Understanding Prostate Cancer Surgery and Navigating Its Side Effects
- ESPN’s Jay Harris, 60, is. celebrating a successful prostate cancer surgery and looking forward to getting back to work.
- A prostatectomy is a surgical procedure for prostate cancer. It’s an option for men with any risk group of prostate cancer that hasn’t spread outside of the prostate gland.
- During this procedure, the surgeon removes the entire prostate, along with some tissue around it, including the seminal vesicles that release fluid into the semen. Side effects may follow this procedure, which may include erectile dysfunction and urinary incontinence.
- The nerve-sparing surgery option can reduce the risk of side effects like sexual dysfunction, though it may not be suitable for everyone. Nerve-sparing surgery involves removing cancer without harming the nerves, but if the cancer is near the nerves, it may need removal.
- Surgery may not be needed for all men diagnosed with prostate cancer. In some cases, active surveillance is a preferred treatment option for older men or those with a low risk of the disease spreading. It helps people avoid unnecessary treatment and side effects.
The uplifting news comes just weeks after he went public with his diagnosis—which is he said didn’t come as a surprise because “prostate cancer disproportionately affects Black men” and his dad victoriously battled the same disease.
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He further explained in the short clip, shared on both Instagram and X, “There are other details that I won’t bore you with. The main thing is … we’re all good. And looking forward to July 12th, getting back to SportsCenter, getting back to wor.
“So Just home, resting up, chilling. I appreciate the prayers and the thoughts and the messages and the calls and the deliveries. Thank you so much. I appreciate all the love, and I will holler. Take care. Peace.”
Expert Resources On Prostate Cancer Treatment
- How Military Service Combats Racial Gaps in Prostate Cancer Survival
- How Partial Gland Ablation Is Helping Prostate Cancer Survivors Preserve Sexual and Urinary Function
- New Evidence Surgery Better Than Waiting When It Comes to Extending Life for Prostate Cancer
- Will Prostate Cancer Surgery Side Effects Be Long-Term?
- Don’t Believe the Hype: Do Your Own Research on Prostate Cancer Treatment
- Debating How to Treat Prostate Cancer: A Significant New Study Argues for Surgery Plus Radiation
- Molecular Testing Can Help Create a Tailored Prostate Cancer Treatment Path
We’re delighted to hear Harris is doing well, as he announced his diagnosis on Good Morning America back on June 5.
He also chose to spread awareness for the disease in an ESPN press released, where he explained, “I’m 60. It’s something I’ve always been cognizant of, and my doctor and I talk about it every annual visit. And I’m sharing it all with my 26-year-old son. Maybe I’m oversharing at times … but he needs to know.
“My treatment plan begins with surgery, which is scheduled for Tuesday, June 10. After my diagnosis, a PET scan showed no spreading. While that was quite the relief, I know that’s not the final word, and they’ll find out more when they go inside. My hope is that they won’t find anything extra so that I can return to work in a month or so, 100 percent healthy.”
Harris added, “My goal in sharing this is to join the many others who also want to normalize this conversation and hopefully provide a bit of guidance and preparation, just as it has been offered to me.”
Understanding Prostate Cancer
If you or a loved one has been diagnosed with prostate cancer, it’s important to remember that most types of prostate cancers are treatable. According to the National Cancer Institute, the five-year survival rate of prostate cancer in the U.S. is 97.1%. There is, however, a small number of men whose type of prostate cancer may become unresponsive to treatment, for example, when cancer cells develop a resistance hormone therapy, the treatment may no longer work.
RELATED: Prostate Cancer: Overview
Prostate cancer begins in the prostate the walnut-shaped gland located between the rectum and bladder that produces the fluid that nourishes sperm. Outside of skin cancers, prostate cancer is the most common cancer in American men with about one in eight men being diagnosed with this disease during his lifetime.
It’s important to remember a prostate cancer diagnosis is not always preceded by symptoms. And even when symptoms do occur, they can be inconsistent and hard to pinpoint.
