Erectile dysfunction is the inability to achieve and/or sustain an erection adequate for sexual intercourse. A concern for many men with a diagnosis of prostate cancer is whether or not they will still be as sexually functional as they were prior to having received treatment. It can be both physically and emotionally taxing to cope with.  It’s important to understand that prostate cancer is not the direct cause for erectile dysfunction, although certain treatments for the disease can directly cause the condition. 

Prostate cancer treatments linked to erectile dysfunction

Radical prostatectomy: A surgical procedure which involves the removal of the entire prostate gland and the surrounding tissue.

Radiation therapy: Incorporates the use of high-energy radiation (gamma rays, x-rays) to minimize the size tumors and to kill cancerous cells. Another method is brachytherapy (radioactive seed implant) which is administered internally on the site or near the cancerous cells.

Hormone therapy: Also known as androgen deprivation therapy and works by depriving the cancer of the male hormone testosterone. This done by using estrogen to counter the effects of testosterone or by the surgical removal of the testicles where testosterone is produced through a surgical procedure called an orchiectomy.

 Symptoms for erectile dysfunction and their severities will vary from patient to patient.  A few men may experience a complete inability to achieve an erection, while others may only be able to sustain an erection for a short period of time. Erectile dysfunction is fairly common but estimating the frequency is difficult due to the varying severities. However, researchers have estimated that nearly 40% of men suffer from the condition. The most common symptoms of erectile dysfunction include:

●      Difficulty achieving an erection

●      Difficulty maintaining a sufficient erection for sexual intercourse

●      Diminished sexual desire

 Treatment for erectile dysfunction for patients who have been treated for prostate cancer varies. As each patient is different a determination will be made by your doctor as to your best options based on your specific needs. Options include:

Medications: FDA approved oral medications used to treat erectile dysfunction include: Cialis, Viagra, Levitra, Stendra and Staxyn. All medications essentially work by increasing the blood flow to the penis thereby allowing a man to achieve an erection.

Alprostadil: A medication which causes blood vessels to expand increasing blood flow thereby allowing a man to attain an erection. This specific medication can be administered either by a direct injection to the penis or as a suppository. If given as a suppository the medication is inserted into the tip of the penis.

Vacuum Constriction Device (VCD): A VCD is an external pump comprised of an acrylic chamber with a pump that is attached at the end. A band is located on the other end and is attached to the penis. The pump is used to create a vacuum within the cylinder to help achieve and maintain an erection with the aid of the band.