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How Does Prostate Cancer Affect You Sexually

If You Have A Partner

Dr. Jim Hu – How Does Prostate Cancer Affect a Man’s Sexual Function?

If you have a partner, talking openly with them can help you feel closer. It can also help you make changes to your sex life together. Talking about things can help you avoid misunderstandings and find ways to cope with problems.

There are different ways you can show your partner you care about them. This can include spending time together and showing affection through touching, holding hands or putting an arm around their shoulder. You may also find new ways to share sexual pleasure.

Talking to a counsellor or sex therapist may help you and your partner adapt to changes in your sex life. You can ask your partner to come to appointments with you. This will help them understand the issues you are dealing with.

Management Of Erectile Dysfunction

Oral medications relax the muscles in the penis, allowing blood to rapidly flow in. On average, the drugs take about an hour to begin working, and the erection-helping effects can last from 8 to 36 hours.

About 75% of men who undergo nerve-sparing prostatectomy or more precise forms of radiation therapy have reported successfully achieving erections after using these drugs. However, they are not for everyone, including men who take medications for angina or other heart problems and men who take alpha-blockers.

Erectile Dysfunction Recovery After Treatment

You may be offered an ED recovery package soon after treatment. This is usually called penile rehabilitation. You regularly use one or more treatments, such as tablets or a pump, to encourage blood flow to the penis after surgery or radiotherapy. This is to help the penis recover it is not just for sex. When you are ready to start having sex, you should have a better chance of getting an erection. Your doctor or nurse can tell you more about this.

We have more information on managing ED.

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Can Anything Be Done For Erectile Dysfunction Caused By Prostate Cancer Treatment

Yes, there are things you can try if you have erectile dysfunction after your prostate cancer treatment. You should keep in mind that the following things will affect your ability to have an erection after your prostate cancer treatment:

  • How good your erections were before your treatment
  • Other medical conditions you have like high blood pressure or diabetes
  • Some types of medicines you may take such as medicines for high blood pressure or antidepressants
  • Things you do in your life such as drinking or smoking
  • Your age
  • The type of prostate cancer treatment you had

It is important that you and your partner speak with your doctor or healthcare team about what you can do. Your doctor or healthcare team will speak with you about what might work best for you if you have erectile dysfunction. It is important that you speak with them since some treatments for erectile dysfunction can affect other medical problems you may have.

Types of treatment for erectile dysfunction include:

  • Penile implants. It is normal for your doctor to try and treat your erectile dysfunction with medicine or external medical devices first. If these options dont help you get an erection, you may want to talk to your doctor about the chance of getting a penile implant. A penile implant is a medical device put in your penis during an operation. The implant will help you have a mechanical erection .
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    Assuming the management of erectile dysfunction requires expert diagnosis and treatment.

    Diagnosis includes sexual function history, general medical history, psychosocial history, medication history, physical examination, and appropriate laboratory testing.

    Treatment follows diagnosis, and we provide a range of treatment options through the Clinic. Minimally invasive treatment options range from oral medications to medications administered directly to the penis to a mechanical vacuum device applied to the penis. Invasive treatments include implants or vascular surgery. We are particularly expert in the surgical treatment of patients with erectile dysfunction. The range of conditions we manage include penile prosthesis complications, penile vascular abnormalities, penile curvature, and abnormally prolonged erection consequences.

    Psychological treatment is an important adjunct to managing erectile dysfunction. If our diagnosis suggests a psychological association with your erectile dysfunction, we may recommend that you pursue counseling with a qualified psychologist available through the Clinic.For instance, there may be relationship problems that negatively affect sexual functioning with your partner. Referrals can be made to the Johns Hopkinsâ noted Sexual Behaviors Consultation Unit.

    Prostate health issues such as benign prostatic hyperplasia and prostate cancer affect hundreds of thousands of men in the United States every year.

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    Other Medications And Devices

    Although medications like sildenafil and tadalafil are effective for many men with post-surgery erectile dysfunction, they arent the best choice for everyone.

    If your prostatectomy causes damage to the nerves near your penis, or if you take medication for hypertension, angina or other health conditions, using an oral ED medication may not be a suitable option for you.

    In this case, your healthcare provider may recommend a different type of medication or a device to help you achieve an erection. Your options may include:

    • Penile injection therapy. This involves using injectable medications to stimulate blood flow and improve your erections. These medications are typically administered using a very small needle to minimize discomfort.Although this treatment method may sound unpleasant, its relatively simple to use and has a success rate of 70 percent to 80 percent.

