How Does Prostate Cancer Affect Sex ?

Cancer of the prostate gland is a disease in which cells of the prostate tissue divide without control, forming a tumor , or lump.
Prostate cancer is the most common non-skin cancer in men in the United States. There are an estimated quarter of a million new cases in the U.S. every year, according to information from the Cleveland Clinic and other sources. Tens of thousands of men die from the disease annually in the U.S.
According to the Centers for Disease Control and Prevention (CDC), most men who get prostate cancer are older than 65 years and do not die from it.
When a tumor of the prostate grows large enough, it can block the urethra, the outlet tube for urine.
Prostate cancer often produces no symptoms. When they do occur, they may include:
Weak or intermittent urine stream
Dribbling of urine
A feeling of having not emptied the bladder fully or having to strain
Blood in the urine
Cancerous cells from a prostate tumor can spread to other sites. This is rare, however, as most prostate cancers are slow-growing and do not spread.
The most common, slow tumors are known as acinar adenocarcinomas, and account for 9 in every 10 cases of prostate cancer, say Cancer Research UK.
Prostate cancer almost always occurs later in life. According to the Cleveland Clinic, up to 80 percent of men older than 80 years show signs of the disease after death. Many men have prostate cancer but die without a diagnosis.
Prostate cancer cannot be passed from one person to another, including via sex. It is not a contagious disease. It is not a
sexually transmitted disease .
Does prostate cancer cause sex problems ?
Prostate cancer itself does not usually cause problems with sex for most men with the disease.
Most symptoms of prostate cancer relate to urine output. This is because the prostate gland begins to obstruct the urethra, the tube that carries urine out of the body. As well as changes to urine flow, there can be blood in the urine.
Many men with prostate cancer do not get any symptoms in the early stages of the disease. The first time many people know that they have prostate cancer is after other symptoms have been caused by the cancer spreading - to the bone, for example.
It is uncommon, but some men with prostate cancer do have erection difficulties related to the disease itself.
How does treatment for prostate cancer affect sex?
Prostate cancer itself does not usually cause problems with sex. However, it can be usual for men to feel depressed when going through cancer diagnosis and treatment.Worries about prostate cancer may mean less interest in sex or relationship stress . These problems should improve, and there can be support for psychological problems surrounding cancer.
There are many treatment options for prostate cancer, including just monitoring. Many men choose to monitor for any development that may need later active treatment. This approach for very slow-growing prostate cancer can be called "watchful waiting" or "active surveillance." It does not cause sex problems.
Active treatment of prostate cancer can lead to problems with sex. These therapies include:
Surgery
Radiation therapy
Hormone therapy
Nerve supplies that help to control men's erections run close to the prostate gland. This raises the challenge of protecting the nerves from damage during treatment of the nearby prostate gland.
Surgery to completely remove the prostate gland is a risk for erectile dysfunction because of the potential nerve damage. This surgery is known as total prostatectomy or radical prostatectomy.
Radical prostatectomy is not appropriate for all men with prostate cancer. It is typically reserved for men who have more aggressive prostate cancer that is likely to grow or spread, and younger men.
The prostate gland can be surgically removed in a number of ways:
Open surgery - the surgeon creates an opening in the belly or the area between the testicles and the anus
Keyhole surgery - the prostate is removed via a small wound, and the surgeon is guided by a camera
Both options are similarly effective. Keyhole surgery may mean less bleeding and less time in the hospital than open surgery.
Keyhole surgery to remove the prostate gland can also be done with the help of a robot. Also known as da Vinci surgery, this is a more recent development in keyhole surgery for prostate cancer.
Nerve-sparing prostatectomy aims to preserve the nerves that control erections. This type of prostate cancer treatment reduces the risk of erectile dysfunction, but the risk of not fully treating the cancer also needs to be considered. There is a risk that some tumor may be left in place.
Nerve-sparing surgery is not possible in all cases. It depends on where and how severe the prostate cancer is.Biopsies are taken as part of any prostatectomy, and this enables the tissue to be examined in a lab. Biopsies may help to work out if cancer is only on one side of the prostate. If it is, the nerves on the other side may be spared.
Surgery is the riskiest treatment in terms of erectile dysfunction. Other options are also risky, including cryotherapy, in which probes are used to freeze prostate cancer cells.
Some decrease in erectile function can follow radiation therapy of the prostate. Erectile dysfunction may be less of a risk with the more focused radiation therapy called brachytherapy. This treatment involves implanting radioactive seeds into the prostate.
Hormonal therapy also carries the risk of erection problems, can cause loss of libido, and affect fertility. Treatments can also involve removing the testicles and antiandrogen drugs.
Fertility problems caused by prostate cancer treatment
Doctors may offer men the chance to store sperm before prostate treatment. Sperm banking is an option because different cancer treatments run the risk of making men infertile .
Not being able to father children may result from radiation therapy, surgery, or drug treatment.
If infertility does result from treatment and the man wishes to start a family, stored sperm can be used in artificial insemination or in vitro fertilization.
Managing sex life with prostate cancer
If erectile dysfunction does occur after prostate cancer treatment, a number of options are available to help with returning to normal sex function.
A loss of interest in sex may occur due to fatigue and other problems linked to prostate cancer and treatment. This can improve or disappear over time.
The number of men affected persistently by erectile dysfunction after prostate cancer surgery varies widely. Factors affecting likelihood include age and health before the operation.