Is there a sexual life after treatment of prostate cancer?

Abstract

Sexual dysfunction is one of the more common consequences of cancer treatment. Sexual dysfