Prostate cancer is becoming increasingly common. For example, prostate cancer is now the fifth most common type of cancer in adult men in Korea. Experts suspect this rise is due to a combination of Westernized diets and better diagnostic tools.
Prostate cancer and its treatments can profoundly impact a man’s sex life, body image, and relationships. One of the most common concerns men have when facing prostate cancer treatment is how to preserve their ability to have erections.
Unfortunately, dealing with the impact of prostate cancer on sexual function isn’t always prioritized in cancer care. If you or a loved one is facing prostate cancer, it’s essential to understand the potential sexual side effects, treatment options, and available resources to help you cope.
In this article, we’ll discuss the ways prostate cancer can affect you sexually, the treatments that can help, and where to find support.
How does prostate cancer affect you sexually?
A prostate cancer diagnosis can impact your sex life in a number of ways. The psychological impact alone – the anxiety and depression that can come with facing a cancer diagnosis – can negatively affect your libido and how often you want to have sex.
But there are also direct physical side effects. Men frequently experience changes in their erections, sex drive, ability to ejaculate or have an orgasm, and even changes in the appearance of their penis.
These changes can also significantly impact a man’s self-esteem and sense of identity. It’s important to find support to help mitigate these effects, whether it’s through therapy, support groups, or talking with loved ones.
Finally, sexual difficulties can put a strain on relationships. Open and honest communication with your partner is crucial. It’s important for both of you to acknowledge the changes that are happening and to work together to find new ways to connect and maintain intimacy.
How Prostate Cancer Treatments Affect Sexual Function
Unfortunately, many prostate cancer treatments can affect your sexual function. It’s important to discuss these potential side effects with your doctor before deciding on a treatment plan. Here’s a breakdown of how different treatments can impact your sex life:
Radical Prostatectomy
A radical prostatectomy, which involves surgically removing the prostate gland, can often lead to erectile dysfunction (ED). This is because the surgery can damage the nerves responsible for erections.
The rate of ED after a radical prostatectomy varies widely, from 10% to 100%, depending on the specific study. Thankfully, surgical techniques have improved over the years to try and preserve the neurovascular bundle – the network of nerves and blood vessels crucial for erections.
Beyond erectile function, a radical prostatectomy can also impact orgasm and ejaculation. Many men experience “dry orgasms” after this surgery, meaning they can still feel the sensation of orgasm, but no semen is released. The surgery can also sometimes cause changes in the size and shape of the penis.
Radiation Therapy
Radiation therapy, which uses high-energy rays to kill cancer cells, can also lead to ED. The rates of sexual dysfunction following radiation range from 20% to 80%. Some studies report that about 50% of men are able to maintain erectile function after radiation therapy.
A frustrating aspect of radiation therapy is that ED can worsen over time. The damage to blood vessels and tissues caused by radiation can gradually impair erectile function years after treatment.
Brachytherapy
Brachytherapy involves implanting radioactive seeds directly into the prostate gland. Some studies suggest that brachytherapy may have a lower risk of ED compared to radical prostatectomy. Reported rates of ED after brachytherapy range from 14% to 35%.
Cryosurgery
Cryosurgery uses extreme cold to freeze and destroy cancer cells. While some studies suggest cryosurgery has a lower rate of sexual dysfunction than other options, more research is needed. Limited data suggests that about 39% of men recover sexual function after cryosurgery.
Hormonal Therapy (Androgen Deprivation Therapy)
Hormonal therapy, also known as androgen deprivation therapy (ADT), is a common treatment for prostate cancer that works by lowering the levels of male hormones (androgens) in the body. Unfortunately, ADT frequently causes sexual dysfunction.
A decreased libido (sex drive) is a common side effect of hormonal therapy. ADT can also make it more difficult for ED treatments to work effectively.
Minimally Invasive Treatments (LFT, TULSA-PRO)
Newer, less-invasive treatments like laser focal therapy (LFT) and transurethral ultrasound ablation (TULSA-PRO) aim to target the cancerous tissue while minimizing damage to surrounding healthy tissue. These treatments generally have a lower risk of ED compared to traditional treatments like radiation and radical prostatectomy.
Studies suggest that the risk of ED with LFT is less than 10%. For TULSA-PRO (when used to treat the entire gland), the risk of ED is around 25%.
Managing Erectile Dysfunction After Prostate Cancer Treatment
It’s important to remember that sexual function after prostate cancer treatment is a journey, and there are many avenues to explore. Don’t be discouraged if the first approach doesn’t work; persistence and open communication with your doctor are key.
Medical Treatments
There are several medical options available to help manage ED after prostate cancer treatment. These range from medications to more invasive procedures.
PDE5 Inhibitors
Drugs like Sildenafil (Viagra), Tadalafil (Cialis), Vardenafil (Levitra), and Avanafil (Stendra) are often the first line of defense against ED. But what about Erectile Dysfunction: New Drugs for Non-Responders? They work by increasing blood flow to the penis, making it easier to achieve and maintain an erection. However, they’re not a guaranteed fix and may not be effective for everyone, especially those who have had nerve-sparing surgery that wasn’t successful.
Intracavernosal Injections
Alprostadil is a medication that can be injected directly into the penis to cause an erection. While effective, it can have side effects, including priapism (a prolonged and painful erection). It’s not for the faint of heart, but it can be a good option for some.
Vacuum Constriction Devices
These non-invasive devices involve placing a tube over the penis and using a pump to create a vacuum, drawing blood into the penis. A constriction ring is then placed at the base of the penis to maintain the erection. It’s a less invasive option but may not be suitable for everyone.
Penile Prosthesis
For more severe cases of ED, a penile prosthesis (penile implant) may be considered. This involves surgically implanting inflatable or malleable rods into the penis. While it’s a more drastic step, it can provide a reliable solution for those who haven’t had success with other treatments. It’s worth noting that infections can occur after surgery. According to the Urology Care Foundation, about three out of 100 men who get an implant experience an infection.
Testosterone Replacement Therapy
The role of testosterone replacement therapy is evolving. While there were initial concerns about its potential to stimulate prostate cancer recurrence, more recent studies, like one published in The Journal of Urology, suggest that it may be safe for some men. Always discuss the risks and benefits with your doctor, especially if you have a history of aggressive prostate cancer.
Lifestyle Modifications
Don’t underestimate the power of a healthy lifestyle, including potentially incorporating pumpkin seed oils for prostate support and BPH relief. Maintaining a healthy weight, quitting smoking, and regular exercise can all positively impact sexual health and overall well-being. Exercise, in particular, can improve blood flow and reduce stress, both of which can contribute to better erectile function.
Important Considerations
- Hormone therapy, often used to treat prostate cancer, can decrease libido and may affect the effectiveness of some ED treatments.
- Nerve-sparing surgery, when successful, can improve the chances of recovering erectile function. However, it’s not always possible or effective.
- Some side effects of prostate cancer treatment, including ED, may improve with time. However, others may persist. Patience is key.
- It’s essential to explore various treatment options and to persist with treatment to find what works best for the individual.
Addressing Other Sexual Changes and Concerns
Erectile dysfunction isn’t the only sexual side effect men may experience during or after prostate cancer treatment. Other changes can occur, and it’s important to be aware of them.
Changes in Ejaculation and Orgasm
Some men experience changes in ejaculation and orgasm, including, what to expect after TURP, and how to manage it. Climax After TURP
- Retrograde ejaculation: This is when semen enters the bladder instead of being expelled from the penis during ejaculation.
- Climacturia: This involves leaking urine during orgasm.
- Pain during orgasm: Some men may experience pain or discomfort during orgasm.
Changes in Libido (Sexual Desire)
Libido, or sexual desire, can also be affected by prostate cancer and its treatments. Several factors can contribute to changes in libido:
- Hormone therapy: This treatment can significantly decrease libido.
- Psychological factors: Stress, anxiety, and depression related to the cancer diagnosis and treatment can impact libido.
- Tiredness: Fatigue from cancer treatment can reduce sex drive.
Penile Changes
Some men may notice physical changes to their penis after treatment, especially after a radical prostatectomy (surgery to remove the prostate). These changes may include:
- Penile shortening: Some men notice that their penis is a little shorter after surgery.
- Changes in penile sensitivity: Some men experience changes in sensation in the penis.
