Does Prostate Cancer Cause Erectile Dysfunction?
A look at the causes and what to do about it
One-in-five Canadian men receiving a cancer diagnosis this year will be diagnosed with prostate cancer. It is the most common cancer among men after skin cancer in the United States and Canada and top three in men around the world. It can also be one of the deadliest. One-in-ten cancer related deaths in Canada this year will be caused by prostate cancer.
Thanks to research, early detection and awareness campaigns like Movember, prostate cancer can actually be quite treatable. The American Cancer Society estimates there are around 3.1 million American men currently alive who were at one point diagnosed with prostate cancer.
For those survivors, another problem potentially awaits them — a problem shared by up to half of all men by the time they reach the age of 40: erectile dysfunction.
Why do prostate cancer survivors suffer from erectile dysfunction?
A lot of systems have to work together for a man to get an erection. Blood has to be pumped through vessels that carry it to glands in the penis. Hormones like testosterone need to be active. Your state of mind needs to be in the right condition to want to be sexually stimulated. And your nerves need to be active in being stimulated, so they can send the right signals to the brain to get the process together in the first place.
It’s that last key component that can be impacted not so much by prostate cancer directly, but by the surgery or procedures used to get rid of the tumour causing the prostate cancer in the first place.
There are generally two main methods of treating prostate cancer: surgery and radiation. When surgery is needed to remove a cancerous tumour or the prostate gland entirely, there’s a potential for nerve damage in the surrounding areas. What’s more, even if nerves aren’t damaged during the procedure, the physical trauma of surgery can affect normal sexual function.
Radiation treatment usually involves an external beam of light being pointed at the problem area, or what’s known as brachytherapy — where a small amount of radioactive material is placed inside the body near the tumour in an effort to shrink it. While no nerves risk being severed in radiation treatments, there is a chance that the nuclear material damages the soft tissues that are necessary to get and keep an erection.
How common is ED among prostate cancer patients?
The rates of erectile dysfunction among erectile dysfunction patients vary widely and depends on different factors. Some estimates place the percentage of men regaining their full erectile function after having their prostate removed between 20–80 percent. Half of all patients who undergo some form of radiation treatment can expect to experience some form of erectile dysfunction. While those who undergo surgery to remove a tumour but don’t necessarily have their prostate removed can take six-to-eighteen months before having their sexual function restored.
What can be done about it?
As if the experience of being diagnosed with and being treated for prostate cancer wasn’t draining enough emotionally and physically, suffering from erectile dysfunction certainly takes its toll. There are however ways to manage erectile dysfunction resulting from prostate cancer.
In addition to a healthy diet, regular cardiovascular exercise, taking care of mental and sexual health, doctors may prescribe a class of drugs known as PDE5 inhibitors to help restore erectile function. These prescription medications include sildenafil citrate (sold under the brand name Viagra), tadalafil (Cialis) and vardenafil (Levitra).
All prescription pills carry with them some risk, so it’s important to only take PDE5 inhibitors if prescribed by a licensed physician. If you’re experiencing an inability to achieve and maintain an erection sufficent for sex between 25 and 50 percent of the time, it might be worth exploring options with your doctor.
Don’t lose hope
Men and their families everywhere benefit from the research and awareness efforts that have turned prostate cancer into the treatable disease it is. If you can, consider making a donation to Movember or other causes that support men’s health this November. And if you or someone you love is experiencing erectile dysfunction, encourage them to get help.
