Cancer is an abnormal condition which occurs once the normal cells start to know an uncontrollable and rapid growth and an even faster death while the cancerous cells tend to multiply at a fast pace and outlive the normal ones; if the tumor spreads far from the primary site to other surrounding parts of the internal body and develop new and secondary tumors then the cancer will eventually become metastatic. If the cancerous cells have entered the bloodstream, they will end up in any tissue or organ; these cells can also travel through the lymph system, which includes the lymph vessels, where a clear fluid called lymph is carried to the heart, being somehow similar to the blood vessels, and the lymph nodes. Basically, the cancer becomes metastasized only when the primary tumor, which is already locally advanced, continues with its spreading and the cancerous cells have reached out from the prostate capsule.
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The cancer will be named after the body part from where it started, even if the tumor has spread and invaded some other body parts and usually, when there are two or more metastatic tumors, this condition is called metastases. Sometimes doctors find it hard to identify the primary site of the cancer: in this situation the disease is called cancer of unknown primary and when the cancer comes back as metastases, refer to this condition as distant recurrence. The bone structures are the third most common site affected by the metastatic cancer, either being a breast cancer, a prostate cancer or any other type of cancer. The carcinomas are more likely to metastasize to bone in comparison to the sarcomas and the most common bone sites affected by the metastatic cancer are the spine, the pelvis or the hip, the femur or the upper leg bone, the ribs, the humerus or the upper arm bone and the skull. Usually the distant bone structures are less likely to get affected if the patient starts a treatment.

The symptoms often associated with bone metastasis are pain, hypercalcemia and pathological fractures. Metastatic cancer will cause pain, a symptom reported by almost seventy percent of the patients diagnosed with bone metastases, because prostate cancer has the predilection of affecting first the bone structures. The pain is caused because of the tumor, responsible for the stretching of the periosteum but also because of the nerve stimulation in the endosteum. The radionuclide bone scans, the coaxial tomography or the magnetic resonance imaging or MRI can confirm if the cancer has spread to the bones or not. The MRI is considered as the most sensitive method of detecting cancer because it can spot the cancerous cells long before they reach and affect the bone structures. The metastatic bone lesions are characterized as osteolytic, osteoblastic or mixed. Osteolytic lesions or tumors can cause an abnormal resorption of bone by the enzymes known as proteolytic and the spreading process outstrips the laying down of the new bone. Osteoblatic tumors cause a secretion of bone extracellular matrix proteins or ECM; in other words the tumor stimulates the bone growth. In most cases the lesions are identified as mixed.

The treatment procedures recommended for the terminal cancer stages are radiotherapy, chemotherapy and depending on the type of cancer, bisphosphonates. Chemotherapy is a popular treatment method for curing cancer and leukemia, while the radiation therapy has the effect of damaging the DNA of the cancerous cells so that it would stop their multiplication. The radiotherapy uses the internal beam radiation method by implanting radioactive seeds into the prostate gland and leaving them there to decay or the external proton beam radiation.

The abnormal condition, which appears when the cancerous cells start to multiply at an abnormal and rapid rate while the normal ones experience a fast growth and die even faster, is known under the name of cancer; cancer determines the spreading of the primary tumor from the primary site to other surrounding areas of the infected part of the body, by growing different small and secondary tumors, until, eventually, the cancer becomes metastasized. The spreading process begins once the cancerous cells enter into the bloodstream or the lymph fluid; these cells travel at an alarming speed through the blood vessels or the lymph system, formed by the lymph nodes and the lymph vessels that carry the lymph, a clear fluid, to the heart. If the cancer is diagnosed as locally advance, left untreated, it will eventually become metastatic, leading to a painful death.
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The cancer is named after the body part from where it starts developing, so, if the primary tumor appears in the prostate gland then the disease will have the name of prostate cancer. If we are talking about the existence of two or more metastatic tumors, doctors refer to this condition as metastases. If the cancer is recurrent and comes back as metastases, this condition is known as distant recurrence; sometimes the cancer has spread so far or the spreading process is so complex that physicians find it hard to identify the exact body part where the primary tumor is: in this situation the medical community name the cancer as cancer of unknown primary. Carcinomas are more likely to metastasize to bone in comparison to the sarcomas and the most common bone sites affected by the metastatic cancer are the spine, the pelvis or the hip, the femur or the upper leg bone, the ribs, the humerus or the upper arm bone and the skull; in most cases the distant bone structures are less likely to get infected by tumors if the patient starts a treatment immediately after the diagnose.

