It's About E.D.
Two concerns that typically come up when speaking with men about a prostate cancer (PCa) diagnosis and potential treatments options often center on urinary incontinence and erectile dysfunction.
While most guys understand the meaning of urinary incontinence, the question most asked is, “How long will I be wearing diapers?” The answer of course is, “No one knows, because we are all different.” It's suggested that some men may see improvement a few months after treatment, but it can very much vary.1
Facing erectile dysfunction
The second concern is the real meaning of erectile dysfunction. If you are male and honestly evaluate your performance, chances are that we can all identify a time or times when we failed to rise to the occasion. Typically, the causes for the occasional “failure” are not a concern. The real concern can be experiencing an ongoing inability to achieve sufficient penile rigidity to complete sexual performance.
The numbers vary on how many men will experience some type of erectile dysfunction, but some estimates have put it at 1 of every 10 men.2
To have an erection, it involves having nerves that are working along with the needed arteries and veins. When aroused, the brain releases chemicals that tell the nerves in a man’s body to release chemicals allow for an increase of blood flow to the penis. At the same time, messages are sent to other veins to collapse so that the penis can remain rigid long enough to complete a sexual act.
Understanding the risks
When considering any treatment for prostate cancer, it is best to understand that all treatment options carry some sort of risk. If you are experiencing rigidity issues prior to you PCa treatment, any remedial course of action most likely will not return you to your 20-year-old self.
Anything that affects the brain, nerves, arteries, or veins can cause trouble with erections. Some causes of “failure to perform” can include such things as strokes, spinal cord injuries, high cholesterol, poor circulation, high blood pressure and medications that treat high blood pressure, diabetes, and depression. Finally, things like a radical prostatectomy, colorectal surgery, pelvic radiation and/or hormone therapy can also impact performance.
A basic rule of thumb: whether your erections were good prior to treatment can play a role in what happens afterward. Even if sexual functioning does return, it may perhaps be different.3
Every man's experience can be different
Men who have undergone a nerve-sparing prostatectomy procedure may see a return to erectile function within 12 to 24 months.4 Again, every man is different, so recovery times will vary depending upon the skill of the surgeon, the extent of your cancer, and how your body reacts.
If you are undergoing radiation therapy, erectile dysfunction can occur in the next few years following treatment.5
Hormone therapy can results in the rapid loss of libido (or the desire to have sex). In my case, what was described as loss of libido clearly resulted in my having zero interest in sex for a period of almost 18 months. That said, as the Lupron left my body, there was an increased desire to enjoy sexual contact.
Making a decision
In summary… no one can know in advance what exact impact a treatment will have. In the end, it is up to each man to decide what type of treatment he is comfortable with and to move ahead with his decision. I hope that whatever decision a man makes or does not make, that it was the best decision for him at the time of his diagnosis.
What was the most difficult part of your diagnosis?