Prostate cancer’s effect on men’s sexual health

For the year 2018, the American Cancer Society estimates that close to 165,000 men in the United States will be given a diagnosis of prostate cancer.  Prostate cancer is the second most common cancer in American men (skin cancer ranks first among men).  Fortunately, survival xrates have increased over the years.  In 1975, only 68% of men with prostate cancer survived for five years.  In 2012, the rate increased to 99%, a tremendous jump thanks to medical advances and early detection.  In comparison, a five-year survival rate for colon cancer only advanced from 50% to 66% during that same time period.

Surviving any diagnosis of cancer is always good and the more men who can be treated and saved with prostate cancer, the better.  But with this higher survival rate comes adjustments. One adjustment for men effects their sexual functioning.  It is not uncommon this area of a man’s life for there to be challenges.  Some of these sexual dysfunctions may only occur for a short time and sometimes longer.

Sexual problems in the short term

Some of the sexual issues men may develop immediately after treatment include:

·      Reduced sexual interest

·      Fatigue and trouble moving

·      Pain

·      An inability to resume sexual activity

·      Depression and anxiety

·      Relationship problems

When a man comes home after treatment for prostate cancer he may find himself more tired than usual and have little interest in having sex. 

Other sexual issues within the first year after prostate cancer treatment may include:

·      Erectile dysfunction

·      Ejaculatory disorders

·      Incontinence

·      Low desire

·      Poor body image

Why can cause sexual problems to occur?

There can be a variety of reasons why some men may have certain sexual problems after prostate cancer. Keep in mind, every man diagnosed with prostate cancer is unique with some men having several sexual issues while other men are barely affected. 

Usually the cause of sexual problems may result from the cancer itself or the treatment or a combination of both.  Here are some considerations:

·      The location and extent of the cancer – If a man’s prostate cancer has spread beyond his prostate to other body parts, there is a greater likelihood of developing sexual dysfunction. 

·      Types of therapy – Surgery, radiation, hormone therapy, and chemotherapy can affect a man’s body in different ways.  For example, surgery can affect ejaculation and urinary function.  Hormonal therapy could reduce libido.  Chemotherapy may leave a man exhausted. 

·      His doctor’s expertise – Men with prostate cancer usually have several doctors working on him as a team and some will be more experienced than others.  If a man with prostate cancer had his prostate gland removed surgically, there are nerves needed for an erection to occur.  Surgeons will do their best not to disturb these nerves but the more skilled they are, the better they will be.

·      A man’s age – As men get older, it is natural to have some sexual problems arise regardless whether he has prostate cancer or not.  Erectile dysfunction is a good example of this.  Men who have never had prostate cancer and yet can develop erectile dysfunction.  Men with diabetes or heart disease are also at a greater risk of developing erectile dysfunction. 

·      Sexual function before treatment – If a man had good sexual function before treatment he is more likely to have that preserved after treatment.  For men who were able to get and maintain a firm erection before cancer has a better chance of recovering erectile dysfunction after treatment.

What can men do to minimize sexual problems?

Men who are diagnosed with prostate cancer should know they are not alone and many men have experienced the same things he is going through.  Sexual challenges may seem overwhelming, but there are some suggestions on how to cope and get through these challenging times to get back on track with their sex life:

·      Talk to your healthcare team – A man’s healthcare team is there for him to answer questions and recommend how to solve sexual issues.  Their solutions can be tailored for each man for some, it might mean medication for erectile dysfunction or counseling for sexual anxiety.

·      Talk to your partner – Avoid bottling up feelings.  Share with your partner that you miss intimacy and express your feelings openly with them.

·      Ask for help – All cancer patients will have side effects from their treatments.  One common side effect is extreme tiredness.  No one expects you to do it all like you did before cancer.  Ask for help from family members and remember each day that goes by, you will become stronger and less tired.

·      Maintain a healthy lifestyle – Once you are given permission to do so, start exercising. Joining a gym enlisting a personal trainer or working out with others can be motivating to get back in shape. Also pay attention to your diet by making healthy food choices. 

·      Consider a sex therapist – If a sexual issue is not resolving itself after some time has passed, it may be time to seek out professional help.  A sex therapist specializes in enhancing communication with your partner and setting realistic goals for sex.

·      Consider a prostate cancer support group – Talking with other men who have experienced the journey of prostate cancer is a valuable way to share information, get advice, and feel some camaraderie.