The bones structures are the third most common site affected by the metastatic cancer, either being a breast cancer, a prostate cancer or any other type of cancer and the MRI detection method or the magnetic resonance imaging, is considered as the most sensitive one, allowing the spotting of the cancerous cells long before they reach and affect the bone structures. The other recommended methods of detection are the radionuclide bone scans and the coaxial tomography. The symptoms associated with bone metastasis are pain, hypercalcemia and pathological fractures. The metastasized cancer will cause pain, reported by almost seventy percent of the patients diagnosed with bone metastases; this happens dew to the predilection of the prostate cancer to affect first the bone structures. The pain is caused because of the tumor, responsible for the stretching of the periosteum but also because of the nerve stimulation in the endosteum. The metastatic bone lesions are characterized as osteolytic, osteoblastic or mixed. Osteolytic lesions or tumors can cause an abnormal resorption of bone by the enzymes known as proteolytic and the spreading process outstrips the laying down of the new bone. Osteoblatic tumors cause a secretion of bone extracellular matrix proteins or ECM; in other words the tumor stimulates the bone growth. In most cases the lesions are identified as mixed.

For the advanced forms of cancer, especially when the bone system is affected, the recommended treatments are chemotherapy, a healing procedure used not only for treating cancer but also for cases of leukemia, the radiotherapy or the radiation therapy, a procedure used for damaging the DNA of the cancerous cells and to stop their multiplication; the radiotherapy is works by inserting radioactive seeds into the gland and leave them there to slowly decay or by using the external proton beam radiation. The side effects for both treatment procedures can not be avoided.
Before choosing for a treatment, the doctor will advise you and explain what are the consequences of the prostate cancer, so make sure to listen to whatever he says or recommends.

Prostate cancer is the second most common type of cancer and is a disease affecting only the male population and more exactly the organ responsible for the seminal fluid, the prostate gland. Some of the causes are still being studied but the unfortunate fact is that the risk factors blamed for the development of cancer can not be avoided. Doctors often recommend for men over forty to start doing the screening tests for an early detection of the prostate cancer since it does not present any early symptoms to make it noticeable. After this age, certain changes occur in the male organism and the level of the male specific hormone, testosterone, begins to decrease. This happens because of the merciless aging process. Yes, age could be seen as the main factor responsible for the prostate cancer.
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While the reasons are still uncovered, race and genetic background are the other causes of the prostate cancer and their study is very important. Several research studies concluded that the American-African men have a higher risk to get prostate cancer in comparison to the American-Caucasian ones. The lowest risk to get prostate cancer is for the Asian and Hispanic men; as a matter of fact this disease is the rarest among Japanese men living in their home country, Japan. As of genetics, it is well known the fact that all types of cancer tend to be inherited by members of the same family, so the prostate cancer is not an exception. Even if the family has only a history of breast cancer that doest not eliminate the possibility for men to develop a prostate cancer. This disease will affect a great number of the male population and as you probably noticed, a disease doesn’t depend on the wealth, popularity or social status of that certain person. The life and fate makes us all equal and leaves us powerless.

The celebrities we often see on the big screens are also humans, despite their popular or social status. Famous men can also be affected by the prostate cancer and below I shall give some examples. Robert DeNiro, the famous actor and Academy award winner was diagnosed with early-stage cancer at the age of sixty, while his father died because of this disease as the age of seventy one. The Godfather of soul music, James Brown, was diagnosed in 2004 with prostate cancer but survived only to die in 2006 because of a heart failure. The former mayor of New York City, Rudy Giuliani, was diagnosed with prostate cancer and had surgery for implanting the radioactive seeds, while his father lost the battle with this disease at the age of seventy three. Nelson Mandela received the prostate cancer diagnose in 2001 but made a full recovery after seven weeks of radiation therapy treatment. Others were less unfortunate and lost the battle against this cruel disease.