    • Vacuum constriction devices . Also known as a penis pump, a VCD works by creating a vacuum around your penis. This draws blood into your penis and allows it to become erect.

    Is Erectile Dysfunction Treatable

    Though erectile dysfunction is a major concern for the affected men, the good news is that it can be easily and successfully treated. Due to the advancement in urological medicine, there are now available multiple treatment options for ED. To determine the best method in your own case, you will need first to consult your doctor. The underlying cause will mainly determine the appropriate treatment. Some of the common ED treatments are:

    • Oral medication

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    Treating Erectile Dysfunction With Shockwave Therapy

    For over four decades, shockwave therapy has been used to treat patients with heart problems, kidney stones, fractures, and joint inflammation. Recently, researchers found that it could help men improve their sex life. Since this discovery, it has become one of the most preferred treatments for ED.

    Shockwave therapy uses low-energy frequencies from acoustic waves to trigger a process known as neovascularization in the targeted parts of the body. This will help improve blood flow to the area, which is a critical factor in erectile function. Most of the physical conditions that cause ED typically form plaques that block blood flow to the penile arteries. The therapy combines its repairing and regenerative effects first to remove the plaque and then stimulate a re-growth process of new and healthy blood vessels.

    Talking With Your Partner

    How does prostate cancer treatment impact sexual functioning?

    Most men find that their sex life is different after prostate cancer treatment. Some men question their manliness when they cannot have an erection or find that they are not interested in sex. This can happen even if you are not currently in an intimate relationship.

    You may find this upsetting. Even if one of the medications or erection aids is helpful, having sex using these things may take some getting used to. It may not feel entirely natural. You can talk with your doctor or healthcare team about these feelings. Counseling may also help.

    This may seem unnecessary in long-term relationships as people tend to assume they know all there is to know about their partner but this is not always the case. With time, you and your partner may be able to find satisfying ways to have a sex life even though you have erectile dysfunction. Your partner will also have concerns about your sex life as well as concerns about your health. Talking about your feelings is very important during this time.

    If you have an intimate partner, it is important for you to talk to your partner about how you are feeling. There is an old saying that a problem shared is a problem halved. Not everyone wants a sexual relationship. Dont try to guess or assume what your partner wants. Have an open and honest discussion with your partner.

    If you are not sure how to begin a conversation with your partner, consider using the questions below as conversation starters.

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    Questions To Ask Your Doctor Or Nurse

    • How could my prostate cancer treatment affect my sex life?
    • How soon after treatment can I masturbate or have sex?
    • Which treatments for erection problems would be best for me? Can I get them on the NHS?
    • Is there anything I can do to prepare myself before I start my prostate cancer treatment?
    • What happens if the treatment doesn’t work? Are there others I could try?
    • What other support is available to me?
    • Can my partner also get support?

    Current Psa Screening Recommendations

    PSA-based screening refers to testing healthy men without symptoms.

    Until recently, physician societies disagreed on screening recommendations, but with the publication of the U.S. Preventive Services Task Force Guideline in May 2018, all the major physician groups are broadly in agreement, including the American College of Physicians , the American Cancer Society , American Urological Association , and American Society of Clinical Oncology :

    • They advise supporting men so that they make informed decisions about screening that reflect their personal preferences and values.
    • Routine screening is not recommended in men between ages 40 and 54 of average risk.
    • For men ages 55 to 69 years, the U.S. Preventive Services Task Force concluded with moderate certainty that the net benefit of PSA-based screening is small for some men, making the decision up to the judgment of the physician and the values of the patient.”
    • For men 70 years and older, they recommend against routine screening because the expected harms are thought to outweigh the benefits.
    • Your doctor should not screen you unless you express a preference for it.
    • A discussion of the benefits and harms of screening should include a family history of prostate cancer, race or ethnicity, any medical conditions that affect your overall health and lifespan, and your values about risk and benefit.
    • If you have less than a 10-year life expectancy, screening is not recommended.

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    What Is A Prostatectomy

    A prostatectomy is a surgical procedure in which part or all of your prostate gland is surgically removed from your body. Its usually carried out to treat advanced benign prostatic hyperplasia or prostate cancer.

    Your prostate is a small gland thats located between your penis and your rectum. Its roughly the same size as a ping-pong ball and plays a key role in your reproductive health by creating the semen that mixes with your sperm before you ejaculate.

