Prostate cancer treatment and sexual function

When going through treatment for prostate cancer, men can often experience some level of sexual dysfunction or lack of interest in sex, depending on their treatment therapy. While side effects like these might cause you additional anxiety, your care team is there to answer any questions you might have about the side effects of your treatment on your overall quality of life. 

According to Johns Hopkins Medicine, most men will experience some occurrence of erectile dysfunction after prostate treatment. However, most men with intact nerves will see substantial improvement within one year after their treatment ends.

Which treatment paths can affect my sexual function?

Radiation Therapy 

Radiation therapy can cause damage to the nerves and blood vessels. One in two men (50% of patients) who go through standard external beam radiation will experience erectile dysfunction, while 25 – 50% of those men who go through brachytherapy will as well. 

If you have a heart or blood vessel disease, diabetes, or a heavy smoker, you may be at a greater risk for erection problems.

Those who do not see an improvement after two to three years might see their dysfunction worsen. If you’re being treated for other conditions such as diabetes or vascular issues, your chances are less to return to your pre-treatment function levels. 

Prostatectomy

During prostate surgery, your surgeon will work on preserving the nerve function around the prostate, also known as nerve-sparing. If nerve-sparing is successful, approximately 50% of patients will return to their pre-treatment functionality. Depending on your cancer risk, age, and the procedure itself, this number can increase or decrease. 

Hormone therapy

Although hormone therapy doesn’t cause damage to the nerves, blood vessels, or muscles surrounding the prostate gland, it lowers the amount of testosterone in your body. Erectile dysfunction may occur two to four weeks after treatment and could lead to a decreased interest in sex. Side effects of hormone therapy vary from person to person, so be sure to talk to your doctor about what to expect. 

Additional risk factors that can impact sexual function

Whether you’re undergoing surgery or radiation, sexual dysfunction is unfortunately a possibility for nearly all treatment methods for prostate cancer. Additional risk factors that can increase your chances of sexual dysfunction include age, comorbidities, obesity, smoking, and antihypertensive medication use. 

What can I do to treat my erectile dysfunction?

For some patients, erectile dysfunction can occur soon after treatment or surgery while for others, it may take years to develop. If you do experience erectile dysfunction, it’s important to remember that there are different strategies to help you.

Be sure to talk to your care team about the following therapies:

• Oral medications: A pill such as avanafil (Stendra), sildenafil (Viagra), tadalafil (Cialis), or vardenafil (Levitra, Staxyn) can be taken prior to sexual intercourse 
• Injectables: Medication is injected directly into your penis, producing an erection
• Vacuum constriction devices: A pump draws blood into your shaft, producing an erection
• Penile implants: A prosthesis is implanted into your penis, producing an erection 
• Counseling: Therapy can help you prepare and cope with the emotional challenges of the side effects of prostate cancer

If you’ve been diagnosed with prostate cancer, open communication with your care team before, during, and after treatment regarding sexual function is crucial. Remember that sexual dysfunction is a common side effect of prostate cancer treatment and you have several options to help you through these challenges.

If you have additional questions about sexual function after prostate treatment or you’d like to speak with someone, you can connect with an Outcomes4Me oncology nurse practitioner at no charge through the Outcomes4Me app, using the “Ask Outcomes4Me” button.