Does cancer treatment affect normal sexual activity?

Many men report changes in sexuality following treatment for prostate cancer. However, these changes vary and occur at different times during recovery. Sexual feelings of desire and arousal may be diminished due to fatigue related to recovering from radiation therapy or surgery or due to shifts in hormones. Difficulty with erections may occur due to changes in blood flow to the penis. Radiation therapy can affect arteries bringing blood to the penis. Surgery can affect the nerves controlling blood flow in the penis. Because the prostate gland produces semen, men whose prostate is removed do not ejaculate. However, small amounts of fluid that come from other glands may be noticed during orgasm. Ejaculation and orgasm are two separate functions. Therefore, many men continue to be able to have orgasms following treatment for prostate cancer. After prostate surgery, though, the experience of orgasm will be different since men often do not have the feeling of ejaculation. Problems with urine leakage may also affect men's feelings about sexual activities.

What can be done to help with sexual changes?

Some changes in sexuality after prostate cancer treatment will improve with time. The stress of treatment may reduce hormone levels for a few weeks but as you recover, your sex life is likely to improve. If problems remain, there are many options to help you regain a satisfying sex life. Penile injection therapy, vacuum erection devices, and medications can help with erections. There is no reason that men treated for prostate cancer can't have a satisfying sex life. It may just take some time to adjust and find the right combination of treatments for you and your partner. You may also need to find new ways to express your sexual feelings for your partner.

What can I do to have a good sexual relationship?

• Be gentle with yourself Recovery from prostate cancer treatment takes time.
• Gather information and support. The New Male Sexuality by Dr. Bernie Zilbergeld and Sexuality and Cancer from the American Cancer Society are excellent sources of helpful information. Health care providers who are informed about and comfortable with sexual issues and who know your particular situation can be helpful with specific questions. Men who have experienced prostate cancer treatment can also be good sources of support.
• Work on good communication with your partner and with your health care provider. Your partner may fear that sex might hurt you. Tell your partner what you need. If you need your partner to take a more active role, you need to let your partner know.
• Keep an open mind about sexual pleasure. Some couples have a narrow idea of what is normal in sex. There are many ways to give and receive pleasure, including holding hands, special looks, hugging, kissing, etc. It is not just the act of sexual intercourse.
• Keep your sex life going. When people are treated for cancer, their self-esteem may suffer. Low self-esteem will happen especially if you withdraw emotionally. Intimacy is an important part of staying close emotionally.
• Forget negative thoughts. With imagination and practice, you can be an even better lover.
• If you are depressed, get help. Your health care provider can help.
• Schedule time to be alone with your partner. Take a weekend trip. Ignore the telephone.

What can my partner do to help?

• Be patient. Resume sexual activities slowly. Reassure your partner of your love and concern for her.
• Tell your mate when you are ready to resume sexual relations. Encourage her to take the initiative. Talk about ways to enjoy each other.
• Explore new ways to give each other pleasure. Now is the time to use your imagination.
• Tell her when you feel tired, pain, or experience changes in sensation.
• Take good care of yourself- try to get sufficient rest, eat nutritiously, exercise regularly, and accept offers of help and support.

What symptoms should I report to the nurse?

There are many things that can be done to help you and your partner. Don't suffer in. silence. Talk to your health care professional. Call your doctor or nurse if you experience:

• Pain during ejaculation or erection.
• Inability to find a satisfying sexual relationship.

What can I do to get more information?

• Read Sexuality & Cancer: For the Man Who Has Cancer and His Partner, available from the American Cancer Society by calling toll free 1-800-ACS-2345.
• Ask about treatment options such as surgery or medications.
• Learn about the medical treatments and medications that can help.
• Contact the American Cancer Society at http://www.cancer.org/.

This information was conducted in affiliation with the Walther Cancer Institute, Indianapolis, IN