ConditionsTreatmentsProstateKidneyBladderTestesUseful Questions

Conditions

What is Cancer? Ė A brief definition.

Psychological and Emotional Issues

Urinary incontinence

Erectile Dysfunction (Impotence)



What is Cancer? Ė A brief definition.

Cancer is a disease that results from abnormal growth and division of cells that make up the body's tissues and organs. Under normal circumstances, cells reproduce in an orderly fashion
to replace old cells, maintain tissue health and repair injuries. However, when growth control
is lost and cells divide too much and too fast, a cellular mass óor "tumour" óis formed.
If the tumour is confined to a few cell layers and it does not invade surrounding tissues or
organs, it is considered benign. By contrast, if the tumour spreads to surrounding tissues or organs, it is considered malignant, or cancerous. In order to grow further, a cancer develops
its own blood vessels and this process is called angiogenesis. When it first develops, a malignant tumour may be confined to its original site. If cancerous cells are not treated they
may break away from the original tumour, travel, and grow within other body parts, the
process is known as metastasis.

Click on the below links to find more about the individual cancers.

Prostate Cancer Kidney Cancer Bladder Cancer Testicular cancer




Psychological and Emotional Issues

 Most people when diagnosed with cancer, experience a combination of new and confused emotions during what may be a highly stressful period. A diagnosis of cancer can also affect family members such as a spouse of children, who may often find dealing with the diagnosis
even more stressful than the patients themselves. This can often add to the burden of anxiety
and so is important to address and understand.

Cancer affects each individual and their family in different ways and often people need to
find their own way of coping. The process of coping can often be one of trial and error,
before finding what works best for you. 

Following are a number of suggestions that may be useful to some people to help them
cope with their experience of cancer.

Talk to others family, friends, your doctor, nurses, counsellors or religious leader.

Information Finding information about your illness and treatment and the help available
will add to your understanding of what you are dealing with. Fear of the unknown may
create uncertainty and increase stress. Good sources of information are your treatment
centre (Hospital etc) or the Cancer Council help line, which is 131120 in NSW

Support Groups Joining a support group will allow you to meet with other people coping
with their illness and can be a valuable source of support and helpful ideas. A list of contact groups and national centres is available on this web site. There are also groups for carers,
contact the Carers Association on 1800
242 636.

AttitudesOur thoughts and attitudes have a great impact on how we feel about things.
We may not always be able to change th3e things that happen to us, but we can influence
the impact they have on our lives. It is important to acknowledge the positive as well as
negative aspects of a situation. Be realistic and try to avoid jumping to conclusions, talking
to others may give you a different perspective on circumstances.
Family and friends are often very upset and fear that their emotions may further exacerbate
the situation. Try not to be afraid of your emotions and the emotional reactions of others,
try to be available to talk about the issue with loved ones.

Listen to Others Try to accept how your close family and friends are feeling, you donít have
to solve their problems, just be there to listen. They may also be going through a tough time,
so getting upset and crying are natural reactions. Not wanting to talk is also a normal reaction
and may be a way of coping for some people. If you are particularly concerned with how someone is coping it may be useful talk to someone to find out how best to help.

Routine Many people find it beneficial to continue with lifeís daily routines. It is important to
try to cheer yourselves up and take your mind off things, an outing or chat about future plans may provide some stress relief.

Manage StressBe aware of your stress levels and try to manage these. Signs of stress
can include; restlessness, fear panic, racing thoughts, forgetfulness, muscle aches,
irritability and a loss of enjoyment in activity and life. There are many ideas and methods
that can assist with relaxation, including breathing exercises or gentle activities such as
Yoga.
Get to know your body and its normal reactions so that you can recognise the signs and symptoms of stress. Try to allow yourself regular time for relaxation so that it becomes
part of your daily routine; stress relievers such as breathing excercies can be performed anywhere. These routines can be enjoyable and may have lasting effects throughout the
day.

Find out what is best for you. Most people find that coping with the diagnosis and treatment
of cancer is a difficult time. However, with time, most are able to cope and get on with their
lives. Some people may need extra help, especially if there are other stresses in their lives.
If you need further information or advice, talk to your treating team, the hospital Social
worker or psychologist or your local or state Cancer Information Service, about what
services might be helpful and available in your area.

 

Suggestions for Patients

You may have many questions about your care, your doctor and treating team will be guided
be how much you want to know and the questions that you ask.
Make a list of questions to take to your appointment and perhaps take someone with you so
that you donít miss anything. Donít be afraid to ask a number of questions or even to ask
the same one twice. There are a number of good sources that can help answer questions,
available through your local or State Cancer Information Service.Hospital and Community services may offer emotional support either individually or through support groups and
networks. Sharing feelings, experiences and ideas can be valuable, spiritual belief may
also bring comfort.

Ill health can disrupt family life, and the roles and responsibilities of family members may
change. Family members may have different needs at different times, some may discuss
issues openly and others may not. This requires patience and understanding and you as the patient should let people know what you are prepared to talk about, with whom and when. 

It may be helpful to examine your lifestyle and responsibilities and to reassess your priorities
and make adjustments accordingly. Learn to pace yourself and to listen to your body, accept offers of help from family and friends. The side effects of treatments can also take their toll on your mind and body. Your energy levels and self-esteem may be affected, so continue to recognise your strengths and remind yourself that your loved ones still recognise these traits
in you. Try to maintain a healthy diet and good sleeping patterns in order to maintain your strength and assist your recovery from treatment. 