“Prostate cancer is a very odd disease in that it doesn’t have a particular symptom,” Dr. Edwin Posadas, director of translational oncology and the medical director of the Urologic Oncology Program at Cedars-Sinai, told SurvivorNet.
Still, it’s important to note changes in urinary function, like urinating more or less often or waking up at night to go more than usual, could be a sign of prostate cancer. So, even if you think there’s nothing to worry about, always talk to your doctor about changes to your health when they occur.
There are many different treatment options for both early and later-stage prostate cancer including active surveillance, watchful waiting, surgery, radiation, cryotherapy, hormone therapy, chemotherapy, immunotherapy and targeted therapy. The disease is one where doctors may have differing opinions on the best treatment path to take, so don’t hesitate to ask lots of questions and seek out multiple opinions.
Second (& Third) Opinions Matter When Deciding Between Surgery or Radiation
“I think it behooves the patient to have multiple discussions or second opinions, not only by the urologist who did the biopsy and diagnosed that man, but also with other surgeons and other radiation oncologist just to get a very circumspect view of what the treatment options are,” Dr. Jim Hu, a urologic oncologist at Weill Cornell Medicine, told SurvivorNet. “Oftentimes, I think patients need to understand that our health system is based a lot on fee-for-service medicine.”
“And so therefore, a lot of physicians, I think, who are very well intentioned, will believe that their treatment is best for that particular man,” Dr. Hu added.
Treatment Decisions After a Prostate Cancer Diagnosis
Although there are numerous treatments available for prostate cancer, what your doctor recommends will depend on what category of risk your disease falls under. Sometimes that may mean doing nothing at all.
Prostate cancer is a slow-growing disease, so unless it’s been a majorly delayed diagnosis and in a more advanced stage, medical experts will sometimes suggest actively monitoring the growth, and the patient will go in for check-ups every six months or whatever timeframe the doctor deems best.
Dr. David Wise, NYU Langone medical oncologist, explains how Gleason score affects treatment and prognosis
The National Comprehensive Cancer Network (NCCN) guidelines divides prostate cancer into one of six risk categories based on how aggressive the cancer looks under the microscope and the chance of it coming back after treatment. These risk categories help guide treatment for the different subtypes of prostate cancers.
The main risk categories for prostate cancer are:
- Very-Low-Risk (VLR) and Low-Risk (LR)
- Favorable- (FIR) and Unfavorable-Intermediate-Risk (UFIR)
- High-Risk (HR) and Very-High-Risk (VHR)
Prostate cancers classified as VLR or LR represent the least aggressive forms of cancer. This categorization will be diagnosed depending on number of factors, including:
- Your doctor can’t feel the cancer on a physical exam, or it occupies one-half or less of one side of the prostate
- Your PSA is less than 10
- Your total Gleason (which is how the prostate cancer is graded) score is 6
- If your cancer is categorized as VLR or LR, your doctor may recommend active surveillance, which is sometimes called “watch and wait.”
Dr. Nicholas Nickols, a radiation oncologist at the UCLA Department of Radiation Oncology, summarizes active surveillance as follows, ‘We carefully monitor the prostate cancer for evidence of progression or not, and then initiate treatment later, if at all.”
During active surveillance, you won’t receive any treatment but your doctor will key an eye on your cancer with a series of tests including:
- PSA Levels
- MRIs
- Repeat biopsies
It’s possible that your cancer may never progress to more aggressive forms of prostate cancer. Active surveillance should help your doctor catch any changes or progression.
RELATED: What is Active Surveillance?
Patients on active surveillance can be spared the side effects of pursuing the traditional ways of treating prostate cancer. If and when the disease becomes more aggressive, as indicated by a rising PSA, development of aggressive-looking disease on MRI, or increasing Gleason score, it can then be treated with surgery, radiation, hormone therapy, chemotherapy, or a combination of these therapies.
