Looking after yourself
Cancer can cause physical and emotional strain. It’s important to try to look after your wellbeing as much as possible.
Eating healthy food can help you cope with treatment and side effects. A dietitian can help you manage special dietary needs or eating problems, and choose the best foods for your situation. Call Cancer Council 13 11 20 for a free copy of the Nutrition and Cancer booklet.
Physical activity may help to reduce tiredness, improve circulation and elevate mood. The amount and type of exercise you do depends on what you are used to, how you feel, and your doctor’s advice. Cancer Council’s Exercise for People Living with Cancer booklet provides more information about the benefits of exercise, and outlines simple exercises that you may want to try.
These therapies are used with conventional medical treatments. You may have therapies such as massage, relaxation and acupuncture to increase your sense of control, decrease stress and anxiety, and improve your mood. Let your doctor know about any therapies you are using or thinking about trying, as some may not be safe or evidence-based.
Alternative therapies are used instead of conventional medical treatments. These therapies, such as coffee enemas and magnet therapy, can be harmful. For more information, call 13 11 20 for a free copy of the Understanding Complementary Therapies booklet or visit your local Cancer Council website.
Relationships with others
Having cancer can affect your relationships with family, friends and colleagues. This may be because cancer is stressful, tiring and upsetting, or as a result of more positive changes to your values, priorities, or outlook on life.
Give yourself time to adjust to what’s happening, and do the same for others. People may deal with the cancer in different ways – for example, by being overly positive, playing down fears, or keeping a distance. It may be helpful to discuss your feelings with each other.
Sexuality, intimacy and fertility
Cancer can affect your sexuality in physical and emotional ways. The impact of these changes depends on many factors, such as treatment and side effects, your self-confidence, and if you have a partner. Although sexual intercourse may not always be possible, closeness and sharing can still be part of your relationship.
If you are able to have sex, you may be advised to use certain types of contraception to protect your partner or avoid pregnancy for a certain period of time. Your doctor will talk to you about the precautions to take. They will also tell you if treatment will affect your fertility permanently or temporarily. If having children is important to you, talk to your doctor before starting treatment.
Call Cancer Council 13 11 20 for free copies of Sexuality, Intimacy and Cancer, Fertility and Cancer and Emotions and Cancer, or download the booklets from your local Cancer Council website.
Life after treatment
For most people, the cancer experience doesn’t end on the last day of treatment. Life after cancer treatment can present its own challenges. You may have mixed feelings when treatment ends, and worry if every ache and pain means the cancer is coming back.
Some people say that they feel pressure to return to “normal life”, but they don’t want life to return to how it was before cancer. Take some time to adjust to the physical and emotional changes, and re-establish a new daily routine at your own pace. Cancer Council 13 11 20 can help you connect with other people who have had cancer, and provide you with information about the emotional and practical aspects of living well after cancer.
Dealing with feelings of sadness
If you have continued feelings of sadness, have trouble getting up in the morning or have lost motivation to do things that previously gave you pleasure, you may be experiencing depression. This is quite common among people who have had cancer.
Talk to your GP, as counselling or medication – even for a short time – may help. Some people are able to get a Medicare rebate for sessions with a psychologist. Ask your doctor if you are eligible. Your local Cancer Council may also run a counselling program.
The Prostate Cancer Foundation of Australia and beyondblue have information about depression and anxiety.
Visit prostate.org.au or call 1800 22 00 99, or visit beyondblue.org.au or call 1300 22 46 36.
After treatment, you will need regular check-ups to monitor your health and check that the cancer hasn’t come back. This will involve testing your PSA level at regular intervals.
Your PSA level will vary depending on the type of treatment you had. After surgery, your PSA level should drop quickly to 0 (or to a level that can’t be detected), as there are no prostate cells left to make the antigen. After radiation therapy, your PSA level should 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 quite low while undergoing treatment.
The PSA is only one test and it might not accurately reflect what is happening to the cancer. The PSA test can be useful with early prostate cancer, to help with diagnosis and monitor the need for treatment, or to detect the return of any cancer cells. With advanced prostate cancer, particularly when the Grade Group or Gleason score is very high, the PSA test becomes less useful.
Your doctor will also consider any symptoms you might or might not have, and the results of other blood tests and scans. These all help to build a picture of what is happening to the cancer that is more accurate and informative than just the PSA test alone.
Talk to your doctor about how often you will need check-ups or a PSA test. Over time, if there are no further problems, your checkups will become less frequent. If you notice any new symptoms in between check-ups, you should let your GP or specialist know.
What if the cancer returns?
For some men, prostate cancer does come back after treatment. This is known as a recurrence or relapse.
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 given more treatment, known as salvage treatment.
It is difficult to do surgery when cancer comes back if you have already had surgery or radiation therapy, both of which cause internal scarring (fibrosis). However, surgery may be an option in particular cases. More often, if you originally had surgery, you may be offered radiation therapy, and if you had radiation therapy, you may be offered ADT or another form of treatment (see pages 40–44). If the cancer has spread beyond the prostate, ADT is usually recommended. Sometimes people have palliative treatment to ease their symptoms (see page 44).
It is possible for the cancer to come back in another part of your body. In this case, you may have treatment that focuses specifically on the area of your body where the cancer has returned. Talk to your treatment team about the options. You can also call Cancer Council 13 11 20 for more information.
“The fear is always there. It never goes away completely.” Neil
Cancer may cause you to experience a range of emotions, such as fear, sadness, anxiety, anger or frustration. It can also cause practical and financial problems.
Practical and financial help
There are many services that can help deal with practical or financial problems caused by the cancer. Benefits, pensions and programs can help pay for prescription medicines, transport costs or utility bills. Home care services, aids and appliances can also be arranged to help make life easier.
Ask the hospital social worker which services are available in your local area and if you are eligible to receive them.
If you need legal or financial advice, you should talk to a qualified professional about your situation. Cancer Council offers free legal and financial services in some states and territories for people who can’t afford to pay – call 13 11 20 to ask if you are eligible.
Talk to someone who’s been there
Coming into contact with other people who have had similar experiences to you can be beneficial. You may feel supported and relieved to know that others understand what you are going through and that you are not alone.
People often feel they can speak openly and share tips with others who have gone through a similar experience.
In a support setting, you may find that you are comfortable talking about your diagnosis and treatment, relationships with friends and family, and hopes and fears for the future. Some people say they can be even more open and honest because they aren’t trying to protect their loved ones.
Types of support
There are many ways to connect with others for mutual support and to share information. These include:
- face-to-face support groups – often held in community centres or hospitals
- telephone support groups – facilitated by trained counsellors
- peer support programs – match you with someone who has had a similar cancer experience, e.g. Cancer Connect
- online forums – such as the Cancer Council Online Community at cancercouncil.com.au/OC.
Talk to your nurse, social worker or Cancer Council about what is available in your area.
“My family members don’t really understand what it’s like to have cancer thrown at you, but in my support group, I don’t feel like I have to explain.” Sam