Life after treatment for prostate cancer

Adjusting to life after treatment

For most people, the cancer experience doesn’t end on the last day of treatment. Life after cancer treatment has its own challenges. You may have mixed feelings when treatment ends, and worry that every ache and pain means the cancer is coming back. Some people say that they feel pressure to return to “normal life”. It is important to allow yourself time to adjust to the physical and emotional changes, and establish a new daily routine at your own pace. Your family and friends may also need time to adjust.

Cancer Connect can help you connect with other people who have had prostate cancer and with information about living well after cancer. Call 13 11 20.

Follow-up appointments

After treatment ends, you will have regular appointments to monitor your health, manage any long-term side effects, check that the cancer hasn’t come back, and discuss any concerns you have. During check-ups, you may have a physical examination, x-rays or scans, and a PSA test.

Depending on the type of treatment you had, PSA results will vary:

• After surgery, if it has been possible to remove all of the cancer, there should be no prostate cells left to make PSA antigen and your PSA level should drop quickly.
• After radiation therapy, your PSA level will drop gradually and it may take 2–3 years for your PSA to reach its lowest level.
• If you have ADT as well as radiation therapy, your PSA level will generally be very low while undergoing treatment.

The usefulness of the PSA test will vary. If you had localised prostate cancer, it can help find any cancer cells that come back. With advanced prostate cancer, particularly when the Gleason score or Grade Groupis very high, the PSA test may be less useful. Your doctor will also consider your symptoms and other test results along with the PSA test results. These all help to build a picture of what is happening to the cancer that is more accurate and informative than the PSA test alone.

Talk to your doctor about how often you will need to have check-ups or a PSA test. Over time, if there are no further problems, you will have check-ups less frequently. If you notice any new symptoms between check-ups, you should let your GP or specialist know immediately.

When a follow-up appointment or test is approaching, many people find that they think more about the cancer and may feel anxious.Talk to your treatment team or call Cancer Connect on 13 11 20 if you are finding it hard to manage this anxiety.

What if the cancer returns?

Sometimes prostate cancer does come back after treatment, which is known as a recurrence. If your PSA level starts to rise and the cancer has not spread beyond the prostate, this may mean you still have cancer cells in the prostate area. If this happens, you may be monitored with regular blood tests or you may be offered further treatment, which is known as salvage treatment.

Your options will depend on the treatment you had. If you had surgery, you may be offered radiation therapy. If you had radiation therapy, some people may be offered further radiation therapy, while others may have the option of surgery or other treatments. If the cancer has spread beyond the prostate, ADT is usually suggested and sometimes radiation therapy. Surgery may be an option in some cases. You may be offered palliative treatment to manage symptoms.

It is possible for the cancer to come back in another part of your body. In this case, you may have treatment that focuses on the area where the cancer has returned. Talk to your doctors about the options. You can also call Cancer Connect on 13 11 20 for more information.

How you might feel

It is natural to have a wide variety of emotions after a cancer diagnosis and during treatment, including anger, fear, anxiety, sadness and resentment. Feelings may increase over time as you adjust to the physical side effects of treatment.

Everyone has their own way of coping. Give yourself and those around you time to deal with the emotions that cancer can cause. For support, call Cancer Connect on 13 11 20.

If you have continued feelings of sadness, have trouble getting up in the morning or don’t feel like doing things that previously gave you pleasure, you may be depressed. This is quite common during cancer.

If your emotions are affecting your day-to-day life, talk to your GP. Counselling or medication – even for a short time – may help. Some people can get a Medicare rebate for sessions with a psychologist. Cancer Council may run a counselling program in your area. Call Beyond Blue on 1300 22 4636 for information about depression and anxiety. For 24-hour crisis support, call Lifeline on 13 11 14.