Enabling Prostate Cancer Conversations: How To Get Comfortable Talking About Symptoms & Side Effects

According to the American Cancer Society, 1 in 8 men will be diagnosed with prostate cancer during their lifetime, and it is also the most common cancer type among our U.S. Veterans and among men in the United States. As the medical field continues to make progress in treating prostate cancer and catching it early, an equally important focus is improving a patient’s day-to-day symptoms — and encouraging more men to get more comfortable about discussing these sensitive topics in order to do so.

“A lot of what we’re focusing on is minimizing impact on quality of life,” says Dr. Jonathan Lischalk, a radiation oncologist with NYU Langone Health. “And a quality of life really lands in three realms. The first realm is genitourinary function. The second is gastrointestinal function and the third is sexual dysfunction.”

The Male Genitourinary System

The male genitourinary (GU) system includes the urinary organs, male reproductive organs and male genitals. Kidneys and ureters, which are tubes that carry urine to the bladder, along with the bladder and urethra, which transports both urine and semen out of the body, make up the urinary organs. The male reproductive organs include the prostate, testicles and penis.

Dr. Lischalk adds that these realms can manifest in a variety of different ways. When he first meets a patient, he wants to “understand how they’re doing at a baseline in all three of those realms.”

Dr. Lischalk says he asks his patients the following:

• “How is your urination?”
• “Are you getting up six or seven times at night or are you just getting up once at night?”
• “Are you already on medications?”
• “Have you had procedures that help you with urination?”

Normalizing Conversations About Cancer

Taking notes on the list above and getting more aware of the symptoms you are experiencing — and how frequently you are experiencing them — can help assist your doctor immensely in getting to know how to help you most. Being more aware of your health can hopefully get you more comfortable with your body and symptoms so that when you do meet with your doctor, you are prepared.

Remember, they are used to discussing these topics clinically on a daily basis — and are there to help you.

“These are really important things that I want to know about because a patient’s outcome after treatment, whether it be surgery or radiation, oftentimes is very linked to how they’re doing prior to the treatment,” Dr. Lischalk says. “And so that’s a critical conversation that we have when we first meet. The same is true for gastrointestinal function. How are their bowel movements? Are they having a lot of issues?”

“These are very sensitive topics — but I think the importance is normalizing this with patients and understanding that it’s really important for their doctor to understand where they are, to figure out where they’re going.”

Prostate Cancer Symptoms & Diagnosis

Prostate cancer begins in the walnut-shaped prostate gland, which is located between the rectum and bladder and produces the fluid that nourishes sperm. Routine screening can help detect this cancer. Prostate cancer can behave differently from one man to another.

After a screening, which consists of a prostate-specific antigen (PSA) blood test (PSA is a protein produced by both noncancerous and cancerous tissue in the prostate), a risk assessment helps doctors determine how to move forward with possible treatment.

Men may be considered “low-risk,” which means the cancer can be slow-growing and treatment might not be necessary. On the other end of the spectrum, men at higher risk could have cancer that grows faster or have more aggressive cancer requiring treatment. Screening should start between 40 and 50 years old, depending on risk level and family history, which you can discuss with your doctor.

Some warning signs for prostate cancer are include:

• Blood in your urine
• Trouble getting an erection
• Pain or burning when you urinate
• Pain in your back, hips, thighs, or other bones
• Unexplained weight loss
• Fatigue

Questions to Ask Your Doctor

If you have experienced symptoms associated with prostate cancer or have a screening coming up, here are some questions you may ask your doctor:

• If I have elevated PSA levels, what could be causing that besides cancer?
• How long will it take to learn if my PSA levels warrant further testing?
• What are the treatment options that are best suited for me based on my risk level?
• What financial resources exist to help me with the costs associated with treatment?
• How long will my potential treatment prevent me from working or continuing normal activities?

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