Advanced prostate cancer: discussing embarrassing topics

Good communication with your healthcare team is essential when treating advanced prostate cancer. Being open, honest, and forthcoming about your experiences will help your healthcare providers understand what you need from treatment.

But sometimes, being open, honest, and forthcoming is not the easiest thing to do. Prostate cancer and the therapies used to treat prostate cancer can cause a number of issues that can be uncomfortable to bring up and embarrassing to talk about. This includes changes to a person’s body as well as a person’s mental health.

The physical burden of prostate cancer

The prostate gland is a walnut-sized gland that is part of the male reproductive system. This gland is located in the pelvic region, just below the bladder, just in front of the rectum. Prostate cancer is cancer that began in this gland, and advanced prostate cancer is cancer that has spread outside of this gland.

Due to the location of the prostate gland and that gland’s role in male reproductive health, both prostate cancer and therapies used to treat prostate cancer can cause problems with urination, bowel movements, and sexual function. Problems like these can also cause significant embarrassment for a person, even in a healthcare setting.

The mental burden of prostate cancer

For many people, mental health ranks among the most difficult health-related topics to discuss, and many people with prostate cancer experience depression or other difficulties with mental health. Uncertainty about the future, sexual side effects, negative feelings about body image, stigma, and the impact the disease has on relationships are all possible contributing factors. Depression can be a side effect of androgen deprivation therapy (also called hormone therapy), a common approach to treating prostate cancer.

The benefits of discussing uncomfortable topics

While bringing up embarrassing or uncomfortable topics can be difficult, it will have benefits. Treatment for prostate cancer is different for every person. A treatment plan should not only consider how to treat the cancer, but how to improve the quality of life of the person living with cancer.

There are also therapies that can help a person manage many of the embarrassing problems that can occur when a person has prostate cancer—including bowel problems, urinary incontinence, sexual dysfunction, and depression.

Strategies for discussing embarrassing topics

If you are living with prostate cancer and are having a difficult time discussing parts of your experience with your healthcare providers, consider trying these strategies:

• Make it a priority. It can help to have a goal for your appointment with a healthcare provider. If there is something bothering you, make it a priority to discuss this topic during your next appointment.
• Use a conversation starter. Write down a few talking points or the first sentence of what you want to say. Bring this to your appointment. Sometimes, the hardest part of having a conversation is starting the conversation.
• Remember who you are talking to. Your healthcare providers are specialists in the treatment of urological cancers, and they are familiar with the symptoms and side effects that people experience when living with these cancers. While a symptom may be embarrassing, it’s something your healthcare provider has seen before.
• Tell your provider you’re embarrassed. You can also start by telling your healthcare provider that you are feeling uncomfortable or embarrassed. Your healthcare provider may have their own strategies to help you feel more at ease and get to the topics that you need to discuss.