Originally published: 2021 | Updated: March 2026
Reading Time: 6 minutes
Medically reviewed on: March 20th 2026 Dr Aqua Asif
Authors: Ms Clare Delmar. The Focal Therapy Clinic
At a Glance
Many men diagnosed with prostate cancer experience mental health challenges, sexual dysfunction, and incontinence — yet stigma prevents them from seeking support. At The Focal Therapy Clinic, our consultants believe that open conversations about these side effects are essential for better treatment decisions and quality of life. Modern focal therapy options now preserve sexual function in 90%+ of men and urinary continence in 97% (FTC audit, n=265), but awareness of all treatment outcomes starts with breaking the silence.
Key takeaways:
- Three taboo topics — mental health, sexual dysfunction, and incontinence remain under-discussed among men with prostate cancer
- 17% of cancer patients — experience depression during their cancer journey, with 73% receiving no adequate treatment for it
- Sexual health conversations — should happen before treatment decisions are made, including partners where appropriate
- Incontinence support — remains poorly communicated to men, with practical infrastructure (such as bins in male toilets) often lacking
- Treatment choice matters — focal therapy can significantly reduce the risk of these side effects compared to radical treatments
Why Are Men Still Afraid to Talk About Prostate Cancer Side Effects?
Prostate cancer is the most common cancer in men in the UK, yet many men remain reluctant to discuss the side effects that follow diagnosis and treatment — including mental health challenges, sexual dysfunction, and incontinence. At The Focal Therapy Clinic, we believe that breaking the silence around these experiences is essential for helping men make informed treatment decisions and maintain their quality of life.
Campaigns like Movember have helped bring men’s health taboos into public conversation. But for the thousands of men diagnosed with prostate cancer each year, the stigma surrounding treatment side effects can be just as isolating as the diagnosis itself.
Elvin Box, Movember ambassador and prostate cancer survivor, is a leading voice in the campaign to normalise conversations about prostate cancer side effects. He spoke to The Focal Therapy Clinic about how he uses his experience to inspire men across the country to speak openly about their health:
“I am lobbying for what every person with a prostate should receive — better and quicker diagnosis of prostate cancer, that leads to undergoing treatment that results in just a minor impact upon the quality of life enjoyed by the victims.”
His mission aligns with the approach taken at The Focal Therapy Clinic, where treatment options such as HIFU (NICE-approved, IPG424) and NanoKnife IRE (NICE-approved, IPG768) are designed to treat prostate cancer while preserving quality of life — with 90%+ sexual function preservation and 97% urinary continence (FTC audit, n=265).
Three side effects of prostate cancer treatment remain particularly stigmatised: anxiety and depression, sexual dysfunction, and incontinence. These conditions affect a significant proportion of men treated for prostate cancer — yet they are rarely discussed openly, leaving many men isolated and unsupported.
The rate at which men experience these side effects varies significantly depending on the treatment they receive. Radical surgery carries the highest risk of permanent incontinence and erectile dysfunction, while focal therapy approaches preserve sexual function in 90%+ of men and urinary continence in 97% (FTC audit, n=265). Understanding these differences is why open conversation matters.
How Does Prostate Cancer Affect Mental Health?
Depression and anxiety are common among men diagnosed with prostate cancer, yet the majority receive no adequate treatment for these conditions. Approximately 17% of cancer patients experience clinical depression during their journey — and prostate cancer patients are no exception. The stigma around discussing mental health compounds the problem, leaving many men to cope alone.
Oncological Psychiatrist Dr Asanga Fernando, who works at St George’s Hospital London, shared the scale of the problem with The Focal Therapy Clinic:
“I think a really damning statistic of our time is that 73 percent of cancer patients diagnosed with depression don’t receive any adequate evidence-based treatment for their depression. Cancers across the board, about 17 percent of cancer patients suffer with depression at some point during their cancer journey. We know for prostate cancer, it’s about that.”
