Who is Responsible?

There are many treatment options for prostate cancer. After diagnosis, the most important thing that you can do is to take responsibility for making your own informed decision about your treatment. Do not simply accept the treatment that your doctor recommends. Doctors tend to recommend the type of treatment that they offer. Surgeons tend to recommend surgery, radiologists tend to recommend radiation, etc. What they practice may not be the best treatment for you.

Making an informed decision requires research about treatment options, the potential side effects of the treatment, and the quality of life after treatment.

The most common side effects of prostate cancer treatment are impotence and incontinence.

To understand these side effects, it is important to understand the “definition” of the terms.

Impotence is the inability to achieve an erection sufficient to achieve penetration. Potency, in medical reports about prostate cancer side effects, is defined as the ability to achieve an erection sufficient for penetration with or without the aid of medication, suction devices, implants, or any other artificial means available. Therefore the reported percentage of “potent” survivors means not just those that have normal erections but those that have erections or partial erections achieved with artificial help of any kind.

Incontinence is the lack of ability to voluntarily control the excretion of urine. Since the prostate surrounds the urinary tract, and since the primary sphincter muscle for controlling the flow of urine is in the prostate, maintaining urinary continence should be a concern for anyone receiving prostate cancer treatment.

For comparison of external proton radiation, external photon radiation, and prostatectomy, see
Table 4. Long-term complications associated with the treatment of prostate cancer.

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