Sex After Prostate Cancer: Your Treatment Choice Matters
By: Dr. Neil Desai/Radiation Oncologist/UT Southwestern Medical Center
Sexual function is one of the first things many men think about if they’re diagnosed with prostate cancer. However, it’s rarely the first, second, or even third thing they discuss with their partners and doctor.
Occasionally, a patient will ask me about it, but many men get embarrassed and wait until their doctor brings it up – often when their partner is in a separate room.
Sex is a natural part of life for people in their 60s and 70s and increasingly has remained so with improved life expectancy and focus on active living.
Men and their partners should be concerned about sexual function, or potency, after prostate cancer treatment. Changes in sexual health are a huge factor in quality of life after prostate cancer and should be considered when weighing your options.
Despite the stigma around discussing it, sex already is a major consideration in deciding how or whether to treat prostate cancer.
Improved techniques, corrective procedures, and medications have reduced many of the urinary and bowel side effects historically associated with treatment, so sexual wellness can be the deciding factor for many men and their partners.
Radiation therapy delivered across many weeks to the entire prostate has long been a standard treatment in prostate cancer treatment but has made slow progress in adapting to advances in anatomic knowledge of the drivers of sexual function.
These include improved imaging characterization of vessels and nerves involved in erectile function. In the late 1990s, nerve-sparing prostatectomy (prostate removal), in contrast, went mainstream.
This procedure caught on due in large part to promises of preserving sexual potency, and it led to a significant shift in the number of men who chose surgery over radiation.
Unfortunately, despite these promises, men who choose prostatectomy still commonly lose potency and, in recent studies, continue to see a greater decrease in sexual function after surgery compared to other treatments.
Thus, there is strong appetite to further improve sexual potency preservation, perhaps by adapting lessons learned from nerve-sparing surgery to other treatments.
Some men with low-risk or early-stage cancer can avoid the risk altogether by opting for active surveillance, or monitoring of the disease, rather than immediate treatment.
However, one study found instances of prostate cancer spreading beyond the prostate (metastases) in more men who chose active surveillance than those who chose some form of immediate treatment, and up to half of men require therapy at some point regardless.
Preserving sexual function with CyberKnife Radiation Therapy, also known as stereotactic body radiation therapy or SBRT, involves applying a precisely targeted dose of radiation directly to the tumor and sparing nearby healthy tissue, including the nerves and blood vessels involved in sexual function.
It’s a convenient treatment that takes place over only five outpatient visits.
Thousands of patients have been treated with SBRT over a period of more than 10 years for low-and intermediate-risk prostate cancer showing impressive rates of potency preservation.
In addition to SBRT’s benefits for sexual health, the treatment appears as effective as other options at eliminating prostate cancer, and it compares favorably in a number of additional areas, such as:
- Bowel function
- Fatigue and inconvenience of therapy
- Urinary incontinence
If you’re newly diagnosed with prostate cancer or you’ve been on active surveillance, talk to our Prostate Cancer Experts at CyberKnife Miami to see if CyberKnife Radiation Therapy is the best treatment option for you 305-279-2900 & click here to visit our prostate cancer website now.