In addition of the complications of the disease itself, surgery for prostate cancer can also lead to serious problems. The major complications that can be resulted from a radical prostatectomy are impotence, urinary incontinence and urethral stricture (narrowing of the urethra). Radical prostatectomy also increases the risk of other complications such as pneumonia, blood clots, infection and (rarely) death.
Metastasis – cancer cells from the prostate gland can spread locally into the bones, lymph nodes, rectum, and bladder. The tumor can also invade distant sites in the body through the bloodstream to form new cancers. Although rare, an advanced prostate cancer can invade the following organs:
- lumbar vertebrae
- thoracic vertebrae
- Adrenal glands.
Impotence – the nerves responsible for erection of the penis are located very near the prostate gland. Therefore, a radical prostatectomy can damage these nerves and cause erection problems. Besides the surgery, radiation or hormonal treatments can also lead to erectile dysfunction. However, nowadays, there are surgical therapies used to treat prostate cancer that preserve those nerves and prevent impotence. If you would like to continue your sexual life after the surgical therapy, talk to your doctor before the surgery.
Urinary incontinence – both cancer and its treatment can be associated with urinary problems. After surgery, it is likely not to have bladder control immediately. This problem does not occur in all men, and even when it happens, urinary continence usually returns within a few months after the surgery. In case the incontinence continues for a long period of time, an artificial urinary sphincter transplant can be the only therapeutic option.
Bone pain – although at first it can be completely asymptomatic, sometimes the cancer spreads beyond the prostate gland to affect nearby or distant bones, causing bone pain and other symptoms related to bone disease. Bone metastases of prostate cancer may even cause destruction of the affected bone. This destruction, in addition to pain, can be responsible for serious metabolic disorders due to high levels of calcium in the blood.
Other complications – In addition, both prostate cancer and its treatment can lead to:
- pelvic compression
- Malaise or general sick–feeling.