At Anatomy Physiotherapy, Suzanne is skilled at dealing with pre and post-prostatectomy care to educate and train patients and alleviate the side-effects of the cancer treatment.
Cancer Treatment
Prostate cancer is the most common cancer in men in Ireland. Despite that 84 per cent of men diagnosed with the disease live for 10 years or more following treatment.
In deciding on a treatment plan with the urologist and medical team, the main focus is initially on the removal of the cancer. Understandably there is a lot to be discussed and often times men “hear” about the side effects of incontinence and erectile dysfunction but never truly take them in as the focus is on survival at that point. However, these unwanted side effects of the various treatments can be socially isolating and very debilitating for the patient. The impact on their quality of life and mental health can be quite profound.
Urinary Incontinence
Aim to start a muscle training programme six weeks before the surgery as it generally takes about 12 weeks to fully train the pelvic floor muscles.
This is the most common side effect following radical prostatectomy and also following radiotherapy. In fact, most men will be incontinent for at least a few weeks following surgery to remove the prostate.
The prostate gland is a mix of muscle and gland tissue that wraps around the urethra – the tube that carries urine from the bladder to the penis. When the prostate is removed (prostatectomy), so is the muscle within the gland. Therefore, because one of the main muscles that helps to regulate the flow of urine has been removed, there will be difficulties with bladder control – leading to incontinence. In addition, immediately after the surgery a catheter is inserted.
There are other muscles though which also help to regulate the flow of urine. Training the bladder and pelvic floor muscles helps the vast majority of men to gain full control. But there is a small percentage of men who will suffer ongoing incontinence because of various other complications related to the surgery. It should be emphasised however that for most men, the prognosis is very good.
The importance of pre-treatment exercises
If possible, it is very important to start bladder control rehabilitation or “prehabilitation” prior to surgery or radiotherapy. This ensures that the muscle control systems are optimised before the rigours of surgery. It also speeds up recovery of continence dramatically.
Aim to start a muscle training programme six weeks before the surgery as it generally takes about 12 weeks to fully train the pelvic floor muscles. If this programme is followed, there is a good chance of full continence being restored by six weeks after the surgery.
After Surgery
Immediately after surgery, a catheter will be inserted. This stays in place for about two weeks and during this time, it is not advisable to do pelvic floor exercises. The focus at this stage should be on resting and recovering from the surgery and gently resuming activities.
Sexual Dysfunction
Prostate cancer is the most common cancer in men in Ireland. Despite that 84 per cent of men diagnosed with the disease live for 10 years or more following treatment.
All men will suffer some degree of erectile dysfunction after prostatectomy and most men will have these difficulties after radiation therapy or hormone therapy. Some men recover function spontaneously, but most don’t. The problem is that prostate surgery or radiation therapy can damage the nerves that supply the muscles which activate to trap the blood in the penis during an erection. The damaged nerves often heal slowly over about a year. However, like any muscle, if these muscles haven’t been used in a long time then they weaken very significantly and may not be strong enough to carry out their function. Therefore, although the nerves may have recovered the muscles are too weak to produce or maintain an erection. Other factors can also play a role – loss of elasticity in the penis (because it has not been erect for some time), obesity, pre-treatment problems, fatigue and of course psychological stress following diagnosis and subsequent treatment.
What can be done?
Treatment for erectile dysfunction following prostate cancer is multi-disciplinary. From a physical point of view, exercises to optimise the muscle function in the area and also a general exercise programme to improve cardiovascular function are essential components. There are additional physical strategies (such as vacuum pumps to help maintain elasticity) that can be recommended to aid recovery.
Hormonal Side Effects
Symptoms can be similar to those associated with the menopause.
Treatment for erectile dysfunction following prostate cancer is multi-disciplinary. From a physical point of view, exercises to optimise the muscle function in the area and also a general exercise programme to improve cardiovascular function are essential components. There are additional physical strategies (such as vacuum pumps to help maintain elasticity) that can be recommended to aid recovery.
Fatigue
There is increasingly strong research evidence that exercise reduces the progression of prostate cancer by 57% and reduces the recurrence and mortality by 30%.
Fatigue is the most common side effect of any cancer treatment. Cancer-related fatigue is not relieved well by sleep or rest. It usually decreases significantly after the treatment ends but can persist for months. Factors that contribute to this include depression, on-going urinary incontinence, pain and insomnia. A number of research studies have demonstrated that a regular exercise programme can help alleviate these symptoms of fatigue. In particular, yoga-based exercise programmes have demonstrated significant improvements in quality of life. Even more importantly, there is increasingly strong research evidence that exercise reduces the progression of prostate cancer by 57% and reduces the recurrence and mortality by 30%.
What can be done?
Treatment for erectile dysfunction following prostate cancer is multi-disciplinary. From a physical point of view, exercises to optimise the muscle function in the area and also a general exercise programme to improve cardiovascular function are essential components. There are additional physical strategies (such as vacuum pumps to help maintain elasticity) that can be recommended to aid recovery.