| Treatment |
Potential Associated Side Effects |
| Surgery |
Removal of the prostate via surgery, or a prostatectomy, may carry long term risks of urinary incontinence (trouble controlling urination leading to urinary leakage) and erectile dysfunction (difficulty attaining and/or maintaining an erection for sexual activity). It is also possible to form scar tissue at the surgical site, leading to difficulty emptying the bladder.
Short terms risks of prostate cancer surgery include the risks of an operation under anesthesia including but not limited to blood loss, infection, nerve injury, heart attacks, and blood clot formation.
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| Radiation Therapy (EBRT and brachytherapy) |
Common side effects of radiation therapy are urinary problems, which usually disappears with time. This can include issues such as increased frequency, blood in the urine, burning sensation, and/or weak stream. Erectile dysfunction, or difficulty attaining and/or maintaining an erection for sexual activity, may also develop, even years after radiation therapy.
Patients who undergo EBRT may experience skin issues such as itchiness, discomfort, and darkening of the skin. Additionally, the effect of radiation on the lining of the rectum and bowels may lead to some abdominal discomfort as well as diarrhea and excessive gas. Patients may also experience at least a mild degree of fatigue during and shortly after their EBRT.
Brachytherapy may cause pain and bruising in the perineum and testicles. Although it is rare, there is a slight increase in the likelihood of new cancers forming in the pelvis years after radiation therapy for prostate cancer.
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| Hormonal Therapy |
Androgen Deprivation Therapy (ADT)
The most common side effects associated with androgen deprivation therapy (ADT) include hot flashes, decreased libido, and increased bone fracture risk. Additional, less specific effects include fatigue, increased risk of diabetes and heart attacks/strokes, weight gain, cholesterol increase, decreased muscle mass, anemia, and memory loss.
Secondary Hormonal Therapy
Use of diethylstilbestrol (DES) is associated with cardiovascular complications, including blood clots and heart attack. Ketoconazole is associated with fatigue, abdominal pain, hepatotoxicity, and nausea; abiraterone may cause shortness of breath, low potassium, and edema; enzalutamide may cause muscle pain, diarrhea, and edema.
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| Chemotherapy |
It is important to note that the chemotherapy you might receive for prostate cancer is likely to be very different than the chemotherapies your friends and family members may have received for other cancers. While there are over 50 chemotherapy medications used for cancer treatment, only 3 are used in prostate cancer patients. Potential side effects of chemotherapy for prostate cancer include anemia, neutropenia, fatigue, nausea/vomiting, diarrhea, and pain.
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| Immunotherapy |
The side effects of immunotherapies such as sipuleucel is mostly limited to infusion reactions, which include chills, fatigue, back pain, nausea, joint aches, and headache. These effects are not long lasting but can often be prevented with careful monitoring during infusion.
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| Bone-targeted therapy |
Bone-targeted therapy such as radium 223 dichloride may be associated with fatigue, nausea, anemia, and pain.
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