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What are the side effects of treatment?

It is hard to limit the effects of therapy so that only cancer cells are removed or destroyed. Because treatment also damages healthy cells and tissues, it often causes unwanted side effects. 

The side effects of cancer treatment depend mainly on the type and extent of the treatment. Also, each patient reacts differently. Doctors and nurses can explain the possible side effects of treatment, and they can often suggest ways to help relieve symptoms that may occur during and after treatment. It is important to let the doctor know if any side effects occur. 

Although patients are often uncomfortable during the first few days after surgery, their pain can be controlled with medicine. Patients should feel free to discuss pain relief with the doctor or nurse. It is also common for patients to feel tired or weak for a while. The length of time it takes to recover from an operation varies for each patient. 

Radical prostatectomy may cause urinary incontinence in 10-20% of cases. Severe incontinence is usually quite rare. Permanent erectile dysfunction (impotence) is not uncommon after radical prostatectomy and occurs in approximately seventy percent of the patients. These side effects are somewhat less common than in the past after the induction of the new surgical technique, the nerve-sparing surgery. Potency can be preserved by a skilled urologist in more than 50% of young patients. When this surgery is fully successful, impotence and urinary incontinence are only temporary. However, men who have a prostatectomy no longer produce semen, so they have dry orgasms only.

Radiation Therapy 
Radiation therapy may cause patients to become very tired as treatment continues. Resting is important, but doctors usually advise patients to try to stay as active as they can. Patients may have diarrhea or frequent and uncomfortable urination. In addition, when patients receive external radiation therapy, it is common for the skin in the treated area to become red, dry, and tender. Radiation therapy can also cause hair loss in the pelvic area. The loss may be temporary or permanent, depending on the amount of radiation used. 

Radiation therapy causes impotence in some men. This does not occur as often with radioactive seed implant (brachytherapy) as with external radiation therapy; brachytherapy is not as likely to damage the nerves that control erection. 

Hormone Therapy 
Orchiectomy, LHRH agonists, and estrogen often cause side effects such as loss of sexual desire, impotence, and hot flashes. When first taken, an LHRH agonist tends to increase tumor growth and may make the patient's symptoms worse. This temporary problem is called "tumor flare." Gradually, however, the drug causes a man's testosterone level to fall. Without testosterone, tumor growth slows down and the patient's condition improves. 

Prostate cancer patients who receive estrogen or an antiandrogen may have nausea, vomiting, or tenderness and swelling of the breasts. (Estrogen is used less now than in the past because it increases a man's risk of heart problems. This form of treatment is not appropriate for men who have a history of heart disease.) 

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