Frank Zappa, the famous singer and writer died at the age of fifty two, on December 4, 1993, because of the prostate cancer. Earl Woods, Tiger Woods’ father died at the age of seventy four in 2006 because of the recurrent cancer. In 2000 the prime minister of Canada, Pierre Elliot Trudeau, died at the age of eighty because of this illness. The Ramones guitarist, Johnny Ramone, was also the victim of this disease and died at the age of fifty five in 2004. Some other famous men affected by this are the Japanese emperor Akihito, the actor Roger Moore, the leader of the Nation of Islam, Louis Farrakhan, the singer and actor Harry Belafonte, the former president of France, Francois Mitterand, the Yankees manager, Joe Torre and the list could go on because cancer is a terrible disease and it seems that no one can avoid it. Doctors can only recommend some prevention measures to be taken early in time, even before the dangerous age of forty.

The radiation therapy is the second most popular conventional treatment procedure used in treating the prostate cancer, after the operation known as prostatectomy. The radiotherapy uses two treatment methods: the brachytherapy or the internal beam radiation and the external beam radiation. The effect of the radiotherapy, in both cases, is the damage done to the DNA of the cancerous cells to stop them from multiplying at a rapid speed. The proton treatment is a procedure invented in the twentieth century and in the first stages, the medical community used the intraprostatic radium implants. Soon after, this method was replaced with the use of the proton energy, more exactly in 1946, when this treatment gave some good results after being used for the more common diseases such as cancer. The proton beam radiation therapy is a complex form of treatment, done only under the general and careful observation of oncologists or the radiation therapy specialists.
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The patient receives this treatment in a guidance room, under the direct observation of physicians and specialized computers, the beam being directly used only on the infected area of the body. This procedure goes something like this: the proton used in this kind of therapy starts its journey in an injector, found in an electric field, where the hydrogen atoms are divided into positively charged protons and negatively charged electrons; the protons are transported through a vacuum tube to the synchrotron, circulating at a rapid speed and increasing the protons energy with approximately two hundred fifty million electron volts, penetrating the skin at any depth. The proton therapy treatment successfully replaces the Cobalt-60 gamma-ray therapy or the x-ray therapy.

The side-effects are normal for all types of prostate cancer treatments, especially for the radiation therapy or the androgen deprivation therapy. The energy dose required to treat the cancer depends on the type of cancer, the stage or just how advanced is the tumor is the body and last, but not least, what are the reactions of the patients to this sort of treatment and the after effects. The common side-effects are impotence and urinary or fecal incontinence and sometimes the proton beam radiation can also damage some surrounding healthy tissues because oncologists don’t have the possibility to guess exactly what necessary energy dose to use. The intensity of the dose can either be low-rate or LDR, medium-dose or MDR, a high-dose or HDR and a pulsed-dose rate or PDR.

It would be better for the doctor to have some experience with these treatment procedures because he will know exactly, just by giving a personal interpretation of the disease’s characteristics, the required proton energy dose and usually the results of the temporary brachytherapy will be affected if the radiation sources aren’t correctly placed on the infected area for the necessary period of time, either being a few minutes or sometimes, hours. If a patient has a disease with low risk he can either choose radiotherapy or prostatectomy as a treatment method; the intermediate and high risk diseases are treated with radiation therapy and for a long or a short period of time with hormonal ablation. If the patients respond well to the treatment, there is a high chance to cure the cancer, but only if it is detected in the early stages. The metastatic cancer makes life painful and should be avoided at all cost.

