Dr. David Samadi | September 9, 2025 |

Navigating the Side Effects of Prostate Cancer Treatments A Practical Guide for Patients

By Dr. David Samadi

Prostate cancer remains one of the most frequently diagnosed cancers among men. Thanks to advances in medical technology, treatment outcomes have improved significantly, offering patients better survival rates and quality of life. However, these treatments—while often lifesaving—can bring a range of side effects that vary depending on the method used.

This guide outlines the most common side effects associated with major prostate cancer treatments. It offers evidence-based strategies for managing them, helping patients and caregivers approach recovery with confidence and clarity.

1. Robotic-Assisted Surgery: Precision with a Recovery Curve

Robotic-assisted laparoscopic prostatectomy is a cutting-edge, minimally invasive surgical procedure used to remove the prostate gland. This approach provides enhanced precision, reducing trauma to nearby tissues and nerves. One example is Dr. Samadi’s renowned and innovative SMART technique  (Samadi-Modified Advanced Robotic Technique), designed to preserve urinary and sexual function.

Potential Side Effects:

  • Urinary Incontinence: Leakage or reduced bladder control, especially in the weeks following surgery.
  • Erectile Dysfunction: Temporary or long-term erectile difficulties due to nerve impact.
  • Pelvic Discomfort: Mild, localized pain or pressure during early recovery.

Management Strategies:

  • Pelvic Floor Rehabilitation: Kegel exercises enhance bladder control and strengthen pelvic muscles.
  • Erectile Function Support: Treatment options include PDE5 inhibitors, penile injections, vacuum devices, or consultations with a sexual health specialist.
  • Pain Management: Mild discomfort often resolves with time, but physical therapy and non-opioid pain relievers can help.

2. Immunotherapy: Boosting the Body’s Defenses

Immunotherapy helps the immune system identify and attack cancer cells more effectively. While promising, it can also trigger widespread immune responses.

Potential Side Effects:

  • Fatigue: Persistent tiredness due to immune system activity.
  • Flu-like Symptoms: Fever, chills, muscle aches, or mild nausea.
  • Autoimmune Reactions: Inflammation of healthy tissues (e.g., colitis, thyroid issues, dermatitis).

Management Strategies:

  • Rest & Hydration: Prioritize sleep, fluids, and gentle physical activity.
  • Symptom Relief: Over-the-counter medications, such as acetaminophen or NSAIDs, can help ease discomfort.
  • Close Monitoring: Regular lab tests and symptom tracking help identify autoimmune effects early, allowing for prompt treatment.

3. Hormone Therapy: Slowing Cancer by Suppressing Testosterone

Hormone therapy reduces testosterone levels, which slows cancer progression. This systemic approach is practical but can impact various bodily systems.

Potential Side Effects:

  • Hot Flashes & Night Sweats: Sudden, intense feelings of heat, often disrupting sleep.
  • Muscle Loss & Weight Gain: Shifts in metabolism and reduced lean mass.
  • Mood Changes: Irritability, anxiety, or depression caused by hormonal shifts.
  • Bone Density Loss: Increased risk of osteoporosis and fractures.

Management Strategies:

  • Exercise & Strength Training: Regular resistance workouts support bone and muscle health.
  • Nutritional Support: Consuming calcium-rich foods and taking vitamin D supplements helps promote bone strength.
  • Emotional Wellness: Cognitive-behavioral therapy, antidepressants, or peer support groups may provide relief.
  • Bone-Strengthening Medications: Drugs such as bisphosphonates or denosumab may be prescribed to reduce the risk of fractures.

4. Traditional Radiation Therapy: A Proven but Broad-Spectrum Approach

Conventional external beam radiation uses targeted X-rays to destroy cancerous cells. While effective, it can have an impact on nearby organs and tissues.

Potential Side Effects:

  • Skin Irritation: Redness, peeling, or tenderness in the treated area.
  • Bowel & Bladder Changes: Increased urgency, frequency, or mild diarrhea.
  • Erectile Dysfunction: Damage to nerves and blood vessels may lead to sexual side effects over time.

Management Strategies:

  • Gentle Skincare: Use non-irritating, fragrance-free lotions and wear breathable fabrics.
  • Dietary Adjustments: Stay hydrated and follow a low-residue diet to ease digestive issues.
  • Sexual Health Solutions: Consider medications, counseling, or other therapies as needed to address your specific needs.

5. Proton Therapy: A Targeted, Tissue-Sparing Radiation Option

Proton therapy delivers radiation with pinpoint precision, reducing exposure to surrounding healthy tissue. It’s especially beneficial for minimizing long-term side effects in prostate cancer patients.

Potential Side Effects:

  • Fatigue: A common side effect during and shortly after treatment.
  • Urinary & Gastrointestinal Changes: Increased frequency or urgency of urination; occasional bowel changes.
  • Skin Sensitivity: Mild redness or irritation in the treatment zone.

Management Strategies:

  • Energy Conservation: Incorporate rest periods into daily routines and opt for low-impact exercise like walking or yoga.
  • Bladder & Bowel Support: Limit caffeine and spicy foods and maintain adequate hydration.
  • Skin Protection: Apply approved moisturizers and avoid excessive heat or sun exposure to affected areas.

Final Thoughts: Partnering in Care

While prostate cancer treatment can pose physical and emotional challenges, many side effects are manageable with proactive care and support. Open communication with your healthcare team, regular follow-ups, and a tailored wellness plan can make a significant difference in long-term recovery and quality of life.

For patients and caregivers, staying informed and engaged is a vital part of the journey—because managing side effects isn’t just about reducing discomfort; it’s about reclaiming your health and living fully beyond diagnosis.

 

Dr. David Samadi is the Director of Men’s Health and Urologic Oncology at St. Francis Hospital in Long Island. He’s a renowned and highly successful board certified Urologic Oncologist Expert and Robotic Surgeon in New York City, regarded as one of the leading prostate surgeons in the U.S., with a vast expertise in prostate cancer treatment and Robotic-Assisted Laparoscopic Prostatectomy.  Dr. Samadi is a medical contributor to NewsMax TV and is also the author of two books, Prostate Cancer, Now What? A Practical Guide to Diagnosis, Treatment, and Recovery and The Ultimate MANual, Dr. Samadi’s Guide to Men’s Health and Wellness, available online both on Amazon and Barnes & Noble. Visit Dr. Samadi’s websites at robotic oncology and prostate cancer 911.

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