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Advanced Prostate Cancer and Side Effects

Many men who have advanced prostate cancer experience side effects. Some of these side effects result from the treatments used to slow the spread of cancer. Other side effects come from the disease itself. Understanding these side effects can relieve fears and help you cope better. So can being an active participant in your own care. Ask your doctor questions. Learn about potential symptoms and options before receiving treatments. Carefully weigh each option with your doctor's input. 

Prostate Cancer and Impotence

Impotence -- the inability to achieve or maintain an erection -- is a major side effect of most treatments for advanced prostate cancer. Among men who have their testicles removed by a surgery known as orchiectomy, about 90% will experience impotence. Drugs to reduce testosterone levels, called endocrine therapy, also causes impotence in most men. Some men who become impotent can regain erections over time, with no assistance. Other men seek treatment. Options range from devices worn externally, medicines taken orally or injected into the penis, and penile implants. Discuss these options with your doctor before you have treatment that may result in impotence.

Prostate Cancer and Incontinence

Incontinence -- the inability to control urine flow -- is a common side effect of prostate cancer surgery and radiation. Most patients do eventually regain urinary control. Exercises to strengthen the sphincter and surrounding pelvic muscles can help you regain urinary control. These are called Kegel exercises. A training program called biofeedback helps reinforce the proper performance of Kegel exercises. Medications may also help relieve incontinence. Ask your doctor about these options.

Prostate Cancer and Infertility

Most treatments for prostate cancer cause infertility. Several techniques can help preserve fertility, but they must be done before cancer treatment. If you want to preserve your fertility, tell your doctor before undergoing any treatment for prostate cancer.

Prostate Cancer Pain and Weakening Bones

Prostate cancer most commonly spreads to the bones. This is called bone metastases. This condition can cause pain. It can also weaken bones and make them prone to fractures. So, too, can the endocrine therapy that's often used to slow the spread of prostate cancer. But doctors can offer treatments to relieve bone pain and support weakened bones.

Bisphosphonates to Strengthen Bones

These drugs help reduce or delay problems such as fractures caused by bone metastases in prostate cancer. The drug zoledronate is the most effective bisphosphonate in reducing fractures caused by prostate cancer and endocrine therapy.

A new class of drugs, the rank ligand antagonists, specifically denosumab, has been found to be superior to zoledronate in reducing fractures in castrate independent prostate cancer. It is also used to prevent osteoporosis caused by endocrine therapy for non-metastatic prostate cancer,

The drug toremifene, a serum estrogen receptor modifier used primarily for metastatic breast cancer, is also useful in the treatment of osteoporosis related to prostate cancer.

WebMD Medical Reference

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