Survivorship & Follow-Up Care
At the Polsky Urologic Cancer Institute, we provide an integrated, multidisciplinary approach to cancer survivorship and vitality preservation. We offer a number of services that can help patients learn to manage the long-term side effects associated with cancer. Browse the topics below to more about how we can help patients optimize their quality of life following urologic cancer treatment. Explore the Robert H. Lurie Comprehensive Cancer Center’s survivorship section to learn about additional resources.
Urologic Cancer Survivorship Program
The Polsky Institute provides disease-specific resources and holistic care for patients from the time of diagnosis and throughout treatment and recovery. In addition to assessing for, treating and preventing many of the long-term effects of cancer and cancer treatment, the Adult Survivorship Clinics at the Lurie Cancer Center collaborates with urologic oncologists to create a tailored survivorship care plan with a surveillance schedule that includes screening for other cancers. Each plan includes formal education on optimizing health and wellness through exercise, nutrition and psychosocial enhancement. Patients are also given the opportunity to participate in studies evaluating psychosocial interventions to reduce symptom burden and improve health related quality of life.
Restoration of Sexual Vitality Following Cancer Treatment
Men and women can suffer from a wide range of sexual changes both during and after cancer treatment. The Polsky Institute partners with sexual health experts in the Northwestern Medicine Department of Urology to provide integrated treatment and therapy to address the physical, medical and hormonal conditions that impact sexual health following a urologic cancer diagnosis. In addition to treatment with medication, patients who have experienced changes in sexual function as a result of cancer treatment will be offered education, counseling and physical therapy.
Men facing urologic cancers are especially prone to sexual side effects following treatment. These include erectile dysfunction, decreased libido and change in penile shape, ejaculation problems and orgasm alterations. Nelson Bennett, MD, director of men’s health, specializes in the care of patients struggling with erectile dysfunction or other sexual conditions. Bennett has more than 20 years of experience in sexual rehabilitation and treatment, partnering with individuals and their partners to restore sexual function and intimacy following cancer treatment.
Preservation of Fertility Following Cancer Diagnosis
Chemotherapy, radiation and surgery greatly increase infertility risk, but it is difficult to predict which patients will be infertile following treatment. The American Society of Clinical Oncology (ASCO) recommends that physicians discuss the possibility of infertility and fertility preservation options with patients treated during their reproductive years. ASCO also highlights the importance of a referral to a reproductive specialist. Robert Brannigan, MD, professor of Urology, is an internationally recognized expert in the field of male reproductive medicine and surgery. He provides fertility preservation for men of all ages. Prior to surgery or radiation therapy, Brannigan counsels patients on the likelihood of infertility based on the type and severity of cancer and planned treatment. For interested patients, Brannigan will discuss options to preserve fertility prior to cancer treatment. The most common procedure for fertility preservation is a process known as sperm cryopreservation (banking), in which ejaculated sperm is stored before surgery or treatment. For prostate cancer patients who have already undergone radical prostatectomy but wish to have children, Brannigan can perform a simple procedure in which sperm is harvested from the testis or epididymitis. The harvested or cryopreserved sperm is then used during in vitro fertilization with intracytoplasmic sperm injection.
Reconstruction of the genitourinary tract is necessary when normal function of one or more of its components are impaired. One of the most common scenarios necessitating genitourinary reconstruction is tissue damage that occurs following cancer treatment, specifically surgical and radiation treatment for prostate cancer. Research estimates that up to 11 percent of patients undergoing radiation for prostate cancer will encounter radiation-induced strictures in addition to 3 to 25 percent of prostatectomy patients. Urethral strictures result in approximately 5,000 inpatient visits annually and may result in significant deterioration of quality of life if left untreated. Surgery is the only proven treatment for urinary stricture disease, with success rates of greater than 95 percent in experienced academic centers like Northwestern Memorial Hospital.
Bladder Health Optimization
Patients with genitourinary malignancies may experience urinary issues following cancer treatment. These conditions include incontinence, frequency, urgency and incomplete bladder emptying. Incontinence risk increases among patients with prostate and bladder cancers and is a common side effect following surgery for prostate or bladder cancer. The Department of Urology has a longstanding history of achieved breakthroughs in the understanding and treatment of these common urological conditions. Our urologists provide extensive follow-up care to optimize bladder health among urologic cancer patients, including education on exercises known to strengthen muscles associated with urinary continence or medication to improve urinary flow and treat bothersome bladder symptoms. Patients with persistent urinary incontinence are referred to our fellowship-trained urologists in pelvic medicine and reconstructive surgery to explore surgical options to improve urinary function.