Erectile Dysfunction And Prostate Cancer Treatment

It has been a well-recognized myth that the treatment of prostate cancer leaves the man with permanent erectile dysfunction; thereby making their sex life difficult. Research and clinical study indicates that a man undergoing treatment for prostate cancer should always prepare himself for the possible erectile dysfunction and even though this treatment induced ED is not avoidable; you can still ensure sexual pleasure in your life as well as intense orgasms with simple lifestyle modifications and therapies.

Most Prostate Cancer Treatments Are Equally Effective

Prostate cancers can be diagnosed at an earlier stage (before the cancer spread outside the gland), if you get your prostate examination at regular intervals (at least once in 6-12 months after 40 years of age). Early diagnosis leads to good prognosis and speedy recovery. According to American Cancer Society, approximately 239,000 new cases of prostate cancer were diagnosed in the year 2013, out which 30,000 patients died of cancer related complications, despite advanced diagnostic and treatment strategies (i.e. prostate cancer has a high mortality rate of about 13%).

Removal of early stage prostate cancer can be done in one of the three following ways:

• Radical prostatectomy – removing prostate gland tumor via surgery. This approach is usually utilized for localized tumors with restricted disease.
• Seed implantation – a radioactive pallet is inserted inside the prostate tissue. Once implanted, the radioactivity can degrade or destroy the cancer cells
• External beam – the prostate gland is exposed to radiations via an external source

According to a new study conducted at M.D. Anderson Cancer Center, scientists evaluated 2,991 men receiving different treatments for prostate cancer. Among which 1,034 had undergone radical prostatectomy, 950 received seed implantation while external beam radiation was advised to 785 men. In addition, a combination of seed implantation and external beam radiation was suggested for 222 subjects. The 5-year survival rate for different groups was found to be:

• 81% in radical prostatectomy
• 81% in external beam radiation group
• 83% in seed implantation group

The survival rate was found to be 77% in study participants who received combination treatment. Thus, all treatments are almost equally effective.

Risk Factor For ED After Treatment

The risk for having erectile dysfunction after treatment of prostate cancer depends upon various factors including, location of tumor, severity, and luck! Besides theses, there are two main risk factors:

• Age: The older you are at the time of treatment, higher will be your chances of developing ED, afterwards.
• Type of treatment: Surgical treatment causes more cases of ED as compared to radiation therapy. Researchers at National Cancer Institute conducted a five- year follow up study on 1,187 men. 286 underwent radiation therapy, while 901 subjects opted for prostatectomy. Both groups showed decline in the sexual functioning, but it was more serious/ severe in those who had surgery. The prostatectomy induced erectile dysfunction develops soon after the procedure but some men may regain some degree of sexual functions, after some time.
• Nerve sparing surgery: The nerves responsible for generating erections surround the gland. When a person undergoes the surgery or radiation treatment, these nerves may either get severed or undergo serious injury. Nerve sparing surgery is a type of surgical procedure which can lower the ED risk significantly. Nearly 60 to 80% men have functional erections after nerve sparing surgery. However, the quality of erections is generally not the same as they once use to be before the procedure. Furthermore, nerve spare surgery cannot be performed, if tumor is located near the nerve.

Speak to your doctor if you still have questions about which treatment strategies are most helpful for your sex life.

References

• D'Amico, A. V., Whittington, R., Malkowicz, S. B., Schultz, D., Blank, K., Broderick, G. A., ... & Wein, A. (1998). Biochemical outcome after radical prostatectomy, external beam radiation therapy, or interstitial radiation therapy for clinically localized prostate cancer. Jama, 280(11), 969-974.
• Heidenreich, A., Bastian, P. J., Bellmunt, J., Bolla, M., Joniau, S., van der Kwast, T., ... & Mottet, N. (2014). EAU guidelines on prostate cancer. Part 1: screening, diagnosis, and local treatment with curative intent—update 2013. European urology, 65(1), 124-137.
• Resnick, M. J., Koyama, T., Fan, K. H., Albertsen, P. C., Goodman, M., Hamilton, A. S., ... & Van Horn, R. L. (2013). Long-term functional outcomes after treatment for localized prostate cancer. New England Journal of Medicine, 368(5), 436-445.