New research finds that men who undergo prostate removal often suffer more from incontinence and impotence than they expected, even when advised beforehand about possible after effects.
The findings suggest there's a wide gap between what men with prostate cancer expect after the surgery and what actually happens. It turns out that many are shocked by the level of dysfunction after the operation.
After the surgeries, "we find that men are very disappointed and very sad. It's as if they really didn't hear what was being told to them," said study lead author Daniela Wittmann, a sexual health coordinator at the University of Michigan's prostate cancer survivorship program.
Removal of the prostate, a treatment for prostate cancer, is especially common among younger men, while older men often turn to radiation, said Dr. Stephen Freedland, an associate professor of urology and pathology at Duke University in Durham, N.C. The procedure can lead to urinary incontinence, sometimes to the point where men need to wear padding, as well as difficulty attaining and maintaining an erection.
Prostate cancer is also sometimes treated with hormonal therapy, which can also lead to impotence and other serious side effects, or by "watchful waiting," which means having regular exams while doctors keep an eye on the tumour to see if it grows or spreads. The latter is usually recommended when physicians feel someone's age will allow them to outlive the generally slow-moving cancer.
The study appears in the August issue of the Journal of Urology.
The problem is that the prostate is located right next to the urinary sphincter and nerves that contribute to erections, Freedland said. The operation to remove the prostate can disrupt those other parts of the body.
Competition among doctors may cause them to downplay the risks, Freedland said. "If one doctor says, 'Look, almost everybody I operate on leaks a little bit,' and the guy next door says, 'None of my patients leak,' one of them is telling the truth and the other isn't."
Compassion can be another factor preventing physicians from telling the entire story about risks. And patients themselves may be overly hopeful due to human nature, he said. "You're going to always have a mismatch between realities and expectations."
The new study tries to measure that gap. A total of 152 men undergoing radical prostatectomy (prostate removal) took part in the study. They received full advice about the surgery and were questioned before the operation and then a year later.
The counsellors talked to the patients for about 20 to 45 minutes with a focus on side effects, said study lead author Wittmann. That's more time than patients typically get with a urologist, she said.
A year after the surgery, 46 percent reported that urinary incontinence was worse than expected, while 44 percent said the same about sexual function. Most of the rest said their experiences in those areas were what they expected.
The researchers concluded that patients had "unrealistic expectations" despite the extensive counselling about side effects. They also discovered that a minority of the men (12 to 17 percent) expected to have better bladder control and improved erections after the surgery, which is the opposite of what usually occurs. Many more had thought that their bladder and sexual functioning post-surgery would at least remain the same, they noted.
Wittmann said the researchers plan to test another approach -- two-hour seminars for the patients and their partners about side effects, including tips men can use to try to alleviate them. "It includes the kinds of things that men can do to help themselves
afterward," she said. "It's not just information on what you can expect, but what you can do."
My last test came out with an unlikely result of 2 ?!
I am seriously wondering if PSA tests are accurate at such low figures.
Please don’t ask me how that has been achieved, because I have no idea ! I began in January with 1.9 and it reached a high of 2.8 so. If the urologist who did the operation had not personally told me that I had prostate cancer with a Gleason score of 3+3 I would be thinking I did not have PC.
For most of the month I have been merely having three OxCgen capsules, apricot seeds and my honey and bicarb mix.
My hands are still painful with some arthritic pain so I am off Vit C and as I said will leave that, (using IV) for any high, high PSA figure which may occur in the future.
I note that the immune system can be jolted out of kilter and begin to attack the body. So am now looking around for a method of resetting, rebooting it back to a ‘normal’ setting.
Acupuncture may work I am looking in to that.
Please note that this is a reminder that what I am doing is not a recommendation for you to do the same.
It is just an opportunity for you to see what may happen if you opt for an alternative method of cancer treatment.
Saw Palmetto is Rubbish ?
A popular herbal supplement bought by men to relieve discomfort caused by an enlarged prostate does not work, say experts.
It must be my age but I am very wary of experts ? ‘Who are they’ as a non celebrity in the Big Brother said some years ago. Actually I think she said ‘who is she’ come to think of it.
But what do we find ? Professor Gerald Andriole, from the Washington University School of Medicine in St Louis is the study leader. The completed research was published in the Journal of the American Medical Association.
If you are part of an organisation which sells prostate products it must be to your organisation benefit if you can denigrate one of the alternative products which is taking away sales from your products.
Read more:- http://www.dailymail.co.uk/health/article-2042966/Herbal-supplement-saw-palmetto-used-treat-prostate-problems-does-work.html#ixzz1ZQh7ALKJ