The National Institutes of Health estimates that as many as 30 million men in the U.S. experience erectile dysfunction, and prostate cancer is a contributor. Before you choose a treatment course, it’s important to understand this serious side effect and learn more about how it might be avoided or minimized.
Getting your questions and concerns out in the open will help ensure that you have the real story. Let’s start with the basics.
What: Erectile dysfunction, also called ED or sometimes impotence, is used to define a range of problems that have to do with achieving and maintaining an erection suitable for sexual relations. Some men define ED as one of the worst things that could happen. But if you’re facing a diagnosis of prostate cancer, you know that not appropriately treating your disease could be much worse.
Why: The nerves that control erection are inconveniently located on both sides of the back of the prostate. If they’re removed or damaged during treatment, ED is the result. Damage to the blood vessels in the prostate also can interfere with your ability to get an erection. Invasive prostate treatments such as prostatectomy (removal of the prostate) are the biggest culprits, but surgical techniques that spare the nerves that control erection are increasingly making prostatectomy a less risky option.
Who: For the millions of men in the U.S. affected by ED, prostate cancer treatment is just one of many potential causes. Others include heart disease, diabetes, high blood pressure, depression, certain medications, smoking, and elevated cholesterol. Men undergoing prostate cancer treatments that involve the delicate nerves and blood vessels that control erection are often at risk for ED.
When: Most men undergoing surgery or radiation therapy for prostate cancer will experience ED for at least the first few months following treatment. For many men, erectile function eventually returns, but it can take up to a year.
If you have been diagnosed with prostate cancer but not yet treated, consider your options and the likelihood of erectile dysfunction. External beam radiation, brachytherapy (seed implantation), and radical prostate surgery (prostatectomy) all carry a risk of side effects including ED and urinary and bowel dysfunction. While the effects can be temporary, because of tissue changes and damage, sometimes the side effects last permanently.
Now what: If you do experience ED, all hope is not lost. A variety of solutions—from oral and injectable medications to vacuum pump devices to penile implants—all can help you achieve an erection. As with all this information, talk with your doctor about your concerns so he can help find the best solution for you.
Download a free patient guide to learn more about erectile dysfunction.
A board-certified urologist, Derek K. Zukosky, DO, specializes in minimally invasive urological procedures. One of the most experienced and highly trained robotic surgeons in the Denver area, Dr. Zukosky specializes in robotic prostatectomies. He also has a special emphasis in prostate cancer, BPH, urinary stone disease, kidney cancer, urolithiasis, and men’s sexual health including erectile dysfunction.