Sex after Prostate Cancer
- Welsh TV presenter Gabby Logan, 49, recently took to her podcast to speak with her husband, Rugby star Kenny Logan, 50, about his prostate cancer journey. In the episode, the couple make a point to discuss his sexual function post-surgery.
- Prostate cancer, the most common form of cancer in men, can sometimes be misdiagnosed based on results from a PSA test. Still, our experts maintain that the PSA tests are helpful, and you should talk with your doctor about your own risks for the cancer and screening options.
- There are several things that can determine a man's sex life post prostate cancer surgery, including the duration of the therapy, a man's overall health and age, and how intense the treatment was. But there are ways to treat sexual dysfunction if it should occur like medications, a Vacuum Erectile Device (VED) or a prosthesis.
When Welsh TV presenter Gabby Logan, 49, urged her husband, Rugby star Kenny Logan, 50, to get a wellness check, the couple never expected the resulting diagnosis.
Read MoreFor treatment, he opted to have his prostate removed, but he’s doing much better today.
“I’m now three months since the operation, had the prostate out, I’m probably 95% back to normal,” he said. “I’m extremely lucky.”
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In a special episode of Gabby’s podcast, The Mid.Point, Kenny joined his wife to discuss his cancer journey and open up about sex after treatment.
"Recently I’ve been a lot more active on that front," he said of his erections returning before joking with his wife. “You haven’t seen it yet, it’s coming this weekend, big weekend!”
He went on to say he’s been keeping up with his recommended exercises, training and even implementing a penis pump, or Vacuum Erectile Device (VED).
"You’ve got to keep doing exercises, your pelvic floor. And I must admit, since I’ve started training again I think that’s really helped me," he said.
Overall, Kenny is happy with his recovery progress and determined to stay positive.
“I think the key thing is to be positive,” he said. “I’ve been lucky with you being very positive, kids have been great.”
Understanding Prostate Cancer
Before we talk more about sexual function after a prostate cancer journey, let’s get a better understanding of the disease itself. Prostate cancer is the most common cancer in American men except for skin cancers. About one in eight men will be diagnosed with prostate cancer during his lifetime. The disease begins in the walnut-shaped prostate gland located between the rectum and bladder. This gland produces the fluid that nourishes sperm.
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Symptoms of the disease are inconsistent and hard to pinpoint.
"Prostate cancer is a very odd disease in that it doesn't have a particular symptom," Dr. Edwin Posadas, director of translational oncology and the medical director of the Urologic Oncology Program at Cedars-Sinai, explained.
But changes in urinary function like urinating more or less often or waking up at night to go more than usual could be a sign of the disease. However, it's important to note that these potential symptoms could also could be caused by a urinary tract infection or even an enlargement of the prostate gland (which is not cancer).
There's No One Definitive Symptom for Prostate Cancer, But There Are Clues
Doctors that have spoken with SurvivorNet shared a hopeful outlook when considering a prostate cancer diagnosis because there are many treatment options, and there's been significant treatment progress over the past decade. Surgical and radiation options, for example, have made improvements in reducing side effects of treatment while still providing excellent cure rates. Even for men with an advanced-stage diagnosis, many new options exist to treat prostate cancer and help them maintain an excellent quality of life.
Prostate Cancer Screening
In the United States, many prostate cancer cases are caught with screening examinations. Screening guidelines depend on your risk for the disease. Age, race/ethnicity, geography, family history and gene changes are the main risk factors for prostate cancer. You should talk with your doctor regardless, but here are some things to consider when gauging your risk for the disease:
- Men younger than 40 are less likely to get prostate cancer, but age-related risk quickly rises after age 50. Approximately six of ten cases of prostate cancer are found in men older than 65.
- Prostate cancer develops more often in African-American men and in Caribbean men of African ancestry than in men of other races, and these men tend to develop the disease at a younger age.
- Prostate cancer is most common in North America, northwestern Europe, Australia and on Caribbean islands. It is less common in Asia, Africa, Central America and South America. The reasons for this risk factor are unclear, but more intensive screening and lifestyle differences like diet might be contributing factors.