Dr. Edwin Posadas tells you what clues might signal that you have prostate cancer
A Healthy Sex Life After Prostate Cancer
It’s not unusual for men to experience sexual side effects after surgery or radiation for prostate cancer. Some men struggle to get an erection. However, there are solutions to regain sexual activity according to Dr. James Brooks, the Chief of Urologic Oncology at Stanford Medicine.
“There are treatments that we can use, including oral agents. Viagra and Cialis and Levitra have been game-changers in this situation. They don’t work for all patients,” Dr. Brooks explained.
“There are other alternatives that a urologist can work with them to help them get back to being– getting erections and getting back to being sexually active,” Dr. Brooks continued.
Couples who are journeying to recovery after treatment are encouraged to seek counseling from a sex therapist.
There are several different medications on the market that work for prostate cancer survivors. Devices including the Vacuum Erectile Device (VED) and a prosthesis are also options.
WATCH: Coping with side effects after prostate cancer surgery.
Other side effects from prostate cancer surgery may include urinary incontinence. Dr. Stephen Freeland is a urologist at Cedars-Sinai Medical Center. He says, your care team will work with you to aid with any leakage issues.
“We’re going to work with you on some exercises to try and improve that, and the vast majority of people get to a point where they don’t really need pads or diapers or anything for leakage, but a sizable percentage of patients do,” Dr. Freeland said.
How Long Does It Take to Regain Sexual Function
It can take several months for most men to regain sexual function after surgery.
“When a patient has surgery, nobody can get an erection for about six months afterward. It’s rare,” Dr. Patrick Swift tells SurvivorNet.
Dr. Swift is a radiation oncologist at Stanford and points to differences in side effects for surgery and radiation.
WATCH: Preserving sexual function after surgery depends on several factors.
“If you’re using radiation alone, the risk of you losing sexual function quickly is very, very low. And in fact, with external radiation therapy alone, at two years, about 80% of patients are still getting good erections, but they make less of an ejaculate,” Dr. Swift explains.
Meanwhile, if you undergo surgery, your sexual function is more dependent on your surgeon’s ability to spare the neurovascular bundles which are small collections of nerve and blood vessels.
“If both neurovascular bundles are injured at the time of surgery, the chance of getting back sexual function without some kind of prosthetic device is very, very low,” Dr. Swift said.
Hormone therapy can also affect your sexual interest which may inhibit your testosterone level.
Questions for 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?
Choosing to Continue Working During Cancer Treatment
Many SurvivorNet experts recommend patients continue working or their normal lifestyle, if possible, after a diagnosis.
“We always encourage people to continue to work if they can,” says Sarah Stapleton, a clinical social worker at Montefiore Medical Center. “I think it creates a sense of normalcy for patients.”
If you’re able to work, you’ll be busy, and you may not be worrying all the time about how your treatment is going, Stapleton adds.
Sometimes, cancer can make you feel isolated and lonely, and being around people for work can alleviate feelings of loneliness.
It would be best to talk with your doctor before continuing to work during treatment. Ask your physician what you can and cannot do so you don’t disrupt ongoing treatment.
Remember, sometimes cancer treatment can cause fatigue, leaving you unable to fulfill your duties as you once could.
Fortunately, some on-the-job accommodations can make working during cancer treatment much easier.
WATCH: Choosing to Work During Cancer Treatment
The Rehabilitation Act or the Americans with Disabilities Act protects people with job problems related to cancer. The Family and Medical Leave Act (FMLA) may also benefit others. This law allows many people with serious illnesses to take unpaid leave to get medical care or manage their symptoms.
Your human resources department should be able to share with you your options.
In some situations, employers must accommodate a qualified applicant or employee with a disability unless the employer can show it would be an undue hardship to do so. This could mean making changes to work schedules, equipment, or policies.
Laurie Ostacher, a behavioral health clinician at Stanford Health Care, recommends that cancer patients discuss accommodations they may need upon returning to work with their employers.
“Patients need to let their employer know [they’re] going to need some flexibility… Because there are going to be days when you’re not as energetic or feeling as well as other days,” Ostacher explained.
Contributing: SurvivorNet Staff
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