Editorial note: The content in this post is specific and may be offensive to some readers. Unfortunately, biology being what it is, clarity of expression is sometimes essential to accuracy of communication.
The other day, a female correspondent left a question on this site asking, “Is there any risk in the ejaculate for the partner of a man with prostate cancer?”
We responded by stating clearly that, “As far as anyone is aware there is absolutely no risk of any transmittable disease related to prostate cancer, through male ejaculate or otherwise. Any man who has been effectively treated from prostate cancer will, in any case, have ‘dry’ orgasms with no ejaculate because his prostate tissue is dead.”
However, the corresponent apparently heard a somewhat different message from her physician when she asked the same question. The doctor appears to have indicated that, while there is no risk to a female partner in the male ejaculate of men with as yet untreated prostate cancer, “the situation would be different for a male partner.”
We have no wish to put words in anyone’s mouth; we don’t know exactly what the doctor said to this correspondent; and this may be a simple case of miscommunication. However, we would like to be extremely clear about this issue. We are aware of no reason whatsoever to believe that male-male intercourse is associated with any risk for transmission of prostate cancer. If this was the case, then there would almost inevitably be a higher incidence of prostate cancer among gay men in the USA than among straight men, and that is certainly not the situation.
Having said that, there are, of course, specific risks related to disease transmission associated with all forms of intercourse. These are most commonly related to transmission of infectious diseases. Furthermore, certain types of cancer (e.g., cervical cancer) are known to be associated with viral infections (HPV infection in the case of cervical cancer), and this is why vaccination of young women against certain strains of the HPV virus was recently approved in the USA and in Europe. The most recent data actually suggests that vaccination of men may also help to prevent the spread of HPV and therefore the incidcence of cervical cancer.
It is also the case that vaginal intercourse is associated with differing risks than anal intercourse because of the biological properties of the differing organs and tissues involved (regardless of whether two males or a male and a female are involved in the latter activity).
What is of great concern to us is to ensure that the potential for misinformation here is ruled out. We know of no data to suggest that there is any chance for transmission of prostate cancer from a male to another male as a consequence of sexual activity. Furthermore, to date, there is no evidence that risk for prostate cancer has ever been associated with transmission of any other form of disease as a consequence of intercourse.
There are some data that suggest the possibility of an association between prostate cancer and the XMRV retrovirus (see a recent presentation by Klein). XMRV can be identified in expressed prostatic secretions in some 10-15 percent of men with prostate cancer. However, as yet there are no data that substantiate either the sexual transmission of the XMRV virus or a cause and effect relationship between the presence of the virus and the onset of prostate cancer.