Dr. Brian Keith McNeil is the vice chair of the Department of Urology at SUNY Downstate Health Sciences University.

Dr. Brian Keith McNeil

Dr. Brian Keith McNeil talks about managing the emotional and mental health impact of prostate cancer for patients and caregivers.

A Holistic Look at Emotional Burdens After a Prostate Cancer Diagnosis

A prostate cancer diagnosis is not just a medical challenge; it also carries a heavy emotional burden for patients and their families, according to Dr. Brian Keith McNeil, who takes a holistic view of the disease.

Drawing on his personal experience, having lost his father to prostate cancer when he was a teenager, McNeil stressed the far-reaching impact of a diagnosis. As part of its Speaking Out video series, on behalf of ZERO-End Prostate Cancer, CURE spoke with McNeil, vice chair of the Department of Urology at SUNY Downstate Health Sciences University, about managing the emotional and mental health impact of prostate cancer for patients and caregivers.

McNeil said that when faced with a diagnosis, people often turn to “Dr. Google,” which can lead them down a dark path of worst-case scenarios. He added that if these mental health issues are not addressed, they can lead to depression and anxiety, affecting family structure, work performance and even a child’s schoolwork.

For caregivers, McNeil advised being empathetic, patient and present. He stressed that it is important to be willing to help and to ask questions. He also said that it is OK for patients and caregivers to not be OK, and that vulnerability is key to seeking help. If a patient or caregiver opens up to someone and doesn’t get the response they want, McNeil said there are others who can help.

McNeil recommended several resources for those struggling with a cancer diagnosis. He said support groups are incredibly helpful and can be found in person at community organizations or places of worship, as well as online. He also suggested that speaking with a therapist or other mental health professional can be beneficial.

When looking for information, McNeil urged people to be careful of what they find online. He recommended seeking information from trusted organizations like Zero-End Prostate Cancer, the American Urological Association and the American Cancer Society, which have vetted resources.

McNeil said that Zero-End Prostate Cancer has a variety of resources available to help patients and caregivers, including podcasts, online support groups, and one-on-one advisors. He emphasized that patients are not alone in their journey and that there are people and organizations available to help them get the care they need.

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As part of its Speaking Out video series, CURE talked to Dr. Brian Keith McNeil, on behalf of ZERO-End Prostate Cancer, about managing the emotional and mental health impact of prostate cancer for patients and caregivers.

As part of its Speaking Out video series, CURE talked to Dr. Brian Keith McNeil, on behalf of ZERO-End Prostate Cancer, about managing side effects following prostate cancer treatment.

How to Manage Side Effects After Prostate Cancer Treatment 

While treatment modalities for prostate cancer may cause a variety of side effects, there are ways to manage and improve these effects of treatment, such as urinary issues and erectile dysfunction to help improve quality of life.

According to Dr. Brian Keith McNeil, an open conversation with one’s healthcare team is the first step toward getting the help you need.

As part of its Speaking Out video series, on behalf of ZERO-End Prostate Cancer, CURE spoke with McNeil, vice chair of the Department of Urology at SUNY Downstate Health Sciences University, about managing side effects following prostate cancer treatment.

Urinary incontinence, or difficulty controlling the flow of urine, is a common problem after prostate cancer surgery. McNeil explains that this is because the muscles that control urine flow, called the sphincter, need time to recover. While this side effect almost always happens after surgery, he says it improves over time. He suggests that patients do Kegel exercises, which can help strengthen the pelvic muscles used to stop the flow of urine. This helps with what he calls "urinary rehab."

Erectile dysfunction is another common side effect, which can occur after surgery or radiation. McNeil reassures patients that “where there is a will, there is a way,” and a number of solutions are available. These include pills, injections, and even implants. He says it’s vital for patients to be open with their doctor about this. He understands it can be a difficult conversation because some men connect their manhood with their sexual performance. But he wants patients to know it's okay to feel vulnerable and ask for help.

Other side effects can include changes in bowel habits. McNeil recommends staying well-hydrated and increasing the amount of fiber in diet to help with these issues. He says fiber is key.

For men on hormone therapy, he notes that other side effects can include bone problems, mood changes and weight gain. Some men may also experience gynecomastia, or the growth of breast tissue. He advises patients to pay attention to these changes and discuss them with their doctor.

McNeil stresses the importance of having open communication with providers, adding that if they aren’t aware of a problem, they can’t help fix it. He recommends having a healthcare advocate, such as a family member or friend, attend appointments. He also suggests writing down questions before appointments and taking notes during the visit.