- Most prostate cancers occur in men without a family history of the disease, but it's still important to look at your family history because prostate cancer does seem to run in some families. Having a father or brother with prostate cancer, for instance, more than doubles a man's risk of developing the disease with a higher risk for men with a brother with prostate cancer than those with a father who have it. The risk is also especially high if a man has several affected relatives that developed the cancer at a younger age.
- Inherited gene changes, or mutations, like that of the BRCA1 or BRCA2 genes can also elevate risk, but this probably accounts for a small percentage of overall cases.
It's not clear if the benefits of prostate cancer screening outweigh the risks for most men. Nevertheless, screening can be life-saving, and it's important to at least discuss the pros and cons of screening and your risk factors for the disease with your doctor.
Prostate cancer screening methods look for possible signs of the disease, but they can't determine for sure if you have cancer. The only way to know for sure if the patient has prostate cancer is with a prostate biopsy a procedure in which small samples of the prostate are removed and examined under a microscope. But generally speaking, screening for prostate cancer involves a PSA (prostate-specific antigen) test and a digital rectal exam to feel the prostate gland.
When Should I Get Tested for Prostate Cancer?
"It's slightly uncomfortable but painless, and takes less than 30 seconds," Dr. Posadas said of these methods. "The amount of information that is gained from that is tremendous, and it can be a life-and-death type decision that is made."
But it's important to note that the PSA test is not perfect. The prostate-specific antigen is a protein secreted by the prostate gland. Men have a small amount of PSA in their blood all the time, but large amounts can be a sign of cancer because when cancer cells grow, PSA spills into the blood.
An elevated PSA test, however, does not always mean you have prostate cancer. It can simply reflect that your prostate is enlarged which is common or it could signal an infection or inflammation. Because of this, the PSA test is controversial since high levels may lead to over-treatment in men who are more likely to die from something else. Regardless, our experts maintain that the PSA tests are helpful, and you should talk with your doctor about your own risks for the cancer and screening options.
Sexual Function after Prostate Cancer
As a result of radiation or surgery, some men may have trouble getting hard, or maintaining an erection, while others can no longer have an erection at all. It’s important to remember that although most men do suffer some compromised sexual function after prostate cancer treatment, your specific case depends greatly on various factors and many men get back to their pre-cancer sexual function after treatment.
Preserving Sexual Function Post-Treatment Depends on Several Factors
In a previous interview with SurvivorNet, Dr. Patrick Swift, a radiation oncologist at Stanford Medicine, said most men won't gain sexual function for about six months after surgery. It does happen earlier, he said, but it's rare.
It's "highly dependent on whether the surgeon was able to spare both sides of the neurovascular bundles, one side, or [if] they weren't able to spare either," he said. "So, if both neurovascular bundles are injured at the time of surgery, the chance of getting back sexual function without some kind of prosthetic device is very, very low."
Dr. Swift also explained that men who undergo radiation therapy for prostate cancer have a significantly lower risk of suffering from sexual side effects. And adding a hormonal therapy to radiation will significantly increase the risk of erectile dysfunction, and may also affect a man's desire to engage in sex.
In other words, there are several things that can determine a man's sex life post surgery, including the duration of the therapy, a man's overall health and age, and how intense the treatment was.
Dr. James Brooks Talks Sex After Prostate Cancer
But there are ways to treat sexual dysfunction if it should occur.
"There are things we can do, treatments we can use, to get couples back to being sexually active," Dr. James Brooks, a urologic oncologist at Stanford Hospital and Clinics, previously SurvivorNet.
There are several medications available such as Viagra, Cialis and Levitra that may work for prostate cancer survivors. There are also the options of devices like the Vacuum Erectile Device (VED) or a prosthesis on the market.
"Prostate cancer can require couples to think more broadly about their intimacy," Dr. Brooks said. He suggests men speak with their urologist and perhaps seek counseling with a sex therapist.
Contributing: Laura Gesualdi-Gilmore
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