When confronting with a terrible disease such as the prostate cancer, one must make sure to find the right treatment for it and to avoid as much as possible for the cancer to become metastasized. A better option would be to prevent this disease but certain factors such as the age, the genetic background and race are seen as the main causes for the prostate cancer and unfortunately these causes can not be ignored and no one can get rid of them. Bone care is highly important because cancer has the predilection to affect the entire body structures once it starts spreading and the prostate cancer is no different. The most common prostate cancer symptoms are frequent urination or weak urine stream, burning or pain while urinating, blood in urine or semen, painful ejaculation, back pains, stiffness and ache.
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Cancer is a cruel disease which can be cured only if it is detected in its early stages and since it is an abnormal condition, occurring once the normal cells know an uncontrollable and fast growth while the cancerous cells tend to appear and multiply, radical treatment procedures such as prostatectomy and radiation therapy are highly recommended to stop the spreading process. The invasion is done through the bloodstream and the lymph vessels, affecting the surrounding tissues and organs of the gland, and once it becomes locally advanced the original tumor will grow other small, secondary tumors on distanced areas, until the cancer finally becomes metastatic. In this stage the terminal symptoms are painful and if the cancer is left untreated it could lead to a painful but certain death.

In the worst case scenario, the spinal cord will be affected by the prostate cancer which will cause a compression of the spine, resulting in muscle weakness or fecal and urinary incontinence; if the lungs are affected the patient will experience some respiratory problems, excessive coughing and pains in the chest; the cancer will also affect the liver causing abdomen pains and giving to the skin a yellow color. Calcium is important for the bone structures and muscle weakness or fatigues happen when the complex activity of movement, described as the detection of the flow of electrical impulses by the muscle cells and generated by the brain after giving them the signal to contract when calcium is released by the sarcoplasmic reticulum, is not working very well.

The leg pain can be an early symptom or a terminal symptom, but a correct diagnose can only be put after the routine screening tests or after the prostate biopsy is done. The metastatic cancer will affect the bone structures because as a main characteristic, cancer will affect first the bones: the pelvis, the ribs, the spinal cord, the vertebrae and the leg bones. It is not uncommon for prostate cancer patients to report extreme leg pains and that usually happens in almost forty per cent of the cases. A healthy, nutritional diet, rich in antioxidants and mineral supplements such as selenium, zinc and calcium, is often recommended not only by herbalists but also by doctors, because prevention is highly important. If you experience any strange symptoms, and this advice should be taken in consideration mostly by men over forty, contact immediately your personal doctor because the prostate cancer has no early symptoms so there is a possibility that the existing cancer already started to spread. If the screening tests gave a good result, the prevention measures should not be forgotten and the practice of a daily physical exercise is found in this category.

The radiation therapy that uses the brachytherapy and the external beam radiation as the main treatment procedures has the general effect of damaging the DNA of the cancerous cells to stop their multiplying process. The proton theory is the same as the one mentioned above and is an operational procedure developed in the twentieth century. In the first stage this treatment method consisted of intraprostatic radium implants but the use of proton energy, proposed for the first time in 1946, for treating diseases such as cancer became a standard and popular operation only in these last two decades. The proton therapy is defined as a radiation treatment that uses an external beam and is regarded as the alternative for the Cobalt-60 gamma-ray therapy or the x-ray therapy.
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These are the following steps for the proton beam radiation therapy:  the proton starts its complex journey in an injector placed in an electric field. There, the hydrogen atoms are divided into positively charged protons and negatively charged electrons; the protons are transported through a vacuum tube to the synchrotron at a rapid speed, circulating at about ten million times per second and increasing the energy of the protons with approximately seventy and two hundred fifty million electron volts, until they finally penetrate the skin of the patients body, an any depth possible. In the guidance room, where the patient receives the radiation treatment and the doctors guide the beam placement directly on the infected area of the body, all is recorded and observed by computers.

