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The psychological impact of the disease
Few things are as difficult as learning that you have cancer. The word itself casts a chilling shadow, as does the knowledge of the side effects and complications from treatment.
Much like the impact of breast cancer, the psychological effects of prostate cancer are deeply troubling to the sufferer. Prostate cancer touches a very sensitive place in the male psyche. For one thing, a man’s physical integrity is threatened by the risk of erectile dysfunction and urinary incontinence brought about by treatment. But even more profoundly, the disease troubles a man’s very perception of himself, his body, his sexuality and his intimate relationships.
For a younger man – A man of 82 who develops prostate cancer does not go through the same thing as a man of 49 who is still sexually virile and able to reproduce. Not only does the latter fear dying young, he also worries about losing his sexual powers. He might feel that “it’s all over,” that he is “no longer a man” and that his partner will abandon him. Most men in this age bracket are ready to do anything to cure the disease and will undergo the most aggressive treatment available.
For an older man – Older men tend to react differently. Generally less sexually active, these men may find it a little easier to accept having their prostate removed or losing the ability to achieve erections. On the other hand, they may have more trouble dealing with treatment side effects like urinary incontinence and be less willing to spend a great deal of time in hospital. They might therefore choose to undergo treatments with “milder” side effects.
The person hearing this terrifying news knows that life will never be the same, and emotions can range from denial to anger, despair to hope, and courage to fear, for both the patient and his or her loved ones. All of this is completely normal.
What you can feel
People who have cancer often experience a high level of stress that they may find difficult to deal with. There are so many unknown factors and so many questions to ask. What effects will the treatments have on me? Am I going to get better?
When you learn you have cancer
When you’re told you have cancer, it’s natural to react in one of these ways:
- experiencing a sense of “shock”
- not believing the diagnosis, especially if you haven’t had any symptoms
- feeling angry
- feeling that the situation is so unfair
- having no reaction or just a mild reaction for a while
Many men also:
- feel they’ve lost control of their lives
- are afraid their body and self-image will change
- feel powerless, sad, guilty
- have a sense of lost masculinity
- worry about their family, work or financial situation
- worry about their relationship, their quality of life, their sexual life
These reactions reveal what you’re feeling inside. Pay close attention to your reactions. They will show you how you need to take care of yourself, reach out to your support system and find a new life balance.
Stages that can be difficult
Certain stages can be especially difficult:
- waiting for medical tests
- receiving test results
- discussing treatment options
- experiencing side effects
- finishing your treatment and resuming an active life
- coping with a reccurence
- accepting the end of life
Recognizing the signs
Forms of distress you may feel
Each person experiences the disease and treatments in a different way. Some people have strong reactions and experience psychological distress. This may take the form of:
- physical signs: these may be unconnected to the disease or treatments, e.g. stomach ache, headache, loss of appetite, insomnia (difficulty to sleep), muscle tension, fatigue, trouble concentrating, etc.
- unusual behaviours: losing interest in activities you normally enjoy, being irritable and aggressive, avoiding family and friends, being completely disorganized, etc.
- false beliefs: for example, -telling yourself “It’s my own fault I have cancer” or “I deserve this” or “I should stay home and not see anyone to avoid infection.”
- intense emotions: frequent bouts of crying, extreme anxiety or anger, etc.
Watch for signs of distress. These signs can become a concern if:
- they are intense
- they continue for a long time
- they affect your everyday tasks; e.g. you can’t stop crying, can’t sleep, you avoid seeing others for fear of catching an infection…
If you’ve had psychological issues in the past, such as depression, tell your doctor. If you think you need help, don’t wait – talk to a care team member. It may be helpful to see a psychologist.
In fact, approximately 40 to 50 percent of men with prostate cancer require some type of psychosocial intervention at some point during their illness. By getting help promptly, you’ll feel better psychologically and adjust more easily to the situation.
If you have pervasive thoughts of death or suicidal ideas, don’t delay – see a psychologist right away or go to the emergency room at the nearest hospital.
Who can help
It is well-known that men are less likely than women to consult a professional for psychological problems. Men are generally less willing to open up and some even believe that it is not “manly” to share their most intimate feelings with a professional. Unfortunately, this attitude does not usually change with age.
Not all men with prostate cancer need professional psychosocial support. Indeed, about 55 to 60 percent of patients never consult. However, those who do feel the need for such support should not let their shyness or pride stop them from picking up the phone and making an appointment. It could make a huge difference in their quality of life, both during and after treatment.
You can obtain help from several sources at once, or first from one and then another professional.
The psychiatrist is a medical specialist who can diagnose psychosocial problems, evaluate underlying physical disorders and prescribe medication. The psychiatrist can also treat patients for pain. A psychiatrist can help you physically as well as psychologically.
The psychologist on the oncology team evaluates the psychological impact of cancer on patients and their support circle. Your psychologist will listen as you express your distress. He or she will look at your history, lifestyle, and plans, trying to ease your suffering and help you find ways of coping. Feel free to see the psychologist at any stage of your treatment and follow-up.
A sex therapist can help the patient and the couple overcome physical problems or learn how to live with them. For example, the sex therapist provides guidance if the man is unable to achieve erections naturally and the couple is learning how to integrate a medical treatment (oral medication, MUSE or any other type of treatment) into their sex life. The therapist also helps the couple explore other facets of their sexuality and new ways of expressing their love for each other.
Sexuality can take a number of forms and still be fulfilling for both partners, as long as it remains a way for the couple to communicate and express their shared happiness. If the man is undergoing hormone therapy and has therefore lost his sex drive, the sex therapist helps the patient and the couple deal with the situation to prevent suffering, depression and guilt.
The role of the social worker is to promote the social functioning of the patient. The social worker works with the patient and his family. He or she may also assist the patient with procedures for obtaining financial assistance required during cancer treatments. The social worker also works with the healthcare team to organize the patient’s discharge from the hospital with the help of resources in the community (CLSC, rehabilitation centres, etc.)
The spiritual advisor offers religious and spiritual support to people who are hospitalized and their loved ones.
The volunteer gives time, energy and services to those who need it. Volunteers play an important role in the support system offered by hospitals.
What you can do
You know best what makes you feel better. Here are some things that can help. Maintaining healthy lifestyle habits, because they’re good for your body and good for morale:
Give yourself time
- There is a lot of information to retain. Don’t try to learn it all in one day.
- You will have questions. Write them down and bring them with you to your next appointment.
- Your body needs time to recover during treatment.
A healthy lifestyle will help you feel better
- Eat healthy
- Sleep a lot
- Do activities that you enjoy and that relax you
Accept help from others, they want what is best for you
- Practical help
- Emotional support
- Delegate tasks if you need to
- Do not be embarrassed to ask for help
Spend time with others and give them your attention
- Your friends and family also need comfort
- Keep a good line of communication open
- Resolve problems when they happen
You can also participate in the management of your care by keeping a personal medical record on your health condition and by ensuring that all your doctors receive a copy of your tests results. During each medical visit, you can inform your doctor of your discussions with other specialists. This will facilitate communication between each health care provider responsible for your care.
We are here for you
Our urology healthcare professionals are there to listen, support and answer questions from patients, their families, the general public and healthcare professionals. Feel free to contact them.
Also take the time to visit each of our pages on this website, as well as our YouTube channel, in order to get familiar with the disease, with our expert lectures, our section on available resources, the support that is offered to you, our events and ways to get involve to advance the cause.