“I have prostate cancer” is something no one ever wants to hear their partner say. But unfortunately, prostate cancer can and does happen. According to the American Cancer Society, prostate cancer is the most common cancer among American men, and an estimated 161,360 new cases of the disease are expected to be diagnosed this year.
Prostate cancer most often develops in people who are 65 and older, but in rare cases it can affect someone under the age of 40. If your partner is diagnosed with prostate cancer, it’s important to know this: While the disease is serious and it can be deadly, the American Cancer Society points out that most people who develop prostate cancer do not die from it.
But cancer is cancer, and it can take an enormous toll on both the patient and their loved ones. Here’s what you can expect if you find yourself in this situation:
Prostate cancer treatment can vary.
Treatment can include watchful waiting (where your partner is monitored by a doctor to see if the cancer progresses), surgery to remove the prostate, radiation therapy, cryotherapy (which uses very cold temperatures to kill prostate cancer cells), hormone therapy, chemotherapy, and vaccine treatment to help boost immune cells that can fight off prostate cancer cells, according to the American Cancer Society.
In most cases where the cancer hasn't spread outside the prostate, the two most common types of treatment are surgery or radiation, S. Adam Ramin, M.D., a urologic surgeon and medical director of Urology Cancer Specialists in Los Angeles, tells SELF. "If surgery is done with an experienced surgeon, patients can have an excellent prognosis in terms of outcomes, and can also have a high quality of life afterward," he says. Radiation therapy, which involves using targeted beams of radiation on the prostate gland, can be more time-consuming—a patient will typically have to undergo between 28 to 45 treatments, depending on their cancer, Dr. Ramin says.
A good portion of people diagnosed with early stage prostate cancer now will be placed on active surveillance, which requires a patient to check in with their doctor every three to six months for blood testing, an MRI of the prostate, ultrasounds, and periodic biopsies, Dr. Ramin says. Ultimately, a doctor will help your partner choose the best treatment based on the type and stage of cancer they have, their age, and other health conditions they may have. But regardless of the treatment, you and your partner should expect to see his doctor and oncology team pretty often.
As with any cancer treatment, there are side effects.
These will depend on the type of prostate cancer treatment your parter is undergoing, but some of the more common side effects include incontinence, erectile problems, bowel issues, fatigue, vomiting and diarrhea, and swelling of the prostate area, according to the American Cancer Society.
"Any treatment to the prostate can produce unwanted side effects," Brian Chapin, M.D., an assistant professor in the Department of Urology at The University of Texas MD Anderson Cancer Center, tells SELF. But again, it depends on the type of treatment or surgery. For example, Dr. Ramin says that patients can have decreased bladder control for a few weeks after surgery as well as sexual side effects like erectile dysfunction (though typically these are short-term symptoms). With radiation, patients may experience burning with urination, an increased frequency of urination, loss of bladder control, and erectile dysfunction.
It could impact your partner’s fertility.
If you’re considering having children down the road, it’s a good idea to talk to your partner’s doctor about options to preserve fertility. If your partner has prostate surgery, the prostate and seminal vesicle, both of which produce the fluid which help the sperm navigate the ejaculatory duct, are often removed, Dr. Chapin says. Without that fluid, your partner won’t be able to ejaculate sperm, which obviously makes it difficult to conceive without medical intervention. If your partner undergoes radiation, this can also damage their testicles and impair sperm production and fertility, Julie Sroga Rios, M.D., an assistant professor in the Division of Reproductive Endocrinology and Infertility at the University of Cincinnati College of Medicine, tells SELF.
But you have options. Men can bank sperm before surgery and radiation, which Dr. Rios says is the “best chance” for future fertility. There are no clear recommendations for how many vials a patient should try to bank, but she typically suggests six vials for every one child a couple wants to have (usually one sperm collection can create two to three vials of sperm for future use). To use banked sperm later, your IVF clinic would work with your sperm bank (if you used one) to retrieve the sperm and fertilize your eggs (or, if you used an IVF clinic for the sperm banking, they would simply use what they have on-hand).
A post-treatment option is called testicular sperm extraction, which harvests immature sperm for use in IVF, says Dr. Rios. But this can only be done if your partner’s testicles aren’t damaged by radiation. The risk of fertility issues from radiation varies, and depends on the type of radiation your partner has. For instance, people who undergo brachytherapy, a radiation therapy in which radioactive implants are put directly into the tissue, do not have a large dose of radiation to the testicles, and many people will stay fertile or recover their sperm production afterward, the American Cancer Societyreports. But external radiation, i.e. radiation from a machine outside the body, is more likely to cause permanent infertility, even if the patient's testicles are shielded.
All that said, the cost of sperm banking (and using it later through IVF) can be prohibitive—especially when your primary focus is paying for the treatment your partner needs now—but it's something to discuss with your doctor and insurance company while you're considering treatment options.
You are your partner’s first line of emotional defense.
Obviously, you know that you need to be there for your partner, but this is likely uncharted territory for you both. “The hardest thing to cope with when your partner has prostate cancer is that you cannot take it away or fix it for them,” clinical psychologist John Mayer, Ph.D., author of Family Fit: Find Your Balance in Life, tells SELF. He says that it’s important to understand that this is likely about even more than cancer to your partner—they may also be worrying about loss of virility, how their body will function after treatment, and how they'll be perceived—or how they'll perceive themselves.
Tamar Gur, M.D., Ph.D., a psychiatrist at The Ohio State University Wexner Medical Center, tells SELF that it’s important to think about the people in your life and your partner’s life as being concentric circles. Your partner is in the center circle, you’re in the next closest circle, and subsequent outer circles would be other family members and acquaintances. It’s important to make sure that those who are in outside circles don’t “dump” on those in inner circles, she says. For example, your partner’s brother shouldn’t complain to you about his fear of seeing your partner in a sick state. “You need all your strength to support your partner,” Dr. Gur explains. “You only want help and support to come inwards.”
Of course, being your partner’s emotional rock during this time will be tough, which is why Dr. Gur recommends finding a trusted friend or therapist who you can confide in about your fears and concerns. “It’s important to make sure you’re getting support, too,” she says.
While it’s natural to be afraid of saying the wrong thing, Dr. Gur says the most important thing is to show up for your partner—go to appointments if you can, hold their hand, and be there for them if they experience side effects. “Cancer treatment is a very lonely and scary process,” Dr. Gur says. “Showing up and showing acts of love and kindness are the most helpful things you can do when someone is going through an ordeal like this.”