Survivor issues

1. I have a very close friend who has cancer. I know she desperately wants children but I wonder if she'll be able to because of her treatment. I want to be able to support her. Do you have any advice?

A.

Many cancer treatments won't affect a woman's ability to produce a child (fertility). However, some do. This may only be temporary but in some situations it's permanent. Unfortunately, a woman won't be able to have children if she's had

  • Radiotherapy to her ovaries
  • An operation to remove her ovaries
  • Certain chemotherapy drugs (some won't affect fertility, some will only temporarily)

For most women, finding out they can't have children is devastating. Having to cope with a cancer diagnosis and its treatment, as well as infertility is understandably very difficult. This is especially true for women who don't already have children and were planning to. Even women with children who want more or those who thought they didn't want them can find it hard.

Your friend's medical team will discuss the possibility of infertility with her before treatment begins. If it's going to be an issue, preserving her fertility may be a possibility. But unlike with men, this is not such a simple process. Some women may be able to

  • Freeze embryos
  • Freeze eggs
  • Freeze ovarian tissue (this is a very new technique)

These procedures can be difficult, unrealistic and in some situations impossible. But if your friend finds out her treatment will affect her fertility it's always worth her asking her specialist cancer doctor about these.

With regard to how you can best support your friend - just letting her know you're there if she ever wants to talk will be a great help. If your friend is infertile she may not want to discuss this with you at first. Don't feel shut out if this happens.

Loss of fertility is not something people usually find easy to accept. Some people may never accept it and only find a way to live with it. People take time to process information that's going to impact their lives forever.

There's likely to be a grief process your friend goes through if she discovers she's infertile. She may feel like part of her has been taken away. Your friend will have lost dreams and opportunities she never thought would disappear. It's important to allow her the time to adjust and express her sadness in her own way.

Your friend may decide at some stage to share her feelings of loss with you. The best thing you can do is to really listen to how your friend feels and acknowledge her loss without making out you fully understand.

To speak with a cancer nurse, call the Cancer Helpline on 13 11 20.

2. I've had my prostate removed due to cancer and can't believe the change in size to my penis. Will it return to its original size or is this it?

A.

Most men go through an enormous amount of change after treatment for prostate cancer. How this effects each man can depend on several factors including your age, the type of treatment you had and the amount of support you have.

Unfortunately certain treatments for prostate cancer can cause several side effects such as penis shrinkage, erection problems and urinary incontinence. Penile shrinkage can happen if you have a radical prostatectomy or take hormone therapy.

Once the prostate has been taken out a space is left between the neck of the bladder and the urethra (tube through which urine come out of the body). This space has to be connected back up. In some men, the bladder tissue is very mobile making it easy to connect it with the urethral stump. If this is the case then there's usually very little change in size to the penis. However, for some men a significant ‘stretch' is needed to pull the bladder and urethra together. This means the penis is pulled up inside making it shrink a bit.

For most men the shrinkage is very small. But for others there can be up to a 15% decrease in the size of the penis. With time and return of regular erections the retraction can correct itself. This is why most specialists encourage men to have erections naturally or artificially early and regularly after their surgery.

If you're having problems with getting an erection, ask your specialist about medications and devices to help you. There are several things you can try which many men find work well.

If you're in a relationship it can help to talk about how you're feeling with your partner. Some men find this difficult. But letting each other know how you feel can prevent unnecessary feelings of rejection and resentment. Most partners will want to support you in the best way they can. They'll want to feel close to you, understand what you're going through and let you know they're there for you no matter what.

Although it can take time and patience, many men say it's still possible to have an intimate and enjoyable sex life after having treatment for prostate cancer. See also:

Sexuality and cancer: a guide for people with cancer

Life after cancer: a guide for survivors

To speak to a cancer nurse, call the Cancer Helpline on 13 11 20.

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Updated: 17 Jan, 2012