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Treatment Effects

There are three primary questions men ask when first diagnosed with prostate cancer:

  1. Will I be cured?
  2. Will I preserve sexual function? And...
  3. Will I have to wear diapers?

ProstRcision® has the highest cure rate of all prostate cancer treatment options available today. But just as importantly, this unique approach to eradicating prostate cancer preserves sexual function and maintains urinary control for the vast majority of men.

With ProstRcision® you gain years and quality of life. Talk with an RCOG physician today about how best to treat your prostate cancer.

Question 124:
What is the most common problem men experience after ProstRcision?

Answer:
The most common side effect seen after ProstRcision is a weak urinary stream with more frequent urination and more urgency. These symptons vary greatly from person to person and are primarily related to the size of a man’s prostate and the amount of urinary symptoms he has prior to the seed implant. For example, men with normal-sized prostates and no urinary problems before the implant have few, if any, symptoms afterwards. Men who have a weak stream after ProstRcision typically find their symptoms gradually resolve over 6-12 months as the prostate shrinks from the trauma and the normal and cancerous prostate cells disintegrate from ProstRcision. The cause of the weak stream is from trauma to the prostate due to the insertion of the eight-inch long needles into the prostate gland through which the seeds are injected. Insertion of these needles causes sudden prostate swelling, which leads to compression (squeezing) of the urethra tube that empties the bladder and runs through the middle of the prostate. The weak stream from ProstRcision has nothing to do with irradiation. In fact, we see very little effect from irradiation, neither seeds nor beam.

Question 125:
Can you do anything for the urethral compression?

Answer:
Yes. Men who have a significantly slow stream are offered medication called alpha blockers, such as Flomax®, Uroxatral®, Cardura® or Hytrin®. This medication relaxes muscles inside the prostate irritated by the sudden swelling and, in turn, relieves pressure on the urethra, which results in significantly better urination in most men.

Question 126:
Can men develop urinary blockage after the seed implant of ProstRcision

Answer:
Yes. Overall, 2.6% of men will have enough swelling after the implant that they have blockage of the urethra and require insertion of a urinary catheter. The median time to wear a urinary catheter in the few men who have urethral blockage is six days. This is approximately the same length of time (average seven days) that all men wear a catheter after radical prostatectomy.

Question 127:
Do men develop urinary leakage (incontinence) after ProstRcision?

Answer:
No, except for men who have had a prior TURP (roto-rooter operation) or have severe urinary urgency before the seed implant of ProstRcision. This issue was discussed in Question 100.

Question 128:
What about rectal problems after ProstRcision?

Answer:
We rarely see problems of any significance. The most common symptoms we see are irritation of pre-existing hemorrhoids. If a man has hemorrhoids, he may see spotting of blood, especially after a hard bowel movement. Stool softeners usually resolve this problem.

Question 129:
What is the worst complication that can occur after ProstRcision?

Answer:
The worst complication is a rectal fistula, which is extremely rare at RCOG, and no patient has developed a fistula in the past eight years. A fistula means development of a hole between the rectum and the urethra so that urine passes through the rectum. This is a very serious condition that requires surgery and a colostomy bag. Rectal fistulas have occurred after all treatments for prostate cancer, including after radical prostatectomy.

Question 130:
If a man has sexual problems after treatment for prostate cancer, can he use Viagra®, Cialis® or Levitra®?

Answer:
Yes. There are two main factors that determine preservation of sexual function after ProstRcision: a man’s age and the quality of penile erection before treatment. For example, men with normal erection and age 50 or younger have a 94% chance of retaining sexual function, as compared to men age 76 or older with normal erection function, who have a 40% chance of keeping sexual function. If men do have problems with erection, they can use Viagra®, Cialis® or Levitra®. From our database, we find that 38% of all men within five years of treatment use one of these medications at least occasionally, and the majority of these men achieve a better erection with use of these medications.

Question 131:
I have heard that radiation can cause cancer. Is there an increase in cancer, especially bladder or rectal cancer, after ProstRcision?

Answer:
With our database, we monitor development of other cancers in all men who we have treated with ProstRcision. We have not found any increase in cancer in men who have received ProstRcision. And especially, we have not found any increase in bladder72 or rectal cancer. Men who have received ProstRcision can develop other cancers including bladder, rectal, pancreas, lung or other cancers. However, the chance of men who have received ProstRcision developing other cancers is no different than what we see in the general population of men who have never been treated for prostate cancer nor received irradiation of any form.

Question 132:
What happens with most men after ProstRcision?

Answer:
ProstRcision has very little effect on most men. The day after the implant, men can travel, work, go to the gym or play golf. The most common effect is a weak urinary stream for a few months after the implant. If bothersome, men can control these symptoms with alpha blocker medication such as Flomax or Uroxatral. This is not a painful procedure, so pain medication is rarely needed except for Tylenol®. Men typically have no rectal symptoms except for minor irritation if they have pre-existent hemorrhoids. Stool softeners are typically the only medication required for rectal symptoms. Except for men who have had a prior TURP (roto-rooter surgery) or severe urinary urgency, urinary leakage does not occur, and most men who are sexually active retain sexual function. Some men report a mild degree of fatigue for a few months after treatment. On a long-term basis, a few men will develop a temporary increase in urinary symptoms consisting of burning with urination and urinary urgency 18 months after the implant. These symptoms usually resolve within a short time. Problems from ProstRcision are rarely seen after 24 months.