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The medicines you take to treat advanced prostate cancer are strong. While they're working on your cancer, they can also cause side effects.

Find out what's common and what you can do about it. Remember, you need to let your doctor know what's going on with you. He may be able to adjust your doses or switch your treatments, and that can make a difference.

Incontinence

You may leak urine when you laugh, cough, or sneeze. Or you might not be able to control your flow of urine. This can happen after you have surgery to remove your prostate as well as from radiation therapy.

Try these tips:

  • Cut down on or avoid alcohol and caffeine.
  • Do Kegel exercises to strengthen your pelvic floor muscles that control the flow of urine.
  • Ask your doctor what else would help.

Infertility

This may happen after treatments for prostate cancer, such as:

  • Surgery to remove your prostate gland
  • Radiation of your pelvis
  • Chemotherapy

Because infertility may be permanent, men who wish to have children in the future should talk to their doctors about banking their sperm for later use.

Hormonal Changes

Many men with advanced prostate cancer take medicines to lower their levels of testosterone and other male sex hormones, because those hormones can fuel prostate cancer's growth and spread.

During treatment, many men have erectile dysfunction (ED) or lose interest in sex. They also may:

  • Gain weight
  • Grow breasts
  • Feel depressed
  • Lose muscle mass
  • Develop weaker bones
  • Have hot flashes

Men with low testosterone levels may also be more likely than other men to have:

  • Diabetes
  • Heart attack
  • High blood pressure

You can control many of the symptoms of low testosterone with medication and lifestyle changes. Dietary supplements, such as calcium and vitamin D, along with exercise and weight training, can help boost bone strength.

Those hormonal changes are reversible. So if you don't like how it makes you feel, let your doctor know in case you could switch medicines.

Erectile Dysfunction (ED)

Several treatments for advanced prostate cancer can cause this, including:

  • Surgery
  • Hormone therapy
  • Radiation to the prostate

Treatments for ED include:

  • Sildenafil (Viagra)
  • Tadalafil (Cialis)
  • Vardenafil (Levitra)
  • Penile injectable medications such as alprostadil
  • Vacuum pump (A device that uses suction to achieve an erection and an elastic ring to maintain it.)
  • Penile implant

Diarrhea

You can get this as a result of:

  • Hormone therapy (especially the combination of luteinizing hormone-releasing hormone (LHRH) agonists and anti-androgen therapies)
  • Chemotherapy
  • Radiation to the prostate (less common with newer, focused techniques)

To ease the symptoms, drink 8 to 12 cups of clear liquids every day, such as water, apple juice, or sports drinks.

Also, adjust your diet. Eat five to six small meals a day rather than three large ones. And eat foods that are easy on the stomach, such as:

  • Skinless broiled or baked chicken
  • Rice
  • Boiled potatoes

Avoid foods that can irritate your intestines, such as:

  • Milk and dairy products
  • Spicy foods
  • Caffeine
  • High-fiber foods
  • Greasy foods

Ask your doctor if you need any supplements.

Fatigue

The cancer or some treatments for it (radiation, hormone therapy, chemo, or treatment vaccines) can make you feel wiped out. If you’re fatigued, you don't have energy to do your usual activities. It helps to:

  • Exercise every day.
  • Eat a nutritious diet and stay hydrated.
  • Get enough rest.
  • Focus on your most important tasks and delegate.

If your cancer treatment gives you anemia (low red blood cell counts), that will make you fatigued, too. Your doctor may recommend supplements, drugs, or blood transfusions to help.

Nausea and Vomiting

This often happens during chemotherapy. Both may also be side effects of vaccine therapy. The following tips can help:

  • Eat a light meal on treatment days.
  • Stick to foods and drinks that are easy on the stomach.
  • Wear loose-fitting clothes.
  • Talk to your doctor about drugs you can take before your treatment to help prevent and control nausea and vomiting. If one doesn't work, there are others you can try.
  • Also, ask your doctor about complementary approaches, such as acupuncture, hypnosis, biofeedback, and guided imagery, which may also help manage side effects (but don't replace standard medical care).

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