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 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 Prostate Cancer, the American Urological Association and the American Cancer Society, which have vetted resources.

McNeil said that Zero 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 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 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 Prostate Cancer, about managing side effects following prostate cancer treatment.

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 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 Prostate Cancer, about navigating treatment option in prostate cancer.

As part of its Speaking Out video series, CURE talked to Dr. Brian Keith McNeil, on behalf of ZERO-End Prostate Cancer, about the role of PSMA-PET Imaging versus PSA.

Breaking Down PSA and PSMA-PET for Patients With Prostate Cancer 

Prostate specific antigen (PSA) is a protein made by the prostate gland. According to Dr. Brian Keith McNeil, PSA is a key tool for screening for prostate cancer. However, it's important to know that both healthy prostate cells and cancerous cells release PSA.

McNeil, vice chair of the Department of Urology at SUNY Downstate Health Sciences University, explains that because of this, PSA is not a "perfect test." A high PSA level in a blood test doesn't automatically mean a person has cancer. Other things can cause an elevated PSA, such as an enlarged prostate, an infection or inflammation.

A different tool, called PSMA, or prostate specific membrane antigen, helps doctors find cancer that may have spread outside of the prostate. PSMA is a protein found on the surface of prostate cancer cells. The PSMA-PET scan is a type of imaging test that can be used to locate these cells and determine if cancer has spread to other parts of the body, like the bones or lymph nodes.

As part of its Speaking Out video series, on behalf of ZERO Prostate Cancer, CURE spoke with McNeil about about the role of PSMA-PET Imaging versus PSA.

McNeil notes that doctors typically use a PSMA-PET scan for patients with high-risk prostate cancer. When there is a strong possibility that the cancer may have spread based on other test results like the Gleason score or PSA, a PSMA scan can help confirm where the cancer is located.

Beyond finding cancer, PSMA is also being explored as a target for treating prostate cancer that has spread. According to McNeil, researchers are using this protein to create new treatments that can find and destroy prostate cancer cells in the body.

After a patient has been treated for prostate cancer, doctors continue to monitor their health by checking PSA levels on a regular basis. McNeil explains that if the PSA level begins to rise after treatment, it could signal that the cancer has come back. In these cases, a PSMA-PET scan can be used to pinpoint exactly where the cancer has returned, which helps doctors decide on the best next steps.

For patients, McNeil advises knowing key information about their diagnosis, such as the initial PSA level and Gleason score. He encourages patients to ask their doctor important questions like, “What is my risk category?” and “Would a PSMA-PET scan be helpful for me at this time?”

As part of its Speaking Out video series, CURE talked to Dr. Brian Keith McNeil, on behalf of ZERO Prostate Cancer, about the role of PSMA-PET Imaging versus PSA.

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

Breaking Down PSA and PSMA-PET for Patients With Prostate Cancer

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