Prostate Cancer and Genitourinary Malignancies

Abstract

This chapter on prostate and genitourinary (GU) cancers focuses on advances in the science of treating prostate, bladder, testicular, kidney, and penile cancers. These cancers are common and are becoming more successfully treated yet can cause significant worry about both longevity and quality of life. Psycho-oncologists can help patients manage the challenges of potential sexual and intimacy issues as well as disruption to one’s body image, distress about treatment decisions, living with active surveillance and with the potential of cancer recurrence, pain and fatigue related to cancer treatments or bony metastases, and end-of-life issues. Men with prostate cancer deal with erectile and urinary dysfunction and attempt to avoid it at all costs in primary treatment decisions. Men with testicular cancer face a life-threatening situation that can interfere with early relationships, career, and body image. People with bladder cancer face the possibility of needing an external apparatus to deal with a heretofore natural bodily function. Even with improved treatments for kidney cancer, patients still cope with significant mortality prediction. Those men with penile cancers deal with very direct invasion of the body image and sexuality. Psycho-oncologists must keep abreast of breakthroughs in new diagnostic tests, which may facilitate more options for active surveillance, as well as new cancer treatments that patients must consider, and the side effects they might encounter. Advocates for improved symptom control including pain management and fatigue improvement are especially important with prostate and GU cancers because patients and families can feel unwarranted shame and embarrassment because of the location of the cancer.