Impact on Fertility
Prostate cancer treatment can affect fertility. If you’re concerned about your ability to have children in the future, it’s important to discuss this with your doctor before starting treatment. Options to consider include:
- Sperm storage: You may be able to store sperm before treatment.
- Contraception: If you’re not trying to conceive, it’s still important to use contraception after treatment. Talk with your doctor about your best options.
Psychological and Relationship Impact
Let’s be real: prostate cancer and its treatments can really mess with your head and your relationships. It’s not just about the physical stuff; the emotional and psychological toll can be significant.
Emotional Well-being
It’s totally normal to feel down, anxious, or just plain off after a prostate cancer diagnosis. You might be dealing with a loss of self-esteem or struggling to redefine your identity. After all, your sexuality and how you view yourself as a man might feel like they’re under attack.
Coping Strategies
So, what can you do? First, acknowledge that these feelings are valid. Don’t try to tough it out alone. Talk to a therapist or counselor specializing in men’s health or cancer. Support groups can also be a lifesaver, connecting you with other guys who get what you’re going through. And lean on your loved ones – friends, family, your partner – for support.
Relationship Dynamics
Speaking of partners, open and honest communication is key. Talk about your fears, your concerns, and what you’re experiencing physically and emotionally. Explore different ways to be intimate and find pleasure. Sex might look different now, but that doesn’t mean intimacy is off the table. Remember, your partner is going through this too. They need support and understanding, so make sure they have access to resources and a safe space to share their feelings.
Addressing Specific Needs
It’s important to remember that everyone’s experience is unique. Gay and bisexual men might face specific challenges related to intimacy and sexual function. Single men might struggle with feelings of isolation and a lack of support. Whatever your situation, know that there are resources available to help you navigate these challenges. Don’t be afraid to seek them out.
Frequently Asked Questions
What is the biggest symptom of prostate cancer?
Actually, early prostate cancer often doesn’t cause any symptoms at all. When symptoms do appear, they can include frequent urination, difficulty starting or stopping urination, a weak or interrupted urine stream, blood in the urine or semen, and erectile dysfunction. But, it’s important to remember these can also be signs of other, less serious conditions.
What stage of prostate cancer is terminal?
There isn’t one specific stage that’s automatically considered “terminal.” The outlook depends on many factors, including how far the cancer has spread (stage), how quickly it’s growing (grade), and the person’s overall health. Generally, advanced or metastatic prostate cancer (stage IV) is more difficult to treat and manage.
How long can a man live with advanced prostate cancer?
Survival with advanced prostate cancer varies widely. With modern treatments, many men can live for several years, sometimes even longer, with a good quality of life. Factors like age, overall health, response to treatment, and the specific characteristics of the cancer all play a role.
Can men with prostate cancer take Viagra?
Maybe. Viagra (sildenafil) and similar medications (like Cialis and Levitra) can sometimes help with erectile dysfunction that results from prostate cancer treatment, such as surgery or radiation. However, it’s crucial to discuss this with a doctor, as these medications might not be suitable for everyone, especially those with certain heart conditions or taking specific medications.
How can I help my husband with prostate cancer?
Offer emotional support, attend appointments with him, help him manage side effects of treatment, encourage him to maintain a healthy lifestyle, and be patient and understanding. Prostate cancer and its treatments can be physically and emotionally challenging, so your support is invaluable. Taking care of yourself is also key – consider joining a support group for caregivers.
Putting It All Together
Prostate cancer and its treatments can have a range of sexual side effects, including erectile dysfunction, decreased libido, and changes in ejaculation. It’s important to remember that these effects are common, and there are ways to manage them.
One of the most important things you can do is talk openly and honestly with your healthcare team and your partner. Don’t be afraid to discuss your concerns and ask questions. They can help you understand your options and find the best way to address your specific needs.
There are many different treatment options available, and what works for one person may not work for another. You can also seek support and advice from specialist nurses or counselors who specialize in prostate cancer and sexual health.
Take an active role in your care. Understand the potential risks and benefits of different treatment options, and don’t hesitate to seek a second opinion if you’re not comfortable with the recommendations you’re receiving. Prioritizing your sexual well-being is an important part of overall health and quality of life.