?
Explore the benefits and considerations of each treatment option for prostate cancer to determine which might be right for you.
Q-A – New therapies for advance prostate cancer
In this interview, we answer patients’ questions about new therapies for advanced prostate cancer.
Genetic predisposition to prostate cancer
Although rare, some hereditary genetic mutations can increase your risk of prostate cancer.
All about hormone therapy
Hormone therapy can reduce tumor size, control cancer, and prolong life. Is it the right treatment for your cancer?
Active surveillance in 5 points
As surprising as it may seem, your doctor may prefer to wait before starting treatment.
States of prostate cancer post-treatment
Gentlemen, you’re being treated for prostate cancer, and your latest blood tests show an increase in PSA levels?
Your role as a patient
Have you been diagnosed with prostate cancer? Your role as a patient is essential throughout your journey.
Me a guinea pig?
Did you know that participating in a clinical trial advances medical science and improves the lot of patients for future generations?
Sources and references
Last medical and editorial review: April 2024. See our web page validation committee and our collaborators by clicking here.
Discover our animated video!
Symptoms, risk and screening
Are you over 50 years old, or have you been having urinary problems for some time now? This video is for you! Several diseases can affect your prostate, and it’s important to detect them early. Let’s take a closer look.
Anatomy
What is the prostate
The prostate is a gland:
- Located between the bladder and the penis, just in front of the rectum;
- Formed of 2 lobes which surround the urethra, a canal that runs through the center of the prostate, from the bladder to the penis, letting urine and sperm flow out of the body;
- The size of a walnut, which grows larger in size in your forties;
- That has a soft, spongy texture to the touch like a small, ripe plum.
The prostate is made of:
- Gland cells that secrete liquids for ejaculation;
- Muscle cells that participate in the evacuation of your sperm during ejaculation;
- Fiber cells that maintain the structure of the gland.
Around the prostate, we find:
- The seminal vesicles, glands that produce sperm and that are located on either side of the prostate;
- The vas deferens, the tube that carries sperm from the testicle to the seminal vesicles;
- The nerve bundles that control your bladder and erectile function and that are located on either side of your prostate.
Structure
Three main zones of the prostate
Peripheral zone
- The peripheral zone is the largest area of the prostate. It can easily be felt by the doctor during a digital rectal exam (DRE).
- Most prostate cancers start in the peripheral zone.
Transition zone
- This is the area located in the middle of the prostate, between the peripheral and central areas. It surrounds your urethra that runs through the prostate.
- With age, the transitional area increases in size until it becomes the largest portion of your prostate. This is called benign prostatic hyperplasia (BPH) or enlarged prostate.
Central zone
- It is the part of the prostate that is farthest from the rectum. This is why prostate tumors located in this area can not be felt by the doctor during a digital rectal examination.
- If the doctor is in doubt, the following information will help decide if additional investigation is necessary:
- Your PSA level
- Your age and family history
- Your ethnic origin
Fonction
In short
Your fertility and natural fertilization
- It produces … a prostatic fluid rich in enzymes, proteins and minerals that nourishes and protects your spermatozoa.
- It makes … a protein (APS) that is used to liquefy your sperm to facilitate the mobility of your spermatozoa.
- It allows … ejaculation by contracting.
- It promotes … fertility through its enzymes facilitating the penetration of sperm through the cervix.
- It is not related to the mechanism of erection. Therefore, the origin of erectile dysfunction lies elsewhere.
Additional details
Exocrine Function
The prostate is made up of thousands of tiny fluid-producing glands. Specifically, the prostate is an exocrine gland. Exocrine glands are so-called because they secrete through ducts to the outside of the body (or into a cavity that communicates with the outside). Sweat glands are another example of an exocrine gland.
The fluid that the prostate gland produces forms part of semen, the fluid that carries sperm during orgasm. This fluid, produced in the prostate, is stored with sperm in the seminal vesicles. When the male climaxes, muscular contractions cause the prostate to secrete this fluid into the urethra, where it is expelled from the body through the penis.
Urine Flow
The prostate wraps itself around the urethra as it passes from the bladder to the penis. Prostatic changes can affect urine flow. Increasing the size of the prostate or muscle tone may impede the flow of urine due to the close anatomical relationship between the urethra and the prostate.
Prostate Specific Antigen (PSA)
The prostate also produces a protein called prostate-specific antigen (PSA). PSA is released with the ejaculatory fluid and can also be traced in the bloodstream. The testing of PSA levels in the blood is used to detect prostate cancer. The level of PSA in the blood is usually measured in nanograms of PSA per milliliter of blood (ng/mL).
A raised PSA level
Usually, a PSA rate of less than 4 nanograms per milliliter of blood is normal, but age should also be taken into consideration as PSA levels gradually increase with age. A rise in PSA concentration may indicate the presence of:
- An enlarged prostate (benign prostatic hyperplasia)
- An inflammation or infection of the prostate (prostatitis)
- A prostate cancer
Your doctor will have you undergo other tests to determine the exact cause of the increase in your PSA.
We are here for you
You have questions or concerns? Don’t hesitate. Contact us at 1-855-899-2873 to discuss with one of our nurses specialized in uro-oncology. They are there to listen, support and answer your questions, and those of your family or your loved ones. It’s simple and free, like all of our other services.
Also take the time to visit each of our pages on this website, as well as our YouTube channel, in order to get familiar with the disease, our expert lectures, our section on available resources, the support that is offered to you, our events and ways to get involved to advance the cause..
Staying Informed
Pages that might interest you
Want to know more? Just click on one of the links below.
The latest PROCURE news that might interest you
Every week we publish a blog article. Here are some for you.
The medical content and editorial team at PROCURE
Our team is composed of urologists, and nurses certified in uro-oncology with a deep knowledge of prostate cancer and other diseases related to the genitourinary system. Meet our staff by clicking here.
Sources and references
- Prostate Cancer – Understand the disease and its treatments; Fred Saad, MD, FRCSC and Michael McCormack, MD, FRCSC, 4th et 5th editions
- Canadian Cancer Society
- Prostate Cancer Foundation-PCF.org
- National Cancer Institute-USA
- American Cancer Society
- Memorial Sloan Kettering Cancer Center
- Prostate Cancer UK
Last medical and editorial review: September 2023
Written by PROCURE. © All rights reserved
