Dr. Amanda Pomery
Director of Prostate Cancer Clinical Care Services, Movember Foundation
Prostate cancer treatments are improving every year. Today, survival rates are at roughly 95% five years after diagnosis, and many individual cases of prostate cancer are effectively curable. This is fantastic news. At the same time, when the public conversation focuses too heavily on “beating cancer,” discussion of the very real challenges, like incontinence, that come afterwards can fall by the wayside. That needs to change.
“Too often, people don’t talk about the whole story when it comes to prostate cancer,” says Dr. Amanda Pomery, Research Fellow for the Department of Cancer Experiences at the Peter MacCallum Cancer Centre and Director of Prostate Cancer Clinical Care Services at the Movember Foundation. “We’re very fortunate that we have such great survivorship rates, but this also means that we have a huge number of men living their lives in the years following a diagnosis of prostate cancer. For these men who have gone through diagnosis and treatment, we need to make sure that they are not just surviving, but surviving well. It’s important that we tell the whole story, including the challenges that come after treatment.”
In many ways, the prostate cancer journey doesn’t end after treatment — it begins.
A long journey requires ongoing support
In many ways, the prostate cancer journey doesn’t end after treatment — it begins. Men need to take stock of what their new normal is going to look like and find the best supports and solutions to maintain a high quality of life. “You have to really reestablish your life after diagnosis and treatment,” says Dr. Pomery. “Side effects and quality of life issues come in a wide range, including incontinence, sexual dysfunction, pain, fatigue, anxiety, and depression. There is a whole lot going on for these men, not just physically, but mentally as well. We need good evidence-based supports to help men through these challenges.”
It’s very common for men to experience some degree of incontinence after prostate cancer treatments like surgery and radiation. Unfortunately, even when they’re warned about that possibility by their health care providers, men are often unprepared for the reality. “There is a need for us to really narrow down what the experience of incontinence is like,” says Dr. Pomery.
“It can vary from an occasional slight dribble to thoroughly wetting three absorbent products a day. When incontinence is at the high end, men feel like they can’t go about their daily activities or even leave the house, and that leads to a real sense of isolation. But, when men do speak up, there is a lot that can be done to help them.”
It’s important to explore all treatment options available and get onto it early.
Dr. Amanda Pomery, Peter MacCallum Cancer Centre & Movember Foundation
An open conversation reveals a range of solutions
When that dialogue is opened, men will learn that there are anatomic purpose-made products tailored for men with incontinence issues, such as guards or disposable underwear, which can allow them to enjoy life comfortably. In addition to these essential solutions, there are in fact many paths forward with the daily challenge of incontinence following prostate cancer treatment. “It’s important to explore all treatment options available and get onto it early,” says Dr. Pomery. “Some are simple lifestyle changes such as avoiding caffeine and alcohol, going to the toilet regularly, and learning pelvic floor exercises. Others require more clinical intervention, such as medication, surgery, and devices to help control the flow of urine. It’s important to understand all the options. In general, the evidence is clear that the higher your health literacy, the better your quality of life outcome.
Men often pride themselves on their resilience and are reluctant to talk about their health issues, especially when they think that they’re minor or not normal. But incontinence is absolutely normal after prostate cancer treatment, and its impact on quality of life can be anything but minor. “We really need to redefine the concept of what is normal after prostate cancer treatment,” says Dr. Pomery. “We also need to reframe what it means to be resilient. Resilience can mean having the strength to maintain an open dialogue.”