Suggestions for Family and Friends

Avoid trying to keep things from the patient. Often trying to Ďprotectí the patient often makes
their fears even worse. Patients appreciate the opportunity and have a right to make important decisions that affect their lives. Continue to involve the patient in activities you shared and enjoyed in the past. Make specific offers of help that may be easy for the patient to accept,
such as a lift or help with heavy bags etc.

It is important to allow the patient to take the lead in talking about issues, so try to be a good listener. Donít feel that it is up to you to make everything better, no matter how much you wish you could. Offer encouragement and convey affection, try to take time off from taking about the illness, physical contact and laughter are often excellent ways to help people cope.

Try to involve everyone concerned when dealing with important issues such as family matters. Children also need to have information about what is happening within the family unit or to their parents. Always remember, that even when ill, people are still the same person inside as they were before the problems began.

Family and friends are also affected by a cancer diagnosis; so donít forget to look after yourself too. Be realistic about what you can offer and do, if everyone can do a little, it make life easier
all round.

Thanks to Katharine Smith, Psychologist at Westmead Hospital, for advising on these issues.



Urinary incontinence

Urinary incontinence is the inability to control the flow of urine and is a common side effect of
a number of Uro-oncology treatments, including surgery on the prostate and bladder as well Radiation therapy.

After treatment some people may also experience a phenomena called stress incontinence,
the passing of small amounts of urine when exerting the body or even by coughing or sneezing.

The level of incontinence differs for each person and depends upon the treatments that they
have had, however for some people the phenomena may be short lived while for a few it may
be permanent.

There has however been a lot of progress in dealing with continence issues and there are a
wide variety of aids and equipment for collecting urine, preventing infection and protecting the skin and surrounding area. There are also a number of exercises that can be done to
strengthen the urinary sphincter muscle that controls the opening and closing of the bladder.

Talk to the incontinence nurse at your local hospital or to your medical team for advice about
the options management of your continence and the options available to you.



Erectile Dysfunction (Impotence)

As men get older it may become more difficult for them to achieve and/or maintain an erection. The anxiety created by this may be further exacerbated following cancer treatment. Damage to the erectile nerves due to the effects of radiation therapy or during surgery may cause a temporary or permanent loss of erectile function.

Nerve sparing surgery exists that can lessen the impact on erectile function, however the suitability of such surgery depends on a number of factors including the stage and extent of
the tumour.

Symptoms of Low Testosterone
Low sex drive
Emotional, psychological and behavioral changes
Decreased muscle mass
Loss of muscle strength
Increased upper and central body fat

Very good responses to testosterone have been reported for men with low testosterone in various clinical studies and they include:

Improvement in mood and sense of well-being
Increased mental and physical energy
Decreased anger, irritability, sadness, tiredness, nervousness
Improved quality of sleep
Improved libido and sexual performance
A decline in biochemical markers of bone degradation and an increase in bone density
An increase in lean body mass, a decline in fat mass
An increase in muscle strength (hand grip, upper and lower extremities).
Potentially, a decrease in the risk of heart disease

With testosterone therapy, one's attitude improves, reinforcing self-esteem and
self-confidence in success at work, and increased energy at home and in social activities.
Most men will feel more vigorous, experience improvement in energy levels, mood,
concentration, cognition, libido, sexual performance and overall sense of well-being.
This effect is usually noted in 3 to 6 weeks. Other potential benefits include maintenance
or improvement in bone density, improved body composition, muscle mass and muscle
strength, as well as improvement in visual-spatial skills.

If you do experience problems maintaining or achieving an erection, there are a number of treatments that can help.

Tablets are available that can increase blood flow to the penis, thus achieving an erection. Common side effects of this method include hot flushes and headaches. However, men you
have had cardio-vascular problems should consult their doctor, as this method of treatment
may not be appropriate.

Another popular form of treatment is penile injection. This involves injecting a substance
into the base of the penis that dilates the blood vessels enabling them to fill with blood and
thus creating an erection. This method is successful for most men, but it is essential for your doctor to work out an accurate dosage for you to prevent your erection lasting too long.

Other popular methods include the use of surgical implants to help create an erection. Implants are permanently surgically implanted into the penis under general anaesthetic; they can only
be removed through another operation. There are two main types of implant, the Semi-Rigid implant or the Inflatable implant.

Semi-Rigid implants involve placing a semi-rigid rod into the penis. After having this operation you will have a permanent erection, although this will not be as firm as your previous erections,
it is adequately suitable for sexual intercourse. It is also flexible enough to be pulled down and tucked away when you are clothed, thereby avoiding any unwanted attention or embarrassment.

Inflatable implants involve the insertion of two cylinders into the penis and a reservoir of
60-100mls of saline deep behind the pubic bone. A pump and valve are inserted into the
scrotum allowing the saline to be pumped into the penis, thus producing an erection.
When an erection is no longer needed the valve can be released allowing the saline to drain
back into the reservoir and the penis to become flaccid (soft).

Click here to see an image of the inflatable implant.


Problems with Implants

As with all surgical procedures there are risks associated with the anaesthetic that your doctor
will discuss with you.

The implants themselves carry a specific risk, associated with slight risk that your body will
reject the implant or that the implant may become infected. Although these risks are minimal,
the result is that the implants would need to be removed and it is unlikely that another could
be put in. While the inflatable method gives a more natural feeling erection, there are the
added potential problems of tubes blocking or pumps and valves malfunctioning

It is essential that, if you are experiencing problems associated with erectile dysfunction,
you discuss this with your doctor.

There are also a number of books and pamphlets regarding sexual issues and cancer
available from your State Cancer Information Service, call 13 11 20 to find out more

 Dial 000 in an emergency
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