Several therapies may help prostate cancer patients

According to a new survey, only a small minority of men who have undergone surgery or radiation therapy to treat prostate cancer recover normal sexual function after treatment. The results of the survey are reported in the October 15th and December 1st issues of the journal Cancer.

Dr. Leslie Schover of the University of Texas M.D. Anderson Cancer Centre in Houston, and colleagues found in a survey of more than 1,000 men treated for prostate cancer that treatment for erectile dysfunction is often disappointing, although men who tried more than one approach were most likely to find one that worked.

“If you are a man with erection problems after prostate cancer, it is worth trying a medical treatment for erectile dysfunction,” Dr. Schover said. “But if at first you don’t succeed, be prepared to try, try again”.

This new survey included men who underwent a variety of prostate cancer therapies. Dr. Schover and her colleagues used a stricter standard whereby they defined “success” as usually having a firm erection during the previous four weeks when a man tried to have intercourse.

Results of the study included the following: only 13% had a successful sex life without any treatment for erectile dysfunction and 8% had reliable firm erections with the aid of some sort of treatment. Younger men and those who had “nerve-sparing” surgery or had radioactive seeds implanted in the prostate, were more likely to recover sexual function after treatment.

According to the report, most men experience some sort of erectile dysfunction after prostate cancer, but less than two-thirds, 59%, seek treatment for the problem. Of those who sought treatment, only 38% found a medical treatment that provided at least some help. At the time of the survey, three out of 10 men were using some sort of treatment for erectile dysfunction.

Dr. Schover said that most men preferred treatments like the anti-impotence pill Viagra (sildenafil), but she said that this only helped 16% of men. The most effective treatments were those that involve the most “hassle,” including injecting medication into the penis to trigger an erection or surgery to implant an inflatable penile prosthesis.

She noted that “men who succeeded in finding a treatment that worked for them often made several tries with different types of medical therapies before settling on one that helped.”

A major issue after treatment for prostate cancer, according to Dr Schover, is the need for counselling that includes a man and his partner and helps them “change their lovemaking routine to maximise the chance that a medical treatment for erectile dysfunction will work and gives them more realistic expectations about the hassles involved with each type of treatment.” For single men, counselling may help them communicate about sexual needs with new partners, Dr Schover said.

(Source: Reuters Health)