    Prostatectomy surgery is generally described as simple or radical. In a simple prostatectomy, the inner part of the prostate gland is removed through an incision thats made in your lower abdomen. This type of procedure is usually performed to treat prostate enlargement.

    In a radical prostatectomy, your entire prostate gland and some of the surrounding tissue may be removed. This type of procedure is usually performed to treat prostate cancer.

    Stem Cell Transplant Effects On Erections

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    Stem cell transplant involves getting very high doses of chemotherapy drugs. One complication of a transplant is graft-versus-host disease. Men who have had graft-versus-host disease are more likely to have a long-lasting loss of testosterone. In some cases, these men may need testosterone replacement therapy to regain sexual desire and erections.

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    Brachytherapy And Sexual Function

    Unlike conventional radiotherapy, which may cause radiation-induced side effects, like inflammation in the tissues near the cancer tissue due to radiation, brachytherapy only irradiates the cancer tissue, reducing this complication. Brachytherapy has been widely used in the USA and Europe for the past 10 years. Now, it accounts for approximately 30% of the early treatment of prostate cancer. After prostate cancer surgery, incontinence, a common postoperative complication, occurs in 50~90% of patients who undergo the operation, and above all, erectile dysfunction may occur in 10~90% of patients who undergo such surgery. Thus, many patients who undergo such surgery suffer from inconvenience in their daily living after the surgery. In the case of brachytherapy, urinary incontinence and erectile dysfunction occur in 0.6% and 14~35% of patients, respectively, who undergo it. Thus, the frequency of erectile dysfunction is significantly lower in the brachytherapy group than in the conventional surgery group.

    Cancer Treatments May Cause Sexual Problems In Men

    Many problems that affect a mans sexual activity during treatment are temporary and improve once treatment has ended. Other side effects may be long term or may start after treatment.

    Your doctor will talk with you about side effects you may have based on your treatment:

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    How May Erectile Dysfunction Affect My Sexual Relationships

    Prostate cancer and its treatment can affect your desire for sex. Every man is different but the feelings caused by having cancer and the physical stress of treatment can affect the way you feel about your body and your relationships. Some men talk about feelings of a loss of their role within the partnership or family. This can sometimes affect a mans self esteem and confidence. For others, the physical effects of treatment may lead to tiredness and a lack of energy. Physical changes after some treatments can also affect the way you feel about your body and appearance . All of these things may result in a lack of interest in sex.

    If you are feeling tired or under stress, tell your partner how your feel. Loss of interest in sex does not mean you lose interest in a loving and supportive relationship. There are ways to remain physically intimate without having sex. If you are used to a close physical relationship, it is important to remember that hugs, cuddles and kisses maintain intimacy, provide support, and do not have to lead to sex.

    Can Prostate Cancer Be Transmitted Sexually

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    Is prostate cancer really sexually transmitted? When a partner has prostate cancer, it is normal to consider the possibility whether the prostate cancer be transmitted through sexual contact. Although, women do not have prostate gland, but they do have gland known as Skenes gland situated at the inferior end of the urethra. Skenes gland is considered a rudimentary gland similar that functioned similar to a prostate gland in embryo, but regresses in females. These glands are of various sizes and shapes in different women. Although, very rare, there have been reported cancerous cases of Skenes gland. The tumor cells have been known to produce PSA , similar to tumors of prostate gland.

    Regardless of whether there is a link between prostate cancer and sexually transmitted diseases, it is highly unlikely that a woman would extract prostate cancer from her partner. Even if it is hypothesized that prostate cancer is sexually transmitted, the moment it is transmitted to a different body/host the immune system will fight out the foreign cancer cells.

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    The Prostate Gland And Prostate Cancer

    The prostate gland is a male reproductive organ that sits around the urethra, the outlet tube for urine, just below the bladder. The glands surface is usually smooth and regular. The prostate is about the size of a walnut.

    The prostate gland releases a clear fluid into the urethra that represents up to a third of the semen during ejaculation. One of the functions of the fluid is to carry the sperm and help sperm movement.

    The prostate also helps the drive of semen during ejaculation.

    Can I Lower The Risk Of Prostate Cancer Progressing Or Coming Back

    If you have prostate cancer, you probably want to know if there are things you can do that might lower your risk of the cancer growing or coming back, such as exercising, eating a certain type of diet, or taking nutritional supplements. While there are some things you can do that might be helpful, more research is needed to know for sure.

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