Is There Is Sex After Prostate Cancer?

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Is There Is Sex After Prostate Cancer?

by Stephen E. Goldstone, M.D., F.A.C.S.

gayhealth.com

Sexually Active Men

Although the diagnosis of prostate cancer is devastating, the disease is highly treatable. Treatment, however, does have side effects that can drastically affect sexual function—both from a physiologic and psychological standpoint.

Younger men, men with less extensive prostate cancer and those who have had an active sex life before developing prostate cancer are less likely to experience difficulties with sexual function after cancer treatment. Communication between sexual partners and physicians is also crucial for dealing with alterations of sexual function. Sex with another man did not cause the prostate cancer and it will not cause it to return.

Anal sex did not cause the prostate cancer not will it cause it to come back.

“Will I have sex again?” is not an easy question for a physician to answer because it depends on a multitude of factors. Hopefully one’s doctor will have raised the issue before treatment—even if the patient did not. But still, discussing sex with one’s doctor early on may not offer much solace when trying to ‘get it up” that first time after treatment for prostate cancer has occurred.

Treatment for prostate cancer affects sexual function for two important reasons: The prostate contributes the bulk of the fluid that makes up semen (Milsten and Slowinski, 1999); so depending on which of the two major treatments for prostate cancer a man chooses, he may discovered that he has little to no ejaculate at all after treatment. Second, the nerves that stimulate the p**** to become erect run close-by the prostate gland (Mulcahy, 2001). They too can be affected by cancer treatment. In addition, anal sex, which may be an integral part of a gay man’s sex life, may also be affected by certain treatments for prostate cancer. Sexual function can depend greatly whether or not the treatment was surgery or radiation therapy. It is best to discuss the various issues specific to each treatment.

RADICAL PROSTATECTOMY

Surgical treatment for prostate cancer is called a ‘radical prostatectomy.” The surgery removes the entire prostate gland and some surrounding tissue. The doctor tries to spare the nerves that stimulate an erection, but sometimes nerve injury cannot be avoided as the surgeon tries primarily to cure the cancer (Jelsing, 1999). Most men notice significant change in erections even after what is called “nerve sparring” surgery. It can take as long as two years for erections to stabilize.

The other universal complication after radical prostatectomy is failure to ejaculate. When the surgeon removes a man’s prostate, the muscle that closes his bladder allowing his ejaculate to move out of the p**** rather than back into his bladder is destroyed. Instead of shooting out, his ejaculation becomes “retrograde” and shoots into his bladder. While still perfectly capable of having an orgasm, no ejaculate comes out. This can be a very troubling complication of surgery for some men and their sexual partners. Some men feel that they are not really sexually satisfied if nothing comes out. They may also feel less manly. Semen itself is erotic for many gay men. They like to see it, feel it and taste it. Retrograde ejaculation can rob them of this very important stimulant. Fortunately, radical prostate surgery does not affect the anus or rectum. Once the patient gets over the pain from surgery and the incision fully heals, he will be able to have anal sex again without restriction. Anal sex did not cause the prostate cancer not will it cause it to come back.

Excerpted from A Gay Man's Guide to Prostate Cancer edited by Gerald Perlman, PhD and Jack Drescher, MD (The Hawthorne Medical Press)