The moment you learn you have prostate cancer, your world changes. Anxiety over making the right treatment decisions and uncertainty over the outcome can take over your thoughts.
Worries about how your treatment might affect you only add to the overwhelm — and can change the way you see yourself.
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"Depending on the therapy, there can be significant implications, including changes in muscle mass, erectile dysfunction, libido and fatigue," says Ian Sadler, PhD, a clinical health psychologist specializing in cancer at Columbia University Irving Medical Center in New York. "When you think of a man who's normally active and his energy levels aren't what they used to be, it can hit their sense of identity."
It's easy to feel like you're all alone in dealing with these burdens. But in fact, prostate cancer is the second-most common cancer in the U.S. in people with prostates, according to prostate cancer statistics from the American Cancer Society. What's more, while prostate cancer can be serious, the chances of survival are high, the ACS notes. And in some cases, the best course of treatment is simply watchful waiting.
Knowing that prostate cancer is something many people face — and survive — can be somewhat reassuring. But there are other tools to help you process your diagnosis and cope with the emotions you might be feeling — from anger, to uncertainty, to fear. Here are six to try.
1. Gather the Right Amount of Knowledge for You
Learning about your diagnosis and treatment options can give you a sense of control and help you feel better about the course of therapy you ultimately choose to take, according to the National Cancer Institute.
"A lot of times the fears and worries are all what-ifs," says Tacha Kasper, LMFT, a licensed clinical therapist focusing on cancer and psycho-oncology. "Education may alleviate some of that fear."
Bring questions to your primary care doctor or oncologist, and read up on prostate cancer and treatments from reputable sources like the National Cancer Institute, the American Cancer Society, Cancer.net or the websites of major cancer treatment hospitals, like the Memorial Sloan Kettering Cancer Center. But "avoid Dr. Google. That's a wormhole that doesn't address your unique situation," warns Kasper.
Just as important: Be honest with yourself about how much information you really want.
"There will be people who have to track down every piece of information and others who want to know very little. You should get all of the information you want and none that you don't," says Laurel Mellin, PhD, health psychologist and associate professor of family and community medicine at the University of California, San Francisco.
2. Consider Your Treatment Options, but Don’t Let Them Take Over Your Life
It's normal to feel indecisive about the best course of therapy — especially if you're presented with multiple options, including the choice to not treat the cancer and simply keep an eye on it. Weighing your choices carefully is important, but spending too much time ruminating can be a recipe for intense anxiety.
Once you've gathered all your information, Sadler recommends picking a date by which you'll make your decision. Then set aside dedicated time for thinking about treatment.
"Maybe you're just going to give yourself an hour in the morning and an hour in the afternoon to write lists of pros and cons or problem-solve," Sadler says.
Resist the urge to rush into a decision unless your doctor says otherwise. In most cases, it's fine to give yourself a couple of weeks to think, notes Sadler. (Though it's worth confirming the timeline with your oncologist.)
"This is a major decision," Mellin says. "If someone tells you to speed it up, unless there's a medical reason why you should, hang out with it until you feel safe and clear on your choice."
3. Get the Emotional Support You Feel Comfortable With
Going to a support group for people with prostate cancer has been shown to reduce feelings of tension, anxiety, fatigue and even depression, the ACS notes. Talking with others who are going through the same experience can help you feel less alone and give you new ideas for working through problems — including treatment side effects.
But it's not your only option. If sharing your feelings with a group of strangers seems like it would be uncomfortable, try to keep an open dialogue with your partner or even a good friend. "Sharing concerns about sexual intimacy, that's important," Sadler notes.
You could also book a session with a psychologist who specializes in cancer. "A visit with a clinical health psychologist is focused around your diagnosis. It's not an intensive process — they're not going to talk about your early childhood," says Sadler.
Your oncologist or primary care provider can also help you navigate your feelings, especially ones related to the sexual side effects of treatment. "If you've never [discussed things] like ejaculation or orgasm, a medical doctor is someone you might feel more comfortable talking with," Sadler says.
The bottom line? There's no right or wrong way to talk about how you're feeling — as long as you share what's on your mind with someone.
"Whatever makes you happy, if it's your family or a hobby or art, put that into your treatment plan. Make it a priority."
4. Take Care of Yourself
Basic healthy living principles are more important than ever right now.
"I call them your MEDS — mindfulness, exercise, diet and sleep," Kasper says.
Eating right, being active, keeping stress in check and staying well-rested help keep your body's cells in the best possible shape, which can ultimately increase your chance for survivorship, according to the Prostate Cancer Research Institute.
Making time for self-care won't just protect your physical health, though. Both exercise and mindfulness practices can help people with cancer feel more motivated and less depressed, according to the University of Southern California Keck School of Medicine.
Diets high in antioxidant-rich fruits and vegetables are tied to lower rates of depression too, per a September 2019 review in Antioxidants.
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5. Let Your Worries Hang Around — for a Little While, Anyway
Cancer doesn't come with guarantees. Whether you're undergoing treatment or simply keeping an eye on your prostate cancer, not worrying about what the future might hold can sometimes feel impossible.
Remind yourself that these feelings are completely normal — and know that they'll come to feel less crushing with time as you adjust to your diagnosis, per the ACS.
In the meantime, try to strike a balance between acknowledging your worries without letting them overtake your mind completely. "The worst thing we can do is to push those feelings away," Sadler says.
Next time a negative thought comes up — anything from whether you made the right treatment choice to how crummy you're feeling physically to whether your cancer will get worse — start by taking a few deep breaths. Tell yourself that it's OK to worry, then, try to challenge the thought.
"Ask yourself, 'is this constructive? Is this solving anything? I've spent the last hour ruminating, and I'm not sure it's helping me,'" Sadler says.
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6. Try to Live in the Moment
You can't change choices you made in the past or control what will happen with your cancer in the future. But you can decide to make the most of today. And doing so can go a long way toward helping you manage your feelings and cope with stress, according to July 2017 research in the Annals of Palliative Medicine.
That doesn't mean you should force yourself to be happy or carefree all the time — that's not realistic. But you can build moments of joy into each day.
"We forget to do that along the way," Kasper says. "Whatever makes you happy, if it's your family or a hobby or art, put that into your treatment plan. Make it a priority."
Doing the things you enjoy won't solve all your problems or make your cancer go away. But it can take your mind off of them for a while — and go a long way toward lightening your emotional load.
- National Cancer Institute: "Prostate Cancer—Patient Version"
- American Cancer Society: "Prostate Cancer"
- Cancer.net: "Prostate Cancer"
- Memorial Sloan Kettering Cancer Center: "Prostate Cancer"
- National Cancer Institute: "Treatment Choices for Men With Early-Stage Prostate Cancer"
- American Cancer Society: "About Prostate Cancer"
- American Cancer Society: "Attitudes and Cancer"
- Prostate Cancer Research Institute: "Self-Care for Prostate Cancer"
- University of Southern California Keck School of Medicine: "Exercise, mindfulness can improve quality of life for cancer survivors"
- Antioxidants: "Linking What We Eat to Our Mood: A Review of Diet, Dietary Antioxidants, and Depression"
- Annals of Palliative Medicine: "'Living in the moment' among cancer survivors who report life-transforming change"
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