The exact beam radiation dose depends on how far spread is the cancer, the stage of the tumor and what are the first reactions of the body to such a treatment. The common side-effects are impotence and urinary or fecal incontinence and sometimes the proton beam radiation can also damage some surrounding healthy tissues because oncologists don’t have the possibility to guess exactly what necessary energy dose to use. Brachytherapy seems less risky than the proton beam therapy but in general, the radiation therapies have some risk factors and side-effects. The brachy term from the brachytherapy word comes from the greek translation of “short distance”, being known as internal beam radiation because the radioactive seeds or pellets are being inserted right into the prostate gland through needles thus avoiding the damaging of the surrounding organs or body parts.

This radiation procedure is also known as permanent brachytherapy and usually the side effects are: urinary incontinence, dysuria or painful urination, urinary retention, diarrhea, potential rectal bleeding, constipation. There is a possibility that the radioactive seeds implanted in the gland will find their way out of the prostate capsule and migrate to other surrounding areas such as the bladder, the urethra or into the urine or the seminal fluid. The results of the temporary brachytherapy, described as the direct placement of the radiation sources for a certain period of time, usually being only a few minutes or hours, will mostly depend on the type of cancer, the size and the location of the tumor and what is the required energy dose rate. The intensity of the dose can either be low-rate or LDR, medium-dose or MDR, a high-dose or HDR and a pulsed-dose rate or PDR. If a doctor has an experience with such treatment procedures, in this case being the radiation therapy, he will definitely know exactly just what dose should be use for a patient depending on the characteristics of his disease. The proton therapy for prostate cancer is based on what is written above so when deciding for a conventional treatment method the physician will ascertain what are the personal preferences of the patient but also his age, his genetic history and just how advanced is the cancer which affects him.

According to the TNM and Whitmore-Jewett staging systems, the last stage of prostate cancer is stage IV or D. Cancer is an abnormal condition which occurs once the normal cells start to know an uncontrollable and rapid growth and an even faster death while the cancerous cells tend to multiply at a fast pace and outlive the normal ones. If the tumor is benign, the cancer will not develop but if the organ-confined tumor is malignant, it will soon enter the bloodstream and the lymph vessels and spread to other surrounding areas of the gland, growing other secondary, small tumors. If cancer is diagnosed the staging process is used to find out exactly how far advanced is the tumor and what treatment should be prescribed to stop it from becoming metastatic. If the cancer is metastasized the patient will experience some painful symptoms and if it is left untreated the cancer will eventually lead to death.
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The common reported terminal symptoms indicate that the cancerous cells have reached the bone structures and far distanced organs and tissues such as the liver, the lungs, the spinal cord, the pelvis, the ribs or the vertebrae: respiratory problems and chest pains, abdomen pains, pains while urinating, leg pains, muscle weakness and incontinence, the compression of the spine, impotence or other sex problems will soon appear. In stage IV or stage D the cancer is locally advanced or metastatic; this stage is divided into other substages, and as the name of TNM staging system goes, the doctor will determine exactly just how spread is the cancer by analyzing the stage of the tumor, the nodes and the metastatic stage.

In substage D0 the blood tests show that the cancer has spread in the entire body even though the imaging tests and screening examination indicate something different; in substage D1 the cancer is developing in the lymph nodes; in substage D2 the cancer has spread to the surrounding organs, especially the bones since metastatic cancer has a tendency to affect first the bone structures; and in the last substage meaning substage D3, the cancer is somewhat similar as in stage D2, without advancing any further. The treatments available for this end stage give some discouraging and less effective results because in this stage the cancer can not be cured. Surgery or prostatectomy is usually a less effective operation and has little worth in treating the advanced forms of cancer, probably because the cancerous cells had spread outside the prostate capsule and already reached the surrounding areas of the gland.

The other treatment therapy options used in the fighting against cancer, even in its final stages, are: the radiation therapy, damaging the DNA of the cancerous cells with an external beam radiation or implanted radioactive pellets left in the gland until they decay, cryotherapy done freezing the prostate, hormone therapy also known as androgen deprivation therapy or the popular name of chemical castration and chemotherapy. Prevention measures should be taken in consideration by men over forty and the screening tests and prostate biopsy should be routinely done because this is the common method to detect the cancer in its early stages and treat it. Also worth mentioning the fact that cancer can be cured if the patients respond well to the prescribed treatment and if the tumor is not too far advanced.

