An initial response to a diagnosis of prostate cancer can be to get rid of the cancer at any cost. However, treatments have improved, and quality of life after treatment should be considered before a treatment decision is made. Concerns about the impact a prostate cancer diagnosis and treatment might have on a previously healthy sex life must be addressed.
Prostate cancer and prostate cancer treatments can have side effects, including sexual and erectile dysfunction. Understanding how prostate cancer and its treatments might affect sexual function is important, both for patients and their partners, and it is a subject that people should feel confident to discuss with their doctors.
In this article, Consultant Oncologist Dr Jason Lester explores the intricacies of sexual health in the context of prostate cancer and shares his expert opinion on the options available to men that may help preserve this important aspect of life.
What role does the prostate play in sexual and urinary function?
The prostate gland serves primarily to produce and store seminal fluid, a key component of semen. During ejaculation, the prostate contracts, releasing this fluid into the urethra, where it mixes with sperm from the testes. Additionally, the prostate gland is integral to maintaining urinary continence, surrounding the urethra and contributing to urinary control.
Beyond its physiological functions, the prostate also influences sexual pleasure. Stimulation of the prostate can enhance sexual arousal and contribute to more intense orgasms. Thus, the prostate gland plays a key role in a man’s sexual health.
Is prostate cancer a cause of sexual dysfunction?
It’s important to note that experiencing sexual problems doesn’t necessarily imply the presence of prostate cancer. Many risk factors, both physical and psychological, can contribute to difficulties with sexual function in men.
These may include age-related changes, chronic health conditions like diabetes or cardiovascular disease, medications, lifestyle factors such as smoking or excessive alcohol consumption, and psychological factors such as stress, anxiety, or depression. Therefore, while sexual dysfunction can be a symptom of prostate cancer, it also has many other potential causes.
If sexual function is important to you, your doctor should ask you about it in detail. It is important to establish any concerns prior to having treatment for prostate cancer, as these may be helped with the right advice.
How can prostate cancer affect your sex life?
Tumours growing within or near the prostate can disrupt the normal functioning of the gland, affecting its ability to produce seminal fluid and potentially interfering with the nerves and blood vessels crucial for achieving and maintaining an erection.
Treatments for prostate cancer, for example, surgery (radical prostatectomy), radiotherapy (radiation therapy), and hormone therapy, can all contribute to sexual dysfunction by damaging nerves, reducing blood flow to the penis, or causing hormonal changes that affect libido (interest in sex) and erectile function.
Additionally, the psychological impact of a cancer diagnosis can contribute to changes in libido and sexual desire.
Can prostate cancer treatment lead to permanent sexual dysfunction?
The main aim of prostate cancer treatment is to eradicate prostate cancer cells, although while doing this, treatment can also impact sexual function. Whilst for some men, these effects may be temporary, for others, they can persist long-term.
When appropriate, certain measures can be taken to try and maintain sexual function. For example, nerve-sparing surgery aims to preserve erectile function, but this approach is not suitable for everyone.
Generally, men undergoing radiotherapy or proton beam therapy are more likely to maintain sexual function than those men having surgery, particularly if they do not receive hormone therapy (called androgen deprivation therapy or ADT) as part of their treatment.
ADT stops a man from producing testosterone, the male hormone. For some patients, ADT is an important part of their treatment. However, it will result in decreased libido and difficulty in maintaining an erection. The majority of men are unable to enjoy a normal sex life when on ADT. Once ADT stops, the side effects may improve, but this may take months or even years.
Learn more about the different prostate cancer treatments available here.
What prostate cancer treatments can preserve sexual function?
Your surgeon or oncologist should be able to suggest treatments that have minimal impact on the healthy tissue that is essential for preserving your sexual function and minimising the risk of erectile dysfunction.
Proton beam therapy (PBT) for prostate cancer is:
- Precise: It can deliver a sufficient dose of radiation to the tumour while minimising the dose to healthy tissue surrounding the prostate. This can help to reduce the risk of side effects, such as urinary incontinence and erectile dysfunction.
- Effective: PBT has been shown to be at least as effective as other treatments for prostate cancer.
- Safe: PBT is safe and well-tolerated, with a low risk of significant side effects.
In addition, Dr Jason Lester says: “Radiotherapy carries a risk of damage to the back passage (rectum), which in a proportion of men can cause a condition called chronic radiation proctitis. In a small number of men, this can be severe, resulting in diarrhoea, bleeding, pain, and incontinence, which may be permanent.
Men undergoing PBT will have a ‘spacer’ placed before treatment. A spacer is a small medical device that separates the rectum from the prostate. In my experience, the combination of a spacer plus PBT results in a very low dose of radiation to the rectum, and very few, if any men will have significant bowel problems after the treatment.”
How can you improve your sexual function with prostate cancer?
Men diagnosed with prostate cancer should be encouraged to have honest discussions with their healthcare team about any sexual concerns they may have before treatment is agreed upon. Different approaches may be equally effective at treating cancer but may have very different effects on sexual function.
Research suggests adopting a healthy lifestyle can positively impact sexual function when undergoing prostate cancer treatment.
If a man does suffer from problems with sexual function after prostate cancer treatment, there may be effective interventions that can help. Please discuss any concerns with the treatment team.
How can Proton International London help you?
Located at University College Hospital (UCH), Proton International London specialises in delivering private proton beam therapy for prostate cancer. Proton beam therapy is a form of radiotherapy that can be used to treat prostate cancer. It is delivered using a beam of positively charged particles called protons that can be precisely targeted to the cancer. This allows a high dose of radiation to be delivered to the cancer whilst minimising the dose to surrounding healthy tissue.
Our experienced radiation oncologists work closely with the first-class clinical team of radiographers and physicists from University College Hospital (part of University College London Hospitals NHS Foundation Trust) to provide private patients with the highest quality proton beam therapy treatment and care. Our doctors have a strong interest in clinical research, and we are constantly looking for new ways to improve the effectiveness and safety of PBT.
PBT is a good option for prostate cancer patients seeking an effective, safe treatment.
If you have been diagnosed with prostate cancer, are concerned about the impact treatment will have on sexual function and would like a second opinion, Proton International London and our team of oncologists are here to help.
Conclusion
Prostate cancer can present challenges to a man’s sexual function, but with the right information and care, patients can be supported to navigate this aspect of their journey with confidence.
It is important that men and their partners feel able to address any concerns openly from the outset when discussing treatment options for prostate cancer. Understanding the potential effects of cancer and its treatment can allow proactive measures to be put in place to help maintain sexual health. If in any doubt, just ask your doctor.
Proton International London is committed to providing personalised, innovative cancer care which is tailored to your needs.
Reach out for more information and discover how proton beam therapy can be a part of your prostate cancer treatment plan.
This article has been clinically reviewed by Consultant Clinical Oncologist, Dr Jason Lester. and Proton International Medical Director and Consultant Clinical Oncologist, Dr Beatrice Seddon.
