Posts Tagged ‘treatment for prostate cancer’

Sex and the Prostate Cancer Patient

February 28, 2014

Q. I can’t get erections after prostate cancer treatment. Does that mean I will never have sex again?
A. The quality of your erections may not be the same after treatment for prostate cancer, but that doesn’t mean that you can’t enjoy penetrative sex. There are many options to help the firmness: medication, vacuum erection pumps, injections and implants. It is also important to realize that sex can be about more than penetration. Learning different techniques to pleasure your partner may be just as enjoyable. Improving upon your oral sex techniques, or mutual masturbation may bring pleasure equal to vaginal intercourse. A sex therapist can help you learn with these techniques.

Q. Since my treatment for prostate cancer, I have lost my interest in sex. Will that return?
A. Some of the hormone treatments, Lupron, Zolodex, Firmagon, used to fight prostate cancer can interrupt one’s desire for sex by decreasing the testosterone levels in the man’s blood stream. If you have a partner, it is important to discuss this side effect. You may find it helpful to have scheduled sexual activity to encourage closeness and intimacy. Sometimes, interest in sex builds when people engage in more foreplay. Also, touching by handholding and kissing can be also be pleasurable to both the man and the woman.

Q: Will my sexual function ever return to what it once was?
Many men grieve the function they had in their youth, forgetting that even without cancer, their level of function would likely change as they age. In either case, if you are going through proper rehabilitation starting immediately after treatment, you will have a greater chance of regaining most of your sexual function. Depending on the long-term treatment plan you and your doctor choose, you may find you need assistance through medications, vacuum erection devices, injections, and the surgical implantation of a penile prosthesis.

This Q and A was inspired and modified from an article by Melissa Donahue, LCSW from the New Jersey Center for Sexual Wellness http://www.njsexualwellness.com

Prostate Cancer-Watch, Wait, and Not Whither

January 28, 2014

Prostate cancer is the most common cancer in men and the second most common cause of death in men after lung cancer. The diagnosis is made with a PSA blood test and a digital rectal exam and if either of these are abnormal, the man is subjected to a prostate biopsy. Then comes the big decision: does the man proceed to treatment and face the risk of urinary incontinence and\or erectile dysfunction\impotence?

In the past few years there has been a trend towards active surveillance or after receiving the diagnosis of prostate cancer, the man accepts close monitoring with repeated blood tests and possibly repeat prostate biopsies to make certain that the cancer is not progressing or escaping from the prostate and spreading to other organs or structures.

First a comment on screening. Men between the ages of 55 and 69 are those most likely to benefit from screening with a PSA blood test and a digital rectal examination. A man should only be screened after a discussion with his\her physician about the benefits and harms of screening. A new trend is not to treat every man diagnosed with prostate cancer or active surveillance. Not every man qualifies for active surveillance.

Men with a very low risk of cancer progression have a low-grade cancer of the prostate. Prostate cancers are graded from 1-10 and those with a score of 6 or less may be candidates for active surveillance. Men are in the very low risk group if only a few of the biopsies are positive for cancer and that the cancer is not felt on the digital rectal exam.

Men who were on the active surveillance program at John Hopkins School of Medicine had a 2.8% would die of their prostate cancer compared to 1.6% of men who had a very low risk of cancer progression who had surgical removal of their prostate glands. The researches at John Hopkins found that the average increase in life expectancy after surgical removal of the prostate gland was only 1.8 months and that the men on active surveillance would remain free of treatment for an additional 6.4 years as compared to men who had immediate treatment with surgery on their prostate glands.

Bottom Line: Men need to have a discussion with their physicians about the benefits and risks of prostate cancer screening. Men with a life expectancy in excess of 20 years or younger men who have low risk disease may accept the risks of treatment rather than take the chance their cancer will cause harm later. Men with very low risk disease can take comfort that their disease can safely be managed by active surveillance.

Invasion of the Prostate Snatchers-A book about treatment of prostate cancer

January 30, 2011

Ralph Blum, a cultural anthropologist with prostate cancer, and Dr. Mark Scholz, an oncologist who specializes in the treatment of prostate cancer, chronicle the various treatment options for prostate cancer in the book Invasion of the Prostate Snatchers, Other Press.  Mr. Blum looks a the disease from the standpoint of patient who is confronted with the decision of how to treat this common male cancer that affects nearly 200,000 men each year.  Many men receive a radical prostatectomy which surgically removes the prostate gland and leaves the man at risk for erectile dysfunction and urinary incontinence or leaking of urine requiring the use of diaper.

The authors advise those who are confronted with making a decision regarding the treatment of prostate cancer to slow up and take a deep breath and get the facts about all the treatment options including watchful waiting which means treating prostate cancer as a chronic condition and obtaining an examination and a PSA blood test every 4-6 months to monitor the cancer.  I recommend this book as a good resource for those men who have the disease and want to make a good decision with the help of their doctor to find the best treatment for their prostate cancer.