The prostate cancer is usually detected with the help of the screening tests or the prostate biopsy. The screening tests have to be done regularly and they are recommended for men who have reached the age of forty or fifty. The prostate cancer has no early symptoms so these tests are important to discover the organ-confined tumor in its early stages. Left untreated it will eventually develop and spread in the body becoming locally advanced or in the worst case, metastatic. The result of the above tests can be normal and that means that cancerous cells are not detected or abnormal. In this later situation the prostate biopsy is necessary to make a correct diagnose, since cancer is not the only disease affecting the prostate and not all tumors, like the malignant ones, can develop cancer. The screening tests imply two procedures: the digital rectal exam or DRE and the prostate specific antigen blood tests or PSA.
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The first medical procedure is a bit unpleasant and the doctor has to insert a gloved finger into the rectum to palpate the prostate. If he feels hardness or a lump on the surface of the prostate that usually indicates the existence of a tumor. The other procedure is less unpleasant and the blood test uses as an indicator for determining the existence of cancer the prostate specific antigen. The PSA is a protein produced by the cells of the prostate organ and is regarded as a tumor or a biological marker. The PSA blood tests measure the level of the PSA in the blood, in normal cases being very low. A sample of blood is examined in the laboratory and depending of the test results the doctor will decide whether to further examine the patient or look for the prostate cancer signs.

The PSA blood tests don’t accurately indicate the existence of cancer, since a tumor is not only malignant but also benign. Cancer is not the only disease which affects the gland; the prostatitis or the benign prostatic hyperplasia or BPH are not related to cancer, and even though a patient is diagnosed with these disorders that does not mean that cancer won’t develop as well. The level of the prostate specific antigen doesn’t indicate the existence of cancer or that of a benign tumor. This blood test is recommended to be done annually because according to its results small tumors can be detected: if the PSA test result indicates under four nanograms per milliliter of blood then it is considered as a normal result, the result between four and ten is at the borderline, depending on the patients age, genes, symptoms and even race, while a result higher than ten is abnormal, and it is necessary for a doctor to inquire further medical investigations to reach an exact diagnosis. Values between thirty and forty indicate the existence of a prostate cancer.

The PSA blood test is a bit controversial because there is a possibility that the diagnose is nor entirely accurate. For example, small tumors may be detected early but there isn’t the certainty that these tumors will actually develop in the near future into cancer or if they are life threatening. This situation known as overdiagnosis can create some complications for the patients and even though both screening tests don’t give a one hundred per cent accurate result, they still remain the best methods used for discovering the prostate cancer in its early stages.

The prostate cancer is a disease with serious side-effects and it can gravely disrupt the normal life you are having. Sex problems are not uncommon and usually the patient diagnosed with a prostate cancer can overcome these problems only with the help of his partner. The after affects of the prostate cancer aren’t noticeable, not until the tumor starts spreading or if the patient begins a treatment. Also, almost all conventional treatments have some side-effects and impotence can be one of them. The erectile problems you experience can be temporary or permanent, some being caused by shifting moods or strong feelings such as anxiety or the lack of confidence. In these cases the treatment is not to be blamed for the difficulties you encounter. The best thing is to talk about these problems and share your feelings with someone like your partner, your personal doctor or a sex therapist.
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Like I’ve mentioned before, impotence may appear shortly after being diagnosed with a prostate cancer and started a treatment for it. Impotence is seen as an erectile dysfunction when someone is not able to maintain or develop an erection of the penis for a satisfying sexual performance, not even when aroused. The causes are multiple: past traumas, side-effects of the prostate surgery, the radiation therapy and almost all types of hormone therapy or the operations for removing both testicles and drugs side-effects. If they lack information about this body malfunctioning, men will start to get all sorts of crazy ideas like starting to worry not to infect their partner with this disease if they have sex. The prostate cancer is not infectious and even though it could ruin your intimate life because of impotence, that does not mean that cancer could be passed in the semen. You may also experience some loss of interest to have sex, but that probably is also because of the treatments you follow, especially the androgen deprivation therapy.

