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Know what to expect during your recovery from prostate cancer

Agriculture.com Staff 01/26/2006 @ 11:52am

Allen Lash is not someone who enjoys being a patient. "I went back to work five days after prostate surgery, but I probably overdid it the first week at work," Lash admits. "I paid for it. Now I'm doing great."

Two and a half months after surgery, Lash, president of AgriSolutions, Inc., works 12-hour days when necessary.

Lash, 62, shares that work ethic with farmers. "Most patients do quite well," says Michael Blute, chair of the urology department at the Mayo Clinic, and Lash's surgeon. "If their job requires heavy lifting, I advise waiting at least six weeks before going back to work."

About 60,000 Americans undergo prostate cancer surgery each year. A man's age, his overall health, and how advanced the cancer is are factors in deciding whether to undergo surgery.

Surgery typically requires a two-day hospital stay. During recovery, patients use a catheter for one to two weeks while the urinary tract heals, Blute says. "Usually after about a month, swelling has subsided, and urinary control has improved," he says.

To keep urine flowing freely and reduce the chance of blockage, he advises patients to drink plenty of fluids. Walking or other exercise is encouraged to help prevent blood clots in the legs.

One month after surgery, Blute prescribes a pharmacological aid like Viagra or Cialis to increase blood flow for sexual function. Total recovery depends upon age, the success of nerve-sparing surgery, and prior erectile history.

A new landmark study reported in The New England Journal of Medicine shows that for men under 65, surgery cut the death rate by more than half.

"The study followed Scandinavian men under age 75 for a decade after surgery," Blute says. "Overall, surgery reduced deaths."

This is important because "watchful waiting" often is recommended (prostate tumors often grow slowly). But in this study, the watchful waiting group under age 65 had more than double the death rate of the surgery group. For men over 65, the findings are less clear.

Many men choose radiation treatment over surgery. During recovery, sexual function may be affected for up to 18 months.

Urinary and rectal problems usually are temporary, but 5% experience severe and often permanent symptoms (more often with seed implants). Fatigue and appetite loss usually subside within a couple of months.

Radiation is sometimes combined with hormone therapy. Male sex hormones stimulate cancer cells. Hormone therapy can deprive or block these hormones. But it may cause temporary hot flashes, breast enlargement, loss of sex drive, impotence, and weakening of bones. Some side effects may linger.

Many men make lifestyle changes during their recovery. Jerry Carlson, Black Hawk County, Iowa, says he's made some changes to his diet, including adding more fruits and vegetables, since his prostate cancer treatment.

Research indicates that high blood cholesterol accelerates tumor growth.

Prostate cancer is the second most common cancer in Americans. Lash urges men to study treatment options and to avoid making a choice based on someone else's experience.

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