Heart Health Articles

Predicting Sexual Function After Prostate Cancer Treatment Has Improved

April 10, 2017

A study published in the Sept. 21 issue of the Journal of the American Medical Association by a Beth Israel Deaconess Medical Center research team, suggests more open discussion between doctor and patient will assist in improving quality of life for prostate cancer survivors.

The report shows survival rates for early stage prostate cancer sufferers are increasing, making quality of life issues a more important part of treatment, with the main focus being sexual function in previously potent men. Doctors are more able to predict the outcome of a man's sexual function post treatment and this should facilitate more patient / doctor discussion.

Lead researcher, Martin G. Sanda, MD, Director of the Prostate Center at Beth Israel Deaconess Medical Center and Associate Professor of Urology at Harvard Medical School clarifies that :

"It's a daunting situation for any man to face cancer ...... Fortunately, with prostate cancer, we are usually able to control the cancer - however the side effects can still be troubling. But we now have options beyond one-size fits all counseling to help men anticipate possible treatment side effects."

Naturally, there are other issues that affect a man's sexual health post prostate cancer, including factors such as a man's age, prostate specific antigen levels, the use of nerve-sparing surgical techniques or hormone therapy with radiation. However, a large number of men stated that they had not yet considered medications or treatments for Erectile Dysfunction, again showing how doctor patient discussion can help assist patients improve their quality of life.

The team of researchers used questionnaires and telephone interviews to gather data from 2,940 men nationwide both before treatment and two years after. The data was gathered through university affiliated and community based hospitals. Treatments patients received included prostatectomy, or surgical removal of the gland; external beam radiation; or brachytherapy, or the implant of radioactive "seeds."

In summary : 40 percent of men who had their prostates removed said they experienced recovery of sexual function two years after surgery, while 58 percent of men maintained sexual function after external radiation and 63 percent after brachytherapy.

Sanda continues that :

"The ability to inform individual patients how likely they are to develop erectile dysfunction based on their personal baseline sexual function, cancer severity, individual clinical characteristics and treatment plan has been elusive,"

Another issue affecting men is the baseline PSA level, and appears to be closely associated with sexual function after surgery and radiation. Patients with higher PSA levels may have more extensive primary cancers or larger prostates that can affect surgical approach, even during nerve-sparing procedures, or lead to broader distribution of higher doses of radiation.

Sanda added:

"Timely, proper treatment can reduce mortality from prostate cancer, making the impact of side effects more significant . . . . Both patients and physicians can be uneasy talking about sexual function, but men need to be open about their sexuality to optimize outcome after treatment for him and his spouse, and to determine whether medications or other treatment for ED might be helpful.

Obviously each patient is different and his particular circumstances and treatment will be the primary factor affecting his post operative quality of life, potency and sexual function; however it's also clear from Sanda's report that doctor patient conversation and discussion can help implement additional treatments to assist a man's recovery from the disease.

Rupert Shepherd BSc.