Prostate cancer is the second most common cancer affecting males in Singapore, based on the National Cancer Registry 2019 Annual Report. Prostate cancer and its treatments adversely impact sexual function. Dr Wong Siew Wei, a Senior Consultant, Singapore oncologist at Parkway Cancer Centre, writes about this in a recent article on PCC’s website.
Summary of Dr Wong’s Sharing on “Understanding Prostate Cancer & Sexual Function”
Sexual Dysfunction
- Prostate cancer treatment commonly results in sexual dysfunction.
- Surgical and radiotherapy treatments may damage nerves next to the prostate that control erections. This can impact erectile function for patients after treatment.
- Erectile function after treatment may be preserved depending on the patient’s age (younger patients have a better chance), pre-treatment sexual function, and whether a nerve-sparing approach for treatment is possible.
- It usually takes between a few months and two years following surgery for patents to be able to have spontaneous erections.
- Long-term use of androgen deprivation therapy (ADT) for prostate cancer treatment will result in lowered testosterone levels. This may cause reduced sexual desire, erectile dysfunction, and genitalia shrinkage. ADT is used for patients with high-risk of cancer relapse, or where the cancer has spread to other parts of the body. Typically, testosterone levels and libido will improve once ADT treatment is stopped.
- Even if erectile nerves are damaged during treatment, patients will still have penile sensation and potential to achieve orgasms.
Infertility
- Surgery and radiotherapy treatments for prostate cancer will result in infertility.
- Surgery removes the prostate and seminal vesicles (impacts semen production) and severs the vas deferens which connect the testicles and the urethra.
- Radiotherapy impairs semen production, and may potentially damage sperm production in the testicles.
- It should be noted that while patients may become infertile after treatment, many may still retain sexual function.
Mitigating Against Sexual Function Impacts of Prostate Cancer Treatment
- If a patient wants to father children, he can consider sperm banking before undergoing treatment.
- Patients can consider couples counselling if loss of libido causes difficulties for couples.
- Viagra and similar medication can assist with erections if the nerves that control erections are preserved during surgery. Other aides that can be considered include vacuum assisted devices and penile implants.
A prostate cancer diagnosis, treatment and its side effects—including changes to your body and sex life—can greatly influence your sense of self and impact your relationships. A multidisciplinary approach to managing prostate cancer, that includes medicine, counselling and other support services, can provide you holistic care that can help you continue living life as normally as possible following treatment.
About Dr Wong Siew Wei – Singapore Oncologist at Parkway Cancer Centre
Dr Wong Siew Wei is a Senior Consultant, Medical Oncologist at Parkway Cancer Centre. He was formerly a Consultant, Medical Oncologist at Johns Hopkins Singapore International Medical Centre (JHSIMC) and Tan Tock Seng Hospital (TTSH). During his time at JHSIMC / TTSH, Dr Wong was involved in multidisciplinary tumour boards for gastrointestinal, thoracic and genitourinary malignancies, and led a number of clinical trials.
Dr Wong Siew Wei’s areas of expertise and interest are in prostate, kidney, bladder, upper gastrointestinal and lung cancers.
You can make an appointment with Dr Wong at this link.
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This article is informative only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment, and should never be relied upon for specific medical advice.