Supportive care helps people meet the physical, practical, emotional and spiritual challenges of cancer. It is an important part of cancer care. There are many programs and services available to help meet the needs and improve the quality of life of people living with cancer and their loved ones, especially after treatment has ended.
Recovering from bladder cancer and adjusting to life after treatment is different for each person, depending on the extent of the disease, the type of treatment and many other factors. The end of cancer treatment may bring mixed emotions. Even though treatment has ended, there may be other issues to deal with, such as coping with long-term side effects. A person who has been treated for bladder cancer may have the following concerns.
Body image and self-esteem
Bladder cancer and its treatments can affect a person's body image and self-esteem. Body image is a person's perception of their own body. How a person feels about or sees themselves is called self-esteem.
Those who have a urostomy may feel uncomfortable around others. These feelings may cause distress for some people.
Urinary incontinence is a problem for some people following treatment. Embarrassment and worry of ridicule may cause some people to isolate themselves from others.
Women may feel differently about their bodies and themselves as women, especially after having a radical cystectomy. They may feel less like a woman or less feminine because they no longer have a uterus.
Changes in sexual function following surgery or radiation therapy may alter body image and self-esteem in many people.
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Living with an ostomy
Some people will have an ostomy created following a radical cystectomy. An ostomy that provides a way for urine to leave the body is called a urostomy. Living with an ostomy may be frightening at first. However, most people are able to adapt to and live normally with an ostomy.
It takes time and patience to learn to care for the urostomy since new skills need to be learned. Specially trained healthcare professionals called enterostomal therapists teach ostomy care after surgery and offer support and advice after discharge from the hospital.
Local or national ostomy groups and associations are available to provide support and information.
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Urinary incontinence
Urinary incontinence is the involuntary loss of urine or the inability to control urination. Urinary incontinence can develop in some people following surgery or radiation therapy for bladder cancer. Incontinence can result in lowered self-esteem and embarrassment.
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Fertility problems
Infertility is the inability to conceive a child. Fertility problems can affect both men and women following treatment with radical cystectomy, radiation therapy or chemotherapy for bladder cancer.
Fertility counselling should be done before treatment is started.
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Sexuality
Sexuality concerns may develop following radical cystectomy, radiation therapy or chemotherapy for bladder cancer because of changes in sexual function. A urostomy may result in altered body image, lowered self-esteem, worry or embarrassment.
Sexual side effects of radical cystectomy include:
- men
- A man will have a dry orgasm, without semen, because the prostate gland has been removed.
- A man may experience erectile dysfunction because the nerves that control penile erection may be damaged or cut during cystectomy.
- women
- A woman will not be able to get pregnant because the uterus and ovaries have been removed.
- Menopause will occur because the ovaries have been removed.
- Sexual intercourse may be difficult if part of the vagina was removed during radical cystectomy.
Sexual side effects of radiation therapy include:
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Treatment-induced menopause
Menopause is caused by reduced levels of hormones produced by the ovaries. Treatment-induced menopause is a result of removal of the ovaries during radical cystectomy in women. Treatment-induced menopause can also occur following radiation therapy or chemotherapy.
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Erectile dysfunction
Erectile dysfunction (ED) is the inability of a man to get and keep an erection firm enough to have sex. ED can occur following radical cystectomy or radiation therapy for bladder cancer.
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See a list of questions to ask your doctor about supportive care after treatment.