November 9, 2022

A better life after prostate cancer

Doctor consulting with a man in office

Advances in early detection and treatment of prostate cancer means patients are surviving longer than in years past.

Still, the side effects of treatment can cause lasting problems, notably urinary issues and sexual dysfunction. Dr. Matthew Grimes, a surgeon in the Department of Urology, encourages prostate cancer survivors to review their options for relief.

“There’s a lot of treatments that we can offer people, and a lot of times they just aren’t aware of them,” said Grimes, who specializes in genitourinary reconstruction and male sexual health.

Common urinary complications from prostate cancer treatment include erectile dysfunction, incontinence, and development of scar tissue in the urine channel. In rare cases, patients may also develop a fistula, or abnormal connection, between their urethra and rectum.

The nature of these side effects, Grimes said, may make some men hesitant to talk about them or seek treatment. Others just assume that those maladies are part of their new normal after cancer treatment.

“People don’t talk about these as much, and they can be pretty awful,” he said of these side effects. “I think a lot of it is just education that some side effects are common, but that doesn’t mean they are normal or you have to just live with them.”

Grimes said there are a wide range of treatment options available to patients, and he works with patients to find the solution that best suits their current health situation and their needs. Two of the most frequent procedures he does to resolve incontinence are slings and artificial urinary sphincters.

A sling involves surgical placement of mesh to compress and reposition the urethra. Grimes said this procedure is best suited to patients who have not had radiation therapy with more mild or moderate incontinence issues. An artificial urinary sphincter is an implantable device that compresses the urethra to keep them dry and allows the patient to control when they want to urinate using a small, internal control pump.

For erectile dysfunction, there are many treatments including oral medication, external vacuum devices, injectable medications, and placement of an internal penile prosthesis that allows the patient to control when they want to have an erection.

In all cases, the goal is to improve quality of life post treatment and increase their confidence.

“It puts you back in charge,” Grimes said of these procedures. “It gives you control over your body.”

Grimes makes sure patients have a realistic idea of what their options are, and what they can expect post-surgery. Because these are surgical procedures, there can be risks. Recovery takes time. There may still be some bladder leakage. Still, Grimes said he’s heard many happy patients say they wished they had sought relief sooner.

“I try to be very transparent about what these treatments can and can’t do because we can’t help everybody, but for the right person, the quality-of-life benefits can be just huge,” he said.