Cancer
of the prostate gland and its treatment can leave men having difficulties with
sex. Problems range from being unable to get an erection to losing sexual
desire.
This article may help to improve sex life by explaining
the role of the prostate and how it can be affected by cancer treatment.
The
information should be helpful in setting out expectations for sex life, both
for the patient and their sex partner.
Healthcare
professionals working in this field are aware of the issues involved, and they
can offer professional help.
Contents
of this article:
Prostate gland
and prostate cancer
The
prostate gland is a sex organ found in men. This male reproductive organ sits
around the urethra, the outlet tube for urine, just below the bladder. The
gland's surface is normally smooth and regular. The prostate is about the size
of a walnut.
The prostate
gland is part of the male reproductive system.
The prostate gland releases a clear
fluid into the urethra. It represents up to a third of the semen during
ejaculation. One of the functions is to carry the sperm and help sperm
movement.
The
prostate also helps the drive of semen during ejaculation.
What is
prostate cancer?
After skin
cancer, prostate
cancer is the most
common cancer in men in
the United States, according to the Centers for Disease Control and Prevention
(CDC).
Prostate cancer happens when cells of the gland divide
uncontrollably. This leads to a lump, a tumor.
Thousands of men die in the U.S. every year from prostate
cancer, but the CDC point out that most
men who have
prostate cancer are over 65 years of age, and they usually die from something
else instead.
The Cleveland Clinic say up to 80 percent of men over 80 years of age would show
signs of prostate cancer revealed by tests after death.
Symptoms of
prostate cancer
Symptoms
do not often occur with prostate cancer. When they do, they may include:
§ Weak or unsteady urine flow
§ Urine leakage
§ A feeling of not emptying the urine bladder properly
§ Having to strain to produce urine
§ Blood in the urine.
Slow-growing tumors known as acinar adenocarcinomas are
the most common type of prostate
cancer.
Prostate cancer cannot be passed from one person to another,
and it is not a sexually transmitted disease.
Prostate cancer
and sex
Problems
with sex are not usually caused by prostate cancer itself.
Most
symptoms of prostate cancer stem from urine output problems, because the
enlarged gland begins to block the urethra, which carries urine. Urinary
symptoms should not affect the sex life.
Some prostate
cancer surgery comes with a risk of erectile dysfunction.
Only rarely do men with prostate
cancer have problems getting an erection because of the disease itself.
Psychological
problems may occur, however. Men may feel low or anxious about their diagnosis
or treatment, and this can reduce interest in sex.
Men
who opt to manage a very slow-growing prostate cancer with "watchful
waiting" or "active surveillance" should not experience problems
with sex.
More active treatment, such as surgery, radiation
therapy, or hormone therapy, may pose problems.
An erection is controlled by the nerves that run very
close to the prostate gland. Surgery that completely removes the prostate gland
includes a risk of erectile dysfunction for this reason.
This
surgery is usually only for men with aggressive prostate cancer that is likely
to grow or spread. Younger men may opt for it. A nerve-sparing prostatectomy
aims to avoid damage to the erection-controlling nerves.
Nerve-sparing
operations are not always possible, however. While reducing the risk of
erectile dysfunction, this type of treatment may not treat the cancer fully.
Some cancerous tissue may be left behind.
Other
options for prostate cancer can also affect sexual activity, but surgery
carries the greatest risk.
Treatment
options with a risk of erectile dysfunction include:
§ Cryotherapy, using probes to freeze prostate cancer cells
§ Radiation therapy
§ Brachytherapy, or implanting radioactive seeds in the prostate
gland.
Brachytherapy
entails a lower risk of erectile dysfunction than other types of radiation
therapy.
Hormonal
therapy can lead to problems getting an erection. It can also reduce interest
in sex and affect fertility. Hormonal treatments include removing the testicles
and using antiandrogen drugs.
Effects on
orgasm and ejaculation from prostate cancer treatment
A
number of factors may make change how a man feels about sex. Understanding the
risks may help to deal with them.
Removing
a prostate gland completely for cancer treatment means an ejaculation will no
longer be possible. Instead, the man may have a "dry orgasm."
Some
surgical treatments may lead to a disorder called retrograde ejaculation. The
semen does not come out during orgasm, but instead goes up into the bladder and
comes out when urinating.
Other
prostate cancer treatments may result in a smaller amount being ejaculated.
Hormone
therapy may reduce the intensity of orgasm sensations.
Managing sex
life with prostate cancer
A
number of strategies can help a man to regain his normal sexual function, if
erectile dysfunction is caused by prostate cancer treatment.
Oral drugs
such as Viagra may help a man to regain his normal sexual function.
Drugs that can help a man to get an
erection include:
§ Oral drugs, such as sildenafil
(Viagra), avanafil (Spedra), tadalafil (Cialis), and vardenafil (Levitra)
§ Cream to put directly on the penis,
such as alprostadil (Vitaros)
§ Other drugs, namely alprostadil, in
the form of injections and pellets.
Physical or "mechanical"
therapies include:
§ Vacuum pumps used before sex, to draw
blood into the penis and make it hard
§ Implants when other treatments have
failed.
Rehabilitation is possible, following
treatment for prostate cancer. It involves gaining an erection, using the above
treatments if necessary, and masturbating. This encourages blood flow to the
penis, and it may help men to gain and maintain erections.
Some men may benefit from
psychological support, for example with a counselor. This may also help if
relationships become strained by the effects of cancer and treatment. Couples
therapy may help couples to make adjustments to sex and other aspects of their relationship.
Understanding that sex problems are
likely with prostate cancer treatment may help. Learning about the problems of
other men in similar situations could also be useful.
Some men have talked on video about their problems with sexual
dysfunction due to prostate cancer. Some of these are available through the
not-for-profit website healthtalk.org.
Can masturbation cut prostate cancer risk?
A study of 32,000 men, published in the
journal European Urology,
looked at whether regular ejaculation helps to prevent prostate cancer.
Findings
showed that ejaculating more often was linked to a lower risk of prostate
cancer.
Among
men aged 20 to 29 years who had 21 or more ejaculations a month there were 2.39
fewer cases of prostate cancer in every 1,000 person years compared with those
who ejaculated 4 to 7 times a month.
Among
men aged 40 to 49 years, there were 3.89 fewer cases for the same comparison
The
reasons are unclear, but one theory refers to prostate stagnation, where less
frequent ejaculation allows prostate secretions to build up, potentially
causing cancer.
0 comments:
Post a Comment