Impotence is not the only side effect which may affect your sex life: incontinence, diarrhea, urinary catheter or tiredness are some of the most common side-effects and they usually wear off some days or weeks after finishing your treatment. After a treatment, patients sometimes report penis shrinkage or a decrease of the amount of ejaculation. This is the alarm signal for you to immediately contact your doctor and replace the treatment you follow at the moment. Some treatments, such as brachytherapy are quite problematic. For example, the radioactive pellets implanted in the prostate gland and left there to slowly decay could easily find their way out of the prostate capsule and migrate to the surrounding areas such as the bladder, urethra and finally passed in the urinary liquid.

Because there is always the possibility for the seeds to migrate through the sperm, doctors recommend the use of condoms and in case they don’t want to use this safety protection, men could also masturbate a few times after this therapy. As you can probably notice, the side-effects are quite common so before choosing a prostate cancer treatment make sure to gather all the information about it.

The erectile problems you might experience after being diagnosed with prostate cancer can either be temporary or permanent. In most cases, these problems can be regarded as treatment side-effects but it is not uncommon for them to be cause by shifting moods and strong feeling such as anxiety, depression or lack of self-confidence. The best suggestion would be to talk about these problems with your partner, if you have one, or a sex therapist. The physician will always consider as important the patient’s personal preferences when prescribing a treatment; this decision will also be based on the patient’s age, the type of cancer which affects him and the stage of the cancer. Impotence is one of the common treatment side-effect which can affect the sex life, but it is definitely not the only symptom responsible for the erectile problems.
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On the prostate cancer conventional treatments list we find prostatectomy, as the most popular treatment procedure, followed by the radiation therapy, the androgen deprivation therapy also known as hormone therapy, chemotherapy and the newest procedure, cryotherapy. These treatments could also be regarded as the main causes for impotence which is defined as an erectile dysfunction occurring when men find it difficult to develop or maintain a penile erection, even when aroused. When prostatectomy or the surgical removal of the gland is done, shortly afterwards the patient may report impotence. This happens in almost thirty six per cent of the cases but this side-effect could not be avoided; the recommended treatments for such a situation is the well known Viagra or the sildenafil tablets and injections with Caverject; there are also devices which help stiffen the penis and penile prosthesis. Patients sometimes report penis shrinkage or a decrease of the amount of ejaculation, but the causes could also be found at a psychological level.

The radiation therapy is done by using two procedures: the internal beam radiation or the external beam radiation. Both methods have as side-effects incontinence and impotence. The first radiation procedure is done by inserting radioactive pellets in the prostate gland and leave them there to slowly decay; these seeds could easily find their way out of the prostate capsule and migrate to the surrounding areas of the infected organ such as the bladder, urethra and finally passed in the urinary liquid. Because there is always the possibility for the seeds to migrate through the sperm, doctors recommend the use of condoms and in case they don’t want to use this safety protection, men could also masturbate a few times after this therapy. The radiation therapy could also cause incontinence, diarrhea, urinary catheter or tiredness which might affect the sex life of the patient. The androgen deprivation therapy is known as the chemical castration and is a treatment procedure using two types of drugs: the LH-RH agonists and the anti-androgenic drugs. The side effects are physical but also psychological. Breast enlargement and impotence are frequently reported; sometimes the patients lack the interest for sex and start to worry about not infecting their partner, even though prostate cancer is not infectious.

Patients who underwent chemotherapy or cryotherapy have also reported side-effects such as impotence, but as I’ve stated before, it’s a condition which can not be avoided. In the fortunate cases the most common side-effects usually wear off some days or weeks after finishing your treatment; even impotence can be a temporary effect. The important thing is to gather information about the treatment you incline to choose, because you can not possibly leave the prostate cancer untreated, find out more about its side-effects and what impact has on the sexual life and seek for a doctor’s advise whenever you find it necessary.