Living with prostate cancer places significant physical and emotional demands on both the patient and his carer(s).

Working together with your partner or person you care for, to understand the disease and treatments available can have a considerable impact on the overall wellbeing of everyone involved.

It is essential to prepare both yourself and your partner to understand what treatment options are available and what they involve before any procedure is carried out.

This section aims to give help and advice to those caring for people with prostate cancer.

Diagnosis of prostate cancer will be a shock to you as well as your partner or the person in your care. You may initially be in a state of denial or feel very sad.

Panic, anger and fear are also common reactions. Occasionally patients and carers may experience depression. If this happens to you then talk through your feelings with your doctor. It is important that you, the carer, feel able to cope too.

Men with prostate cancer can experience a number of physical symptoms which might make them feel unwell, and some of these are listed below. However not everyone will get all of these, and of course they could be caused by something else which is not cancer related. Patients with early localised prostate cancer may not have any symptoms at all, and may only be diagnosed because of abnormal test resul

• a need to urinate frequently, especially at night
• difficulty starting urination or holding back urine
• weak or interrupted flow of urine
• losing control of the bladder (incontinence)
• painful or burning urination
• difficulty in getting and/or maintaining an erection
• painful ejaculation
• blood in the urine or semen
• frequent pain or stiffness in the lower back, hips or upper thighs
• tiredness

A diagnosis of cancer may also cause emotional challenges, such as:

• panic
• fear / anxiety / worry for the future
• anger
• depression
• feelings of inadequacy
• low self-esteem
• wanting to avoid thinking about it

As a carer it will help to understand what your partner or the person you care for is going through. Understanding the symptoms, treatments and its outcomes may help you manage many of your fears and worries and help you feel in control.

Sources of information and ways of feeling in control:

• Talk openly to the nurse or doctor dealing with your partner
• Keep a diary / log of events and experiences related to the illness
• Attend your partner’s appointments with him and take a list of questions to jog your memory
• Jot down information and advice that your doctor or nurse offers and bring any questions with you in writing so that you don’t forget to ask
• Ask for extra help from professionals if you need it; many hospitals have specialist nurses to help with different aspects of dealing with cancer
• Hospitals also often have patient information rooms where you might find good reading material
• Many of the prostate cancer patient groups and associations have leaflets and lists of recommended reading to help carers learn more about the disease, its effects, and its treatment.

If your partner or the person you care for is undergoing LDR brachytherapy (also referred to as ‘seed implantation’ or ‘pinhole surgery’) then they will be experiencing the same doubts that anyone will have with a diagnosis of prostate cancer. By choosing LDR brachytherapy he will receive a form of treatment that is more convenient and less disruptive to his quality of life than other recommended treatments.

Your cancer specialist doctor or nurse will know about local support groups. Alternatively, websites and phone directories will provide contact numbers.

Try the following websites for more information.

• Prostate Cancer UK Charity
• Prostate Cancer Support Association
• Cancer Research UK
• Prostate Cancer Foundation of New Zealand
• Prostate Cancer Foundation of Australia

Patient groups are often run by patients who have been through prostate cancer themselves. These groups are an excellent place to meet people with similar experiences who are prepared to talk freely about the disease and offer you support as a patient or carer.

When suffering from prostate cancer, it sometimes feels easier to cut yourself and your partner off from other members of the family and close friends, either because you do not wish to burden them with the worry or because you feel awkward with the situation.

However, it may be counter-productive to isolate yourself. Talking openly with your close family members and friends can sometimes be very beneficial. They may just listen on a bad day or they may offer to help with practical matters such as lifts to hospital or keeping the patient company.

However, if you prefer not to discuss things then it is important to just let those close to you know that this is your way of dealing with things and it is not a rejection of their help.

Most employers should understand if you need time off work or if you need to re-arrange working hours around your care duties. Compassionate leave, dependency leave or unpaid leave are all possible options that you need to check with your employer.

Some organisations only allow you to do this for a short time and will not allow you to take much time off. Dependency leave is usually unpaid but some employers have policies which allow paid leave to be taken.

Supporting your spouse or partner with prostate cancer may bring you closer together, but it may be demanding and exhausting too, physically and emotionally. Juggling these new demands with your usual ones will not be easy. You don’t have to feel in control all the time and you need to find an outlet for your emotions. It is essential that you take time out to relax and do things you enjoy – individually and with your partner. Focusing on something else – a night out with your friends, a massage or a brisk walk can help. Organising little treats can be just as helpful, for example a long bath with a good book or watching your favourite television programme with a glass of something is good therapy too!

Your health is important too. Look after yourself. Give yourself time to come to terms with the news.

Prostate cancer and its treatment may have a significant effect on your sexual and intimate relationship. Your partner may feel that the cancer has an impact on his masculinity and sexuality. He may also worry about keeping his job and supporting his family. He may become withdrawn. Periods of despair followed by hope are not an unusual reaction for people suffering from prostate cancer.

His reactions can lead to frustration and anger on your part as his partner or carer. Try to communicate openly and if you still feel you need further help then try talking to somebody at a support group to express your feelings.