Balancing Treatment and Quality of Life: What Men Should Know About Prostate Cancer Care

“I think it’s important for men to really take into account what’s important to them,” Dr. Mark explains to SurvivorNet.

“There are a lot of options for treatments, and every treatment has its pros and its cons. While some treatments may be better in terms of getting better control of the prostate cancer, they may not be what you want in terms of side effects of treatment.”

Side effects of prostate cancer treatment can include changes to urinary control and sexual function. Sometimes, men opt for treatment paths that avoid or limit potential side effects.

What Factors Go Into Treatment Choices?

For many patients, the differences between treatment options — such as surgery, radiation, or hormone therapy — can be subtle. But those nuances matter, especially when side effects impact daily life.

“In certain cases, the differences in treatment options can be relatively minor,” Dr. Mark explains.

One common combination for aggressive prostate cancer is radiation therapy paired with androgen deprivation therapy (ADT), also called hormone therapy, which suppresses testosterone to slow cancer growth. While this approach can significantly improve recurrence rates and survival, it’s not without cost — especially for older patients.

“Adding those treatments to radiation has a big improvement on the recurrence rate of survival,” Dr. Mark says. “But not all men sustain that big of an improvement, and particularly if you’re older, taking out your testosterone can really affect your muscle strength and vitality.”

For some, preserving strength and energy may outweigh a modest increase in cancer control.

“As patients are getting elderly, to some, that is more important than maybe a 10% [increase] in their case of prostate cancer control,” he adds.

Dr. Mark also cautions against rigid treatment protocols that don’t account for individual needs. He encourages patients to ask their care team questions and explore different types of treatments, specifically inquiring about possible treatment outcomes and the side effects they bring.

“Sometimes, it almost seems dogmatic in the way the treatments are delivered,” he says. “It’s always good to ask what the benefit of each aspect of the treatment is and what can be given in a different way.”

Planning For Life Beyond Treatment

Depending on the stage and risk level, treatment options for prostate cancer might include radical prostatectomy, radiation therapy, hormone therapy, and others.

While each of these treatment strategies aims to control or eliminate the cancer, it is important to understand that they come with potential side effects, which may include:

• Urinary irritation or incontinence
• Erectile dysfunction
• Fatigue or weakness
• Hot flashes (stemming from hormone therapy)

With a range of options available, prostate cancer patients deserve a voice in shaping a treatment plan that aligns with their goals, lifestyle, and long-term well-being.

Questions To Ask Your Doctor

• How will each treatment option affect my quality of life — especially things like intimacy, energy, and ability to work?
• What are the pros and cons of surgery, radiation, and hormone therapy in my specific case?
• Is there flexibility in how treatments are delivered, or are there alternative approaches that might work better for me?
• What can we do to manage or reduce side effects like fatigue, erectile dysfunction, or urinary issues?

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