Dr Fernando believes mental health support needs to be better integrated into clinical practice — measuring patient quality of life as a marker of treatment effectiveness, not just cancer control rates.
“As a clinical community we need to drive a shift in culture towards measurement of patient quality of life as a marker of treatment effectiveness. This involves thinking innovatively and more effectively integrating mental health and psychological wellbeing into routine cancer services.”
This principle of prioritising quality of life is central to The Focal Therapy Clinic’s approach. Focal therapy aims to treat the cancer while preserving the functions that matter most to patients — reducing the psychological burden of treatment-related side effects.
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Why Is Sexual Dysfunction After Prostate Cancer So Stigmatised?
Sexual dysfunction is one of the most feared side effects of prostate cancer treatment, yet it remains one of the least discussed. Many men feel unable to raise concerns about erectile dysfunction with their clinicians, and some report they would decline curative treatment rather than lose sexual function. At The Focal Therapy Clinic, sexual function preservation is a core treatment goal — our audit data shows 90%+ of men maintain erectile function after focal therapy (FTC audit, n=265).
Psychosexual specialist Lorraine Grover told The Focal Therapy Clinic what men have shared with her following diagnosis:
“A lot of men have said to me over the years that they would rather be sexually potent than not being sexually active and having their cancer cured — which is so sad to hear when actually, if the subject was raised with them, they would know that there are lots of things to be considering about sexuality and prostate cancer.”
Lorraine believes discussions about sexual health need to happen before treatment decisions are made — and should include partners where appropriate:
“People need a safe environment to be able to talk about their sex lives with a healthcare professional. Partners need the opportunity to talk about the impact prostate cancer has had on their relationship — their fears, their own health challenges. A diagnosis upsets the apple cart, and couples need support to navigate that together.”
How Does Incontinence Affect Men After Prostate Treatment?
Urinary incontinence after prostate cancer treatment can be life-altering, yet it remains one of the least openly discussed side effects. Many men are unprepared for incontinence following radical prostatectomy, and the stigma prevents them from seeking help. At The Focal Therapy Clinic, less than 2% of patients experience urinary incontinence following focal therapy — a 97% continence rate (FTC audit, n=265) — significantly lower than the rates associated with radical surgery.
Pelvic health specialist Jane Simpson shared what patients have told her about the gap in communication around male incontinence:
“A patient recently told me: ‘Like most men, when things go wrong below the belt, I was overcome with squeamish embarrassment and told no one.’ He ended up having a radical prostatectomy and developing stress incontinence. As he put it: ‘Female stress incontinence is discussed quite openly, even with jolly little TV ads. But nothing is ever said about the male version.'”
Jane added that practical infrastructure failures reinforce the stigma — including the absence of bins in men’s toilets for disposing of incontinence pads:
“Male loos don’t have bins in them. If you’ve got a wet pad, you’ve got to put it in your jacket pocket. Men don’t carry handbags! Access to public loos is something men never think about before they’ve had this issue — and suddenly it becomes actually quite important.”
What Can Be Done to Break These Taboos?
Breaking the taboos around prostate cancer starts with open conversation — between patients and clinicians, between partners, and within the wider community. At The Focal Therapy Clinic, we believe that understanding the full picture of treatment outcomes helps men make better decisions about their care.
| Outcome | Focal Therapy (FTC data) | Radical Prostatectomy |
|---|---|---|
| Sexual function preserved | 90%+ | 30–70% |
| Urinary continence | 97% (FTC audit, n=265) | 80–95% |
| Recovery time | 1–2 weeks | 4–6 weeks |
| Hospital stay | Day-case (home same day) | 1–3 nights |
Source: FTC one-year outcome audit (n=265) and published literature
If you or someone you know is dealing with the side effects of prostate cancer treatment — or facing a treatment decision — speak to our team. We are here to listen, answer your questions, and discuss whether focal therapy could be right for you.
Call us: 0207 036 8870 | Email: info@thefocaltherapyclinic.co.uk
