Full Disclosure
Despite what you read
in this blog, I believe the choice to undergo hypofractionated
radiotherapy as my treatment option for malignant adenocarcinoma of the
prostate gland (prostate cancer) was the right choice.
After the ordeal of a
prostate cancer diagnosis, gruelling radiotherapy, and years of dealing with
lingering side effects, you would think I am done with reading up on issues
around prostate gland health.
Now, I am glad to say
it was caught early. I believe I received as good care and support as could be
given by advisory and medical teams, and I am convinced that I chose the best
medical outcome for my situation.
3 Hidden Problems With Radiation Treatment for Prostate Cancer
© The Prostate Clinic
Unsolicited Advice
and Misinformation
In the same vein, I
am usually offered tips, hints, and advice about prostate health; mostly
information shared on social media, none peer-reviewed by experts in either
urology or oncology to prove their efficacy. The impressions are mostly
anecdotal.
My father, for
instance, has mostly been swindled or scammed by snake oil salesmen offering
miracle potions to treat his prostate problems that medical science has been at
pains to prove he ever had. We are left humouring him when it might be prudent
to sternly upbraid him. He is educated and had a high-profile professional
life; he should know better.
The Prostate Clinic
Revelations
Recently, I have been
following The Prostate
Clinic, a YouTube channel hosted by Dr Charles Chabert, a urologist in
Queensland, Australia, and it has taken a few days to properly digest what he
had to say.
In July 2024, I met
with consultants in surgery and radiotherapy for prostate cancer. Later, I
spoke to a support worker at Prostate Cancer UK who opined I should opt for
Active Surveillance or Watchful Waiting over the active treatment suggested at
diagnosis. Even after reading up on extensive material and sharing my journey
in a series of blogs, I had to manage my consumption of information to avoid
being overwhelmed into stasis.
The Question of
Sufficient Information
The question then
becomes: how much more information, detail, reports, studies, and research
should one access before knowing without any shadow of doubt you are making the
right decision, all things being equal?
You are told so much
going into treatment but not nearly enough about the aftermath, it would seem.
Three Hidden Problems
The Australian
urologist addressed the aftereffects of radiotherapy on the prostate that could
leave you concerned about several things, of which sexual dysfunction has been
a recent blog topic. He called them “3 Hidden Problems With
Radiation Treatment for Prostate Cancer”, suggesting why we should not opt
for radiotherapy.
When the prostate
gland is irradiated, it could damage the surrounding tissue connected to the bowel (radiation proctitis,
very graphic, the pictures can cause distress) and bladder (radiation
cystitis) systems. Irradiating the prostate gland shrinks, scars, and can
make it fibrotic, leading to two other consequences: limited salvage options or
progressively reduced sexual function.
Complications and
Salvage Treatments
Complications might
arise if there is a local recurrence of cancer, making salvage activity quite
difficult. This portends more impactful consequences for the patient and
radical alternatives for bowel movements. Salvage treatments are better managed
post-surgery than post-radiotherapy, where options are severely limited.
The state of the
prostate gland after irradiation means that sexual function will increasingly
diminish. This touches on erectile dysfunction and reduced ejaculatory
performance. These are weighty matters that make you wonder if you had known
all this before you commenced treatment, whether you would have made that
choice.
Managing Side Effects
Again, the issue with
choosing any treatment comes down to how you perceive you can manage the side
effects. For surgery, they are immediate, whilst for radiotherapy they are
progressive.
The possible loss of
total sexual function, because the consultant surgeon had already indicated my
prostate was too enlarged to guarantee the salvage of any nerves, immediately
made that option a non-starter. I was not going to wait and see what a malignancy
was going to do in my body through Active Surveillance; it would never have
been an option for me.
My Choice
Choosing radical
radiotherapy was the most comfortable choice in my circumstances. Though having
an additional prayer point before I had my prostate gland zapped might have
made this discovery less of a surprise and caused less concern.
Ultimately, I believe
I did the right thing and will make the best of the good fortune I have to
enjoy life and write better stories, with cancer behind me. I thank God.
Check your Prostate Cancer
risk in 30 seconds.
Blog - Men's
things XXXI: Can Intimacy Be Reclaimed After Prostate Cancer?
Blog – Photons
on the Prostate - A year from starting radiotherapy
Blog - A
prostate cancer diagnosis, one year on
Blog - Men's things - Prostate Cancer blogs
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