Kristin Philbin (Moderator) - 11:51 AM:
Greetings everyone and welcome to NorthShore University HealthSystem’s latest chat: Life After Prostate Cancer with Dr. Charles Brendler and Dr. Pete Colegrove. The chat will not begin for another ten minutes, but please start submitting any questions you may have and the doctors will answer them shortly.
Dr. Charles B. Brendler (NorthShore) - 12:05 PM:
Good afternoon and welcome to the chat. I, along with my colleague, Dr. Pete Colegrove are delighted to be able to answer your questions this afternoon.
Luke (Chicago, IL) - 12:06 PM:
Hi doctor. My question is: why do Prostate Cancer treatments cause Urinary Incontinence?
Dr. Charles Brendler (NorthShore)
Urinary incontinence following prostate cancer treatment usually results from damage to the sphincter muscle which controls urination.
Sarah (Morton Grove, IL) - 12:08 PM:
Hope you're well, doctor. I was curious as to know what kind of couples counseling may be available for life after prostate cancer. My husband has been very distant, and he often blames prostate cancer for it.
Dr. Pete Colegrove (NorthShore)
This problem is not uncommon. There are a number of mental health specialists with expertise in sexual health issues, usually incorporating couples counseling. Prostate cancer support groups have many resources to help address this issue. In addition, Rosemary Hutchinson, a psychologist in Evanston, specializes in sexual health and would be an excellent resource.
Mark (Bridge Port, Chicago, IL) - 12:12 PM:
Is there a special diet I should follow post prostate cancer? I know about Lycopene, but is there anything else I can eat to stay healthy?
Dr. Charles Brendler (NorthShore)
A general recommendation is to follow a heart-healthy diet low in trans and saturated fats. Also, a diet rich in antioxidants such pomegranate and blueberries, and also soy and green tea may be helpful. NorthShore University Healthsystem has a dedicated cancer nutritionist, Ms. Colleen Takagishi, who can be contacted for additional information.
Luke (Chicago,IL) - 12:16 PM:
Is there anything my doctor or I can do to avoid a damaged sphincter?
Dr. Charles Brendler (NorthShore)
If you are considering surgery choose a surgeon with great experience and an established reputation in prostate cancer surgery.
Sarah (Morton Grove, IL) - 12:18 PM:
Thank you so much. Can you recommend a support group or two that we might find helpful?
Dr. Charles Brendler (NorthShore)
US TOO is a national prostate cancer support group with a local chapter in Chicagoland. For more information go here:
http://www.northshore.org/clinicalservices/cancer/cancerspecialties/gu/default.aspx?id=3412
Mark (Bridge Port, Chicago, IL) - 12:19 PM:
Great. Are there any foods I should absolutely avoid?
Dr. Charles Brendler and Dr. Pete Colegrove (NorthShore)
Not specifically, but minimize intake of unhealthy fats (meat and dairy products which are high in saturated fats.) Also, use healthy cooking oils such as olive oil rather than palm or coconut oils.
Luke (Chicago, IL) - 12:21 PM:
what other post-surgery complications can arise from a bad surgery?
Dr. Charles Brendler and Dr. Pete Colegrove (NorthShore)
The two main complications that men experience after surgery include urinary incontinence and erectile dysfunction. These complications can occur even in experienced hands, but tend to occur less often with experienced surgeons.
Greg (Algonquin, IL) - 12:24 PM:
What steps can I take personally to help minimize recurrance after a past diagnosis & treatment via radiation therapy?
Dr. Charles Brendler and Dr. Pete Colegrove (NorthShore)
There aren't many specific recommendations, beyond adopting a healthy lifestyle and diet.
Sarah (Morton Grove, IL) - 12:26 PM:
I'll have to check that out. Also, I know my husband can be a rather private person, so I might have to work him up to a support group. Are there any books that you think he may find helpful?
Dr. Charles Brendler and Dr. Pete Colegrove (NorthShore)
If he is reluctant to participate in a group session, we would recommend seeing his urologist privately to discuss his sexual health. There are often treatments that can help alleviate his issues. We also have a dedicated sexual health program through our prostate cancer center. For more information call 847.657.5730.
As far as recommended reading goes, we would recommend Dr. Patrick Walsh's Guide to Surviving Prostate Cancer. It is an excellent reference for both patients and their spouses.
As a sidenote, in my clinical experience patients with sexual health issues do better if they seek help along with their spouse.
Luke (Chicago, IL) - 12:32 PM:
On the topic of erectile dysfunction. How long post-surgery should I expect to be back to normal, or how long should I wait before I can start to worry?
Dr. Charles Brendler and Dr. Pete Colegrove (NorthShore)
The time to recovery of sexual function is extremely variable. Usually it takes 3-12 months. However, we recommend seeking early treatment and rehabilitation to help regain sexual function. A prolonged delay (waiting to heal) can lead to irreversible to the erectile tissue.
Mark (Bridge Port, Chicago, IL) - 12:34 PM:
Are there any prostate-centric diet books out there that I could buy?
