Side Effects of Prostate Cancer

What is infertility?

Infertility is the inability to father children through sexual intercourse. Some men do not know that the loss of fertility is a common side effect of prostate cancer treatment.

What causes infertility?

Many types of prostate cancer treatment cause infertility. The prostate produces the fluid that helps keep semen liquid. Once the prostate is removed a man no longer has the ability to make or ejaculate semen, so infertility is an unavoidable and permanent consequence of surgery.

Radiation may also damage the prostate’s ability to produce semen or damage the sperm cells in the testicles.

What if I have prostate cancer and want to have children?

If maintaining the possibility of fatherhood is important to you, be sure to discuss that with your doctor. Men with low-risk, slow-growing prostate cancer may be able to avoid infertility by choosing active surveillance. However, if your cancer requires treatment, there are some options you can pursue to maintain the possibility of fathering children:

• Sperm banking: Freezing (cryopreservation) of sperm is the most successful way for men to preserve fertility before cancer treatment. The most common way to collect the semen sample is through masturbation. Men who cannot ejaculate may have vibrational or electrical stimulation to help them do so. The sperm will stay frozen, or “banked,” until you need them. Freezing—even for many years—does not damage sperm.
• Testicular sperm extraction: Even if a man cannot ejaculate sperm, he may still have sperm in the testicles. In testicular sperm extraction, a surgeon removes small pieces of testicular tissue (biopsy) while the patient is sedated or under local or general anesthesia. If the tissue contains sperm, the sperm are either frozen or used to fertilize a female partner’s eggs. This technique may be an option before or after cancer treatment.

Where can I learn more?

If you are interested in fertility preservation, ask for a referral to a doctor who specializes in treating male fertility. This may be an endocrinologist, andrologist, or urologist.

Visit the following links to learn more:

LIVESTRONG Fertility for Men

American Society for Reproductive Medicine

Oncofertility Consortium

Save My Fertility

It is normal to experience a wide range of emotions if you or a loved one has been diagnosed with prostate cancer. Emotional reactions can range from feelings of vulnerability, sadness, loneliness, and fear of recurrence or death. Many of these emotions fade over time, but some may develop into clinical depression, intense anxiety, or panic. Having prostate cancer doesn't mean that you should feel fearful, sad, or depressed all the time.

• Anxiety is unease, fear, and dread caused by stress. Studies show that nearly half of all patients with cancer say they feel some anxiety and about 25% of cancer patients say they feel a great deal of anxiety.
• Depression is a mood disorder in which persistent feelings of sadness interfere with the ability to participate in normal activities.

Depression or anxiety not only impact your quality of life, but they can adversely affect your ability to participate actively in treatments. For these reasons, the American Society of Clinical Oncology (ASCO) recommends cancer patients be screened for anxiety and depression.

For more information about depression, stress, or anxiety, including support resources, visit our mental health webpage.

What is fatigue?

Fatigue is a lingering feeling of tiredness that prevents you from participating in your daily activities. This is not the same feeling of tiredness caused from extreme exercise or over exertion.

What causes fatigue?

Many men experience fatigue as a side effect of androgen deprivation therapy (ADT) or chemotherapy. However, there are several causes of fatigue.

Tell your doctor if you are feeling fatigued. Together, you can work to find out the cause and plan a management strategy for your fatigue.

How can I manage fatigue?

Generally, fatigue will begin to decrease as time progresses. However, some people will have to cope with it for an extended period of time. Here are some tips on managing your fatigue:

• Eat a healthy diet.
• Set realistic goals for what you want to accomplish each day.
• What time of day do you have the most energy? Try to schedule high-effort activities during that time.
• Try to get eight hours of sleep each night.
• Take time to rest during the day as you need.
• Try to be physically active. Start slowly and work up to a comfortable level.
• Ask for and allow others to help you.