Erectile and sexual dysfunctions are long-term side effects of prostate cancer treatment. They affect not just men with prostate cancer but also their spouses and/or partners, and can have significant impact on previously well-established relationships.
Wittmann et al. have conducted an audit of information this topic and published their results in a recent article in the International Journal of Impotence Research.
They searched the PubMed database for papers on prostate cancer-related sexual recovery for men and for couples. They were able to identify articles that addressed four general areas:
- The treatment of erectile dysfunction
- Men’s psychological and culturally diverse adaptation to the sexual side effects of treatment
- The impact of prostate cancer on couples’ relationships
- Interventions intended to promote sexual function
They report that erectile dysfunction after prostate cancer treatment has been widely studied (probably because of interest by pharmaceutical companies and medical device companies in the use of drugs and other methods to stimulate erectile function in prostate cancer patients). Research on the sexual recovery of men and couples or understanding it in a cultural context is apparently much scarcer.
The authors emphasize that greater focus on the impact of sexual sequelae of prostate cancer treatment on men as well as couples in diverse groups is needed, and The “New” Prostate Cancer InfoLink would entirely agree with this.
Wittmann et al. discuss the clinical implications for treating sexual dysfunction and promoting sexual recovery for prostate cancer survivors and their partners. They also make specific recommendations regarding future research. The “New” Prostate Cancer InfoLink notes that as prostate cancer is being diagnosed earlier in younger men, the impact of treatment on sexual function has become more critical for couples and families. Insightful physicians will often now recommend early discussion of the potential impact of prostate cancer treatment on sexual function — prior to actual treatment — so that couples are ready to deal with this after treatment and have a greater appreciation of the issues involved.
Filed under: Living with Prostate Cancer, Management | Tagged: couples, post-treatment, psychosocial implications, sexual function |
THE "NEW" PROSTATE CANCER INFOLINK 
I certainly would have appreciated some insightful discussion of the impact of my prostate cancer treatment before my radical prostatectomy. The statistics my surgeon gave me were rather skewed. … If I had known then what I know now, after the fact, I would have chosen not to have the surgery. … Some of the side effects are worse then death in my opinion. Its all about the quality of life! I was only 51 when diagnosed in 2006.
Dear Barry: We are very sorry to hear about your problems. You might be interested in having a look at the way our social network is able to offer help and appropriate guidance to the newly diagnosed. Surgical outcomes are almost invariably about the skill, experience and dedication of the surgeon! It might be a link you can pass on to other newly diagnosed men who come to you for help.
I agree with Barry 100%! Had there been an honest discussion from my surgeon I likely would not have had the surgery. I was also in my early 50s and the impact of impotence has been devastating — far worse that I expected.
I also agree with Barry. I told my urologist that for me, the ability to have sex was definitely a “life-or-death” situation. He and others have tried to make me feel guilty, shallow, immature, etc., for feeling that way! They’re all wrong!! I am now so deeply depressed that I seriously worry for my future. It has changed the way I relate to women. My wife and I now fight all the time. I have zero self-esteem. I’ve had intercourse once in the last 2 years! Sound like a “pity party”? You bet!! I feel like I’m just waiting to die!
The comments from these three men all emphasize the poorly understood nature of the discussion between men and their doctors about prostate cancer and its treatment. Whatever their individual situations, Barry, Len, and John all feel badly let down by their surgeons.
The “New” Prostate Cancer InfoLink cannot overemphasize the importance for patients of being utterly clear with one’s doctors about one’s priorities when it comes to prostate cancer treatment. We are aware of no interventional treatments that have no risk for significant adverse sexual side effects in either the short or the long term. No physician can ever “guarantee” outcomes that are absolutely free of such side effects.
We have heard stories like this over and over again over the years. It is a sad commentary on our society that some physicians will talk their patients into treatments that have significant risks for adverse consequences without (apparently) either listening to what their patients are telling them or making it completely clear to the patients what these adverse consequences are and their very real degree of probability.
My significant other has had internal/external radiation, along with hormone therapy and chemo. This was done in July 2005. He says he has no desire for sex and feels humiliated by using the VED. I am very frustrated and angry that he is not open to trying other methods … Help.
Dear Kate:
On the left-hand side of this page, you will find a button that says, “Visit Our SOCIAL NETWORK.” Click that button. When you get to the social network, you will need to join the network. However, you can do this anonymously by just calling yourself Kate (or anything else that you feel like).
Once you have joined, go to the group entitled “Of Sex and Sexuality.” This is a “closed” group in order to limit access to what is sometimes very private information. Follow the instructions to join the group. You will then be approved as a member of that group and will be able to leave messages for two highly qualified sexual counselors with specific experience in counseling people about issues that arise associated with prostate cancer treatment. They will be able to offer you “start up” assistance about how to address this issue with your partner.