Dr. Charles Brendler (NorthShore)
Yes, Dr. Katz's Guide to Prostate Health is an excellent nutritional reference. The author is Dr. Aaron Katz from Columbia University in New York City.
Luke (Chicago, IL) - 12:37 PM:
I’ve heard about using the AdVance sling to help treat Urinary Incontinence. Would this be a good option for someone recovering from prostate cancer?
Dr. Pete Colegrove (NorthShore)
Male urethral slings in general are one of several options of treatment for stress urinary incontinence. The specific choice of treatment depends on several variables. You should consult with your urologist about the best option for you. The AdVance System is a viable option, but is not the only option.
Walt (Evantson, IL) - 12:41 PM:
What risks are there in waiting for treatment of prostate cancer? Is it likely to spread as quickly as other forms of cancer?
Dr. Charles Brendler (NorthShore)
The risk of delaying treatment depends on the stage and grade of your cancer. In general, however, prostate cancer grows more slowly than most other cancers and delaying treatment for several months while you investigate your options will not compromise your cure.
Cindi (Woodstock, IL) - 12:43 PM:
My husband thinks that prostate cancer stats are inflated because no men used to get their prostate checked in the past unless they had a problem, but now they are getting it checked early. He's also afraid of unnecessary surgery. Is there something I can tell him that will get him in for a checkup? He's 57, never been checked.
Dr. Charles Brendler (NorthShore)
We would encourage your husband to be screened for prostate cancer which involves only an examination and PSA blood test. While many prostate cancers are very early and do not require immediate treatment, prostate cancer is the second leading cause of cancer deaths in American men. A 57-year old otherwise healthy man runs the risk of decreasing his life expectancy by not being screened for prostate cancer.
Doug (Skokie, IL) - 12:47 PM:
Will I be able to live a normal active lifestyle after surgery? Is there a type of surgery that will increase my odds?
Dr. Charles Brendler and Dr. Pete Colegrove (NorthShore)
Yes, you should expect to resume a normal lifestyle following surgery as do the majority of our patients. With regards to surgery, laparoscopic robot-assisted surgery may lead to earlier overall recovery and quicker return of urinary control and sexual function.
Kristin Philbin (Moderator) - 12:50 PM:
Thank you everyone for your great participation, but unfortunately we only have ten minutes left, so please submit any final questions you have. Thanks.
Walt (Evanston, IL) - 12:51 PM:
What are the benefits to waiting to treat prostate cancer, just avoiding the surgical risks?
Dr. Charles Brendler and Dr. Pete Colegrove (NorthShore)
There are risks with any treatment. Therefore, if you can avoid treatment without compromising your life expectancy, active surveillance of your prostate cancer may be the best option, particularly for older men.
Mark (Bridge Port, Chicago, IL) - 12:52 PM:
Can you tell me about medical genetics counseling?
Dr. Charles Brendler and Dr. Pete Colegrove (NorthShore)
About 10% of prostate cancers are inherited. We have a dedicated medical genetics program which provides patient and family testing. For further information contact Dr. Wendy Rubinstein at 847.570.1029.
Sarah (Morton Grove, IL) - 12:55 PM:
Is it okay for my husband to go back to his regular exercise routine post-prostate cancer? He was very active before he began training. Often engaging in cycling, jogging and boxing. Can he still participate in these sports, or are there other alternatives he can look into?
Dr. Pete Colegrove (NorthShore)
In most cases patients may resume full physical activity within 2-3 weeks with laparoscopic surgery and 4-5 weeks with traditional open surgery.
Mark (Bridge Port, Chicago, IL) - 12:56 PM:
Should I expect certain side effects if I am receiving hormonal therapy along with brachy- or radiotherapy?
Dr. Charles Brendler and Dr. Pete Colegrove (NorthShore)
Yes, and these side effects include, but are not limited to, loss of libido and sexual function, hot flashes, loss of mental acuity, increased risk of cardiovascular disease and loss of muscle mass and bone density.
Radiation therapy may increase urinary frequency and urgency and rectal issues which usually resolve with completion of therapy.
Kristin Philbin (Moderator) - 12:56 PM:
We have time for one last question, please submit any final questions. Thank you.
Mark (Bridge Port, Chicago, IL) - 1:00 PM:
Should I undergo genetics testing for prostate cancer?
Dr. Charles Brendler and Dr. Pete Colegrove (NorthShore)
Yes, if you have one or more first-degree male relatives (father, uncle, brother) who have had prostate cancer or if you have a family history of breast cancer.
Kristin Philbin (Moderator) - 1:01 PM:
Thank you everyone for your great questions and participation. A complete transcript of the chat will be available on NorthShore.org shortly. If you have any more questions about prostate cancer or life after prostate cancer, please visit NorthShore University HealthSystem’s Prostate Cancer Department.
Dr. Charles B. Brendler and Dr. Pete Colegrove (NorthShore) - 1:03 PM:
We thank you for these great questions and hope that we have been helpful. For further information please contact the NorthShore University Healthsystem Prostate Cancer Center at 847.657.5730 or visit our Web site at:
http://www.northshore.org/clinicalservices/cancer/cancerspecialties/gu/default.aspx