Supportive care for bladder cancer

Supportive care helps people meet the physical, practical, emotional and spiritual challenges of bladder cancer. It is an important part of cancer care. There are many programs and services available to help meet the needs and improve the quality of life of people living with cancer and their loved ones, especially after treatment has ended.

Recovering from bladder cancer and adjusting to life after treatment is different for each person, depending on the stage of the cancer, the organs and tissues removed during surgery, the type of treatment and many other factors. The end of cancer treatment may bring mixed emotions. Even though treatment has ended, there may be other issues to deal with, such as coping with long-term side effects. A person who has been treated for bladder cancer may be concerned about the following.

How a person feels about themselves is called self-esteem. Body image is how a person sees their own body. Bladder cancer and its treatments can affect a person’s self-esteem and body image. Often this is because cancer or cancer treatments may result in body changes, such as dealing with bladder problems or a urostomy. Some of these changes can be temporary. Others will last for a long time or be permanent.

For many people, body image and how they think other people see them is closely linked to self-esteem. It may be a real concern for them and can cause considerable distress. They may feel angry or upset, afraid to go out or feel uncomfortable around others, even if the effects of treatment may not show outside of the body.

Some women may feel differently about their bodies and themselves after a radical cystectomy, which includes removing the uterus. Changes in sexual function after surgery or radiation therapy may affect their self-esteem.

Counselling and emotional support can help you cope with changes in your body image and self-esteem.

Find out more about self-esteem and body image.

Loss of bladder control (urinary incontinence) is when you can’t control urine (pee) leaving your body. Some people have loss of bladder control after surgery or radiation therapy for bladder cancer.

There are several ways to manage and help cope with the loss of bladder control, including protective products, diet changes, exercises, medicines and surgery.

Find out more about urinary incontinence.

After surgery to remove the whole bladder (called a radical cystectomy), many people will need a urostomy to drain urine from the body.

Living with a urostomy may be frightening at first. It takes time and patience to learn to care for a urostomy. Specially trained healthcare professionals called enterostomal therapists teach ostomy care after surgery. They also offer support and advice after you are discharged from the hospital.

Local and national ostomy groups and associations provide support and information for people living with an ostomy.

Find out more about urinary diversions, including urostomies.

Some treatments for bladder cancer, including a radical cystectomy, radiation therapy and chemotherapy, can cause changes in sexuality and sexual function. Sexual problems depend on the type of treatment and affect men and women differently.

In men, treatments for bladder cancer may cause:

• dry orgasm (without semen) when the prostate gland is removed
• erectile dysfunction (also called impotence)

In women, treatments for bladder cancer may cause:

• infertility when the uterus and ovaries are removed
• treatment-induced menopause (including vaginal dryness) when the ovaries are removed or treated with radiation
• painful or difficult intercourse if part of the vagina is removed or radiation therapy causes vaginal narrowing

Counselling and education can improve sexuality and help people cope with these concerns. Supportive measures such as lubricants for vaginal dryness and medication such as hormone replacement therapy (HRT) help to manage treatment-induced menopause. There are several types of treatments available for erectile dysfunction including pills and implants.

Find out more about sexuality and cancer, as well as sexual problems for men and sexual problems for women.

Fertility problems can develop after treatment with a radical cystectomy, radiation therapy or chemotherapy for bladder cancer. These problems affect a woman’s ability to become or stay pregnant or a man’s ability to get a woman pregnant.

If you are concerned about fertility, talk to your doctor before treatment starts.

Find out more about fertility problems.

To make decisions that are right for you, ask your healthcare team questions about supportive care.