You’ve Had Your Prostate Gland Removed.. Now What?

Prostate cancer affects approximately 30% of Australian men and is the second most common cause of cancer death after lung cancer.

The risk of prostate cancer increases with age and is predicted to affect 1 in 8 men by the age of 75 and up to 1 in 6 men by the age of 85.

Fortunately, prostate cancer has a relatively high long term survival rate compared with other types of cancer.

While prostate cancer is a multifactorial condition, known risk factors include age, family history of prostate cancer, high insulin levels (ie. pre-diabetes), being overweight or obese, high oestrogen levels, ongoing exposure to toxic chemicals, pro-inflammatory diets and lifestyles.

Treatments for prostate cancer often include medications to manage the urinary symptoms caused by prostate enlargement and 5-alpha-reductase inhibitors which reduce the conversion of testosterone to dihydrotestosterone (DHT).

DHT is a far more potent form of testosterone linked to the development and progression of benign prostate hypertrophy (BPH), male pattern baldness and prostate cancer. In more advanced cases of prostate cancer, prostate removal surgery will be performed which is known as radical prostatectomy.

Research shows that radical prostatectomy is an effective way to control most cases of prostate cancer in the long term and has a high survival rate.

However this surgical procedure carries a high risk of leaving men with significant functional problems such as urinary incontinence and erectile dysfunction which reduce quality of life for months to years after surgery.

Managing Urinary Incontinence 

After surgery, stick to light exercise (eg. short walks) for the first week or two and avoid all heavy lifting. After this time you can get stuck back into some low impact exercise such as walking, golfing, swimming, etc. if you are able.

To help manage the after-effects of radical prostatectomy specific exercises called Kegel exercises are recommended.

While Kegel exercises are more commonly recommended for women following childbirth, they can help men to improve bladder control and possibly even sexual function after radical prostatectomy and should become a permanent part of your daily routine. It is best to also include regular kegel exercises in your pre-operative routine to enhance pelvic muscle tone and contraction strength prior to surgery.

The Mayo Clinic Guidelines for Kegel exercises for men are as follows:

• Find the right muscles. To identify your pelvic floor muscles, stop urination in midstream or tighten the muscles that keep you from passing gas. These are your pelvic floor muscles. If you contract your pelvic floor muscles while looking in the mirror, the base of your penis will move closer to your abdomen and your testicles will rise.
• Perfect your technique. Once you’ve identified your pelvic floor muscles, empty your bladder and lie on your back with your knees bent and apart. Tighten your pelvic floor muscles, hold the contraction for three seconds, and then relax for three seconds. Try it a few times in a row but don’t overdo it. When your muscles get stronger, try doing Kegel exercises while sitting, standing or walking.
• Maintain your focus. For best results, focus on tightening only your pelvic floor muscles. Avoid flexing the muscles in your abdomen, thighs or buttocks. Ensure you are also breathing freely during the exercises. Aim to perform a set of 25-50 Kegel exercises at least 3 times daily.

Urinary incontinence may be exacerbated by urinary tract infections, so immune support is essential throughout your surgery recovery. A high-potency probiotic formula such as UltraBiotic 45 or Immune Enhancing Probiotic will assist with immune health as well as maintaining healthy bacteria balance which is necessary as antibiotics are administered prophylactically to surgical patients.

A therapeutic dose of magnesium, calcium and potassium from a high potency magnesium powder or tablet formula such as Eagle Mag Restore may also help to improve pelvic tone and reduce incontinence.

Finally, it is essential that you avoid foods that may irritate your bladder and urinary system. This includes any foods you have a known allergy to, caffeine, alcohol, foods and drinks high in refined sugars – eg. soft drinks, energy drinks, lollies, etc.

Maintaining Healthy Sexual Function

You can greatly improve your ability to recover from prostate surgery with the right preparation. Healthy dietary and lifestyle changes should be maintained after your surgery as well to support your long term recovery and ongoing health.

If you are overweight, it is essential that you start losing weight at a sustainable and steady pace. Being overweight prior to having your prostate removed can increase your risk of complications during and after surgery.

Following a ketogenic diet modified specifically for cancer support is a great way to reach a healthy body weight. This type of diet is also recommended if you are at a healthy weight, as it is very low in sugar which is a known driver of cancer growth.

Ditch pro-inflammatory foods from your diet – these will drive cancer progression and contribute to erectile dysfunction. Your penis needs a healthy blood flow to function properly so clogging your arteries with processed fats (eg. fried foods) and refined sugars will compromise your ability to gain and maintain an erection.

Cigarettes are not only a proven cause of cancer, they are powerful erection-killers as they cause blood vessels to constrict and damage body tissues to slow surgery recovery rates. Having trouble quitting? Click here for more info.

Regular exercise is a necessity for healthy sexual function as it supports cardiovascular health, increases blood flow, promotes relaxation and assists with healthy weight management. You can also support cardiovascular health and circulation with a high quality fish oil supplement and CoEnzyme Q10. 

Nitric oxide, a potent, endogenously-produced vasodilator may also improve erectile function post-surgery. Nerve damage is a common side effect of prostate removal surgery and can reduce a male’s natural ability to produce nitric oxide. The Nitric Factor can be used to boost nitric oxide levels naturally.

If you have a history of cardiovascular disease as well as erectile dysfunction, a comprehensive Cardiovascular Profile is recommended to assess a range of cardiovascular risk factors and determine the most effective treatment plan for you.

Did You Know? 

Natural therapies can be used to manage symptoms of prostate enlargement or cancer, and to reduce the modifiable risk factors which drive cancer progression both before AND after surgery. Book an E-Consult to get individualised health advice from a qualified Integrative Medicine Practitioner.
Please note – it is important to consult your healthcare practitioner for specific supplement dosage guidelines, as many supplements cannot be taken in the week or two prior to surgery.

Supplements taken after surgery must also be checked for safety alongside any prescription medications.

Further Reading: 

• 10 Tests Every Man Shouldn’t Go Without 
• Manopause – More Than A Male Mid Life Crisis
• Protecting Your Prostate 
• Research Insight – Prostate Cancer Linked to Women’s Use of The Pill

References:

Boorjian, S.A. et al. 2012, A Critical Analysis of the Long-Term Impact of Radical Prostatectomy on Cancer Control and Function Outcomes, European Urology, Vol. 61

Dean, R.C. 2005, Neuroregenerative Strategies After Radical Prostatectomy, Reviews In Urology, Vol. 7(2)

McCullogh, A.R. 2005, Sexual Dysfunction after Radical Prostatectomy, Reviews in Urology, Vol. 7(2)

Prostate Cancer Foundation of Australia, 2013, http://www.prostate.org.au

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