Is hormone therapy safe for my husband with prostate cancer?

Question

Hello doctor,

I am 72 years old, and my husband has recently been diagnosed with prostate cancer. I am feeling confused about how this diagnosis affects me as his wife. His prostate-specific antigen (PSA) level was 22.8, and the biopsy showed a Gleason score of eight in eight out of twelve cores. The urologist has recommended a radical prostatectomy followed by radiation therapy.

I have read online that hormone therapy for prostate cancer can cause mood changes and hot flashes. I am concerned about whether this may affect our relationship. I am also worried about surgery-related urinary incontinence, as I already manage most of the laundry and household work since his arthritis has worsened. We have been married for 45 years and are still intimate, but the doctor warned that surgery may cause erectile dysfunction.

I would like to know if there are treatments available that help preserve sexual function.
I am also concerned about genetic risk because I carry a BRCA1 (breast cancer gene 1) mutation and have a family history of breast and ovarian cancer.
Could his prostate cancer increase the risk for our daughters?
Should they undergo any genetic testing?

I need to understand what this diagnosis means for the entire family, not just for him.

Kindly advise.

Answer 1

Hello,

Welcome to icliniq.com.

I truly understand and appreciate the amount of fear and anxiety felt after learning that your husband has been diagnosed with prostate cancer.

First, it is important to reassure you that prostate cancer is not contagious and cannot be transmitted to you in any way. Treatments such as radiation therapy or hormonal therapy also do not transmit any infection or disease to others. This is an important point to understand.

Second, regarding genetic testing, your daughters may consider undergoing genetic testing once they reach the age of 25 to determine whether they carry any genetic mutations inherited from either parent or from the family history.

Third, concerning treatment options, surgical treatment is not always the preferred approach. In many cases, radiation therapy is favored because its side effects are generally less severe when compared to surgery.

With surgical treatment, the risk of complications and side effects tends to be higher. In contrast, radiation therapy commonly causes side effects related to the urinary tract, such as urinary tract infection (UTI), or the gastrointestinal tract (GIT). These side effects are usually temporary and tend to resolve after completion of radiation sessions.

Hormonal therapy is required only if the prostate-specific antigen (PSA) level remains elevated after radiation therapy. In such cases, hormonal treatment is continued until the PSA level returns to normal, after which the therapy can be stopped. The side effects of hormonal therapy are reversible. Once the treatment is discontinued, symptoms such as mood changes, reduced libido, and related effects generally improve and return to normal.

I would suggest the following measures:

Radiotherapy with androgen deprivation therapy (ADT).

I hope this explanation is clear and reassuring. Please be comforted in knowing that prostate cancer is now much easier to manage than in the past. Many advanced treatment options are available today that are effective and less burdensome for both patients and caregivers.

Thank you.