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Prostate Cancer Treatment Effects: Overview
(05/04/2004) by Ralph and Barbara Alterowitz
Am I the Only One with a Problem?
Survivors assume, "I'm the only one who has a problem. Everyone else came out of therapy OK." The truth is that 70 to 90% of prostate cancer survivors have erectile dysfunction for some time, or permanently.
Leslie Shover, Ph.D., of the Cleveland Clinic Foundation, reported that "the prevalence of sexual problems may be as high as… 70 percent in prostate cancer survivors." (Journal of the National Cancer Institute). Dr. Shover goes on to note that, "Problems faced by survivors include loss of desire, erectile dysfunction, painful intercourse, and difficulty reaching orgasm."
For surgery patients, the statistics are that as many as 90% will have erectile dysfunction immediately following treatment. Recovery varies widely. One prominent medical center (known for prostate surgery) estimates that about 40% of their surgery patients will recover "full function" within six months and about 60 to 70% will recover within 18 months. However, every procedure results in some loss of erectile capability. Even if nerves are not cut during surgery, some nerves are damaged.
A relatively high potency-recovery rate may be expected with surgical excellence. This is illustrated by one study citing low recovery rates following surgery by 30 doctors with varying levels of training and experience. By contrast, highly skilled surgeons quote recovery rates in the 60 to 70% range. Recovery for younger men is higher than for older men. The skill of the surgeon is an important factor in recovering potency, but not the only one.
Nerves are also damaged during radiation. Where radiation therapy is concerned, erectile dysfunction appears to be delayed according to a recent paper in a cancer journal. About 20 to 30% of radiation patients have erectile dysfunction right after therapy.
Radiation damages the small blood vessels supplying the pelvic region. This leads to fibrosis (scarring that causes toughening) of these small blood vessels. The scarring process builds on itself by interfering with nutrients, blood flow, and oxygenation. In time, the tissue goes from soft to leathery.
As a result, five years after radiation therapy, survivors have about the same level of erectile dysfunction as do surgery patients. Although potency is higher in the near term compared with surgery, ultimately the level of impotence resulting from radiation may be comparable to that resulting from surgery.
To read about more effects of prostate cancer treatment, click here.
Excerpted from, "The Lovin' Ain't Over: The Couple's Guide to Better Sex after Prostate Disease." Copyright 1999 by Ralph and Barbara Alterowitz. All rights reserved.
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