A prostate cancer diagnosis, oftentimes, comes with psychological distress. Some patients get depressed or constantly worry that any pain or discomfort may mean the disease has spread or the treatment is not working.
“Sometimes I wake up with swollen legs or breasts, bigger than my wife’s, or urine in blood and I worry throughout the week. I keep wondering if it’s a new disease,” said a patient at a recent prostate cancer support group meeting at Faraja Cancer Support Trust in Nairobi.
Charles Kyangu, a psychologist at Kenyatta University Teaching and Referral Hospital says cancer treatment and the disease itself have symptoms that can cause constant worry.
The disease, surgery, radiation, and chemotherapy cause body changes.
Some patients develop chicken-pox kind of rashes, pee, and poo more often, or the urine comes out slower than normal. Some sweat too much. Other men experience back pains, neck stiffness, fatigue, and low sex drive.
“If you’re not aware of what is happening to your body you worry. The doctor might have explained the side effects of the treatment but the initial shock of the diagnosis makes it hard to retain all you’re being told. Let your spouse or family member or friend accompany you to all doctor’s appointments. You will hear one thing, and they will hear another. Your spouse will likely ask questions that escape you,” he says.
Mr Kyangu notes that the beginning of managing the disease is by being positive. A high number of prostate cancer cases are cured through treatment.
The World Health Organisation data shows it is the most common cancer in Kenyan men, followed by the oesophagus and colon/rectum.
Prostate cancer burden
Every year, about 3,412 Kenyan men are diagnosed with prostate cancer but it has lower death rates than oesophagus cancer.
“There are the constant naysayers who say, 'I know of my father’s friend who had cancer and died.' But who said someone who has cancer has to die? Do not let the disease trigger depression, anxiety, and even personality disorders,” Mr Kyangu advises.
He adds, “Have positive affirmations, such as ‘today, I’m getting better’. Don’t focus on negative thoughts such as, 'I’m a burden, I’m the problem in this house.' Some patients worry so much that they forget about living today. Don’t be so much obsessed with the future, live today, now, and enjoy. Don’t be bitter, bitterness wards off people around you.”
The psychologist adds that some patients focus so much on the body changes, which in most cases are temporary, that they forget who they were before the disease.
“You start calling yourself useless or worthless, forgetting you are a towering educationalist, for instance, you have achieved so much. Go back in time and remember who you were,” he says adding, “as you struggle with prostate cancer and the treatment side-effects, your self-concept should not disappear, it should not make you feel less important.”
Redefine sex life
A majority of prostate cancer patients and survivors worry about their sexual health. This can affect self-esteem or even cause depression.
Stress is known to kill libido, therefore it can add to the problems of lack of sexual desire or erectile dysfunction that may arise after treatment.
“Redefine what your sex life looks like after the disease. Talk to the doctor and your spouse,” says Mr Kyangu.
Disclose the diagnosis
Disclosing the diagnosis to trusted immediate family members plays a big role in ensuring you get support.
“Call a family meeting, tell your children and wife about the diagnosis and what to expect. Don’t surprise your family when the disease has advanced. Most men keep things to themselves, nobody chooses to get sick,'' he points outs.
Mental health treatment as an integral component of your overall cancer care may also go a long way.
"When one person in a family is sick, he or she is also psychologically sick. Seek therapy. Get a family counsellor if need be to assist your family to navigate through these feelings,” he says.