As part of its Speaking Out video series, CURE talked to Dr. Brian Keith McNeil, on behalf of ZERO-End Prostate Cancer, about navigating treatment option in prostate cancer.

Prostate Cancer Treatment Evolution: Focus on Patient Quality of Life

Advancements in prostate cancer treatment are helping patients achieve a better quality of life after surgery or radiation, according to Dr. Brian Keith McNeil. In a recent discussion, he explained that the goal of treatment is not only to address the cancer but also to return patients to their normal activities as much as possible.

As part of its Speaking Out video series, on behalf of ZERO-End Prostate Cancer, CURE spoke with McNeil, vice chair of the Department of Urology at SUNY Downstate Health Sciences University, about navigating treatment option in prostate cancer.

Surgery remains a key treatment, but techniques have improved. McNeil noted that surgeons can now better spare the nerves around the prostate, which has led to improved sexual function and less incontinence after the procedure. He also mentioned that when he thinks about cancer treatment, he considers both treating the disease and maintaining quality of life, which includes concerns like bathroom habits and sexual function.

For patients who choose radiation, treatments have also become more effective and convenient. McNeil said that instead of attending daily treatments for six to eight weeks, some patients can now complete their treatment in as few as five sessions over a few weeks. This change is due to doctors learning how to better target the cancer cells and minimize side effects.

For low-risk or some intermediate-risk cases, McNeil explained that active surveillance is an option. This involves a doctor actively watching the cancer through a series of tests, including prostate specific antigen (PSA) levels, biopsies, and MRIs. If the cancer changes over time, patients can then choose to have surgery or radiation.

Beyond localized treatments, McNeil discussed systemic therapies, which are medications that work throughout the body. Since prostate cancer cells often "feed on" testosterone, these therapies can decrease testosterone levels or target the testosterone receptors on the cancer cells. Chemotherapy is also used for some patients. He noted that genetics can play a role in a person's risk for prostate cancer, and genetic testing may be recommended for some, like young men with high-risk cancer.

McNeil urged patients not to rush into a decision after a cancer diagnosis. He advised them to take time to understand their disease, do research, and get a second opinion. He said he is most excited about focal therapy, a future treatment that would target only the cancer within the prostate to minimize side effects.

As part of its Speaking Out video series, CURE talked to Dr. Brian Keith McNeil, on behalf of ZERO-End Prostate Cancer, about understanding Gleason Score and prostate cancer risk.

Understanding Gleason Score During a Prostate Cancer Diagnosis

A Gleason score is a system used to help doctors understand a patient's prostate cancer. According to Dr. Brian Keith McNeil, this score is determined by looking at a sample of the prostate cells under a microscope to see how they are shaped and organized. The score typically ranges from 6 to 10.

As part of its Speaking Out video series, on behalf of ZERO-End Prostate Cancer, CURE spoke with McNeil, vice chair of the Department of Urology at SUNY Downstate Health Sciences University, about understanding one’s Gleason Score and how it relates to prostate cancer risk.

He explains that the score is often given as two numbers that are added together, such as 3+4=7. The first number represents the most common type of cancer cells found in the sample, and the second number represents the next most common type. This two-part score provides a more detailed picture of the cancer's makeup. McNeil notes that the lowest combined score a patient can receive is 6 and the highest score is 10.

The Gleason score is one of several tools used for risk stratification, a process of classifying a cancer as low, intermediate, or high risk. McNeil acknowledges, however, that doctors also consider other factors, such as the patient’s prostate-specific antigen (PSA) blood level and the results of a physical exam.

For patients with low-risk cancer, he explains that active surveillance may be an option. This means the cancer is less likely to spread quickly and can be watched closely with regular check-ups and tests rather than being treated immediately. McNeil adds that this approach helps reduce anxiety by showing that the cancer is being carefully monitored.

On the other hand, high-risk cancers are more likely to spread. For these patients, treatment is typically recommended. McNeil says that options often include surgery or radiation. In some cases, a combination of these treatments may be used. He also notes that hormonal therapy, which works by starving cancer cells of testosterone, is another potential treatment for high-risk patients.

To help navigate a diagnosis, ZERO-End Prostate Cancer has a variety of resources available, such as podcasts, virtual and in-person support groups, and a mentorship program that can provide guidance from diagnosis through treatment and recovery.

Dr. Brian Keith McNeil

A Holistic Look at Emotional Burdens After a Prostate Cancer Diagnosis

How to Manage Side Effects After Prostate Cancer Treatment

Prostate Cancer Treatment Evolution: Focus on Patient Quality of Life

Understanding Gleason Score During a Prostate Cancer Diagnosis

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