Survivorship and Quality of Life

March 26, 2020

A bladder cancer diagnosis can be a life-changing event. Cancer survivorship begins at diagnosis and includes all of the psychological, emotional, social, health, and financial issues cancer patients cope with as they learn to live with their cancer. Survivorship care focuses on improving survivors’ quality of life. This includes dealing with physical issues like pain, changes in sexual function, or emotional issues like anxiety or depression.

Bladder cancer treatments can affect patients’ physical sense of wellbeing, their relationships, their social lives and their overall health. Bladder cancer can be uncomfortable to talk about because it can cause changes in intimate parts of the body.

Urinary problems

Burning and irritation during urination are common side effects of bladder cancer treatments. Urinary incontinence (urine leaking) can follow bladder removal surgery. These treatment side effects can be very challenging. They may require changes in ordinary routines, such as work, hobbies, and other social activities.

Sexual wellbeing

Sexual issues following bladder cancer is not always discussed when decisions about treatment are being made.  However, sexual issues that can arise following bladder cancer treatment are not at all uncommon. Instillation of medications into the bladder can mean that you have to wait for some time before you can be sexually active. The removal of the bladder (cystectomy) in men may be combined with the removal of the prostate. The removal of the prostate leads to difficulty with erections, a dry orgasm and a long road to recovery. Women may lose their uterus and ovaries when their bladder is removed. The loss of the uterus and ovaries leads to a ‘’surgical menopause”. Women experience loss of sexual interest, vaginal dryness and consequent pain with intercourse. However, there are methods that can help men and women maintain their sexual relationships and enjoy the closeness and pleasure that comes from that connection. Talk to your healthcare provider to direct you to professionals who can help you work on your sexual goals after bladder cancer treatment. You can find a sex therapist in your area by going to the website of the American Association of Sexuality Educators, Counselors and Therapists.

These sexual changes affect both the patient and the partner and may need accommodation in their sexual relationship. Sexual health is a part of overall health. Bladder cancer survivors have a right to ask questions about how their sexual function and sexual relationships will be affected by bladder cancer treatment. They also have a right to learn about available sexual rehabilitation and sexual health resources, such as sexual health counselors, in their area.

Depression and anxiety

Bladder cancer has a high rate of recurrence. Patients need to see their doctors regularly to make sure that the cancer is closely monitored so that potential recurrence is found as early as possible. Even when there is no sign of a recurrence, these tests may cause a lot of emotional distress. Survivors often live with a fear of recurrence between tests. These are normal feelings.  If you feel overwhelmed or are not getting as much pleasure out of life as you are used to, if you feel that you cannot shake these feelings for 2 or more weeks, ask your doctor to recommend a professional you can to talk to. For instance, some social workers and psychologists specialize in helping people manage chronic diseases like cancer.

Asking for support

It is very important to realize that while your main goal is to become free of bladder cancer, you will also have to manage the side-effects of treatment. you may have a lot of questions and a lot of feelings. Do not hesitate to speak to your healthcare provider about any issues that you have questions about or that are concerning you. If your provider cannot help, he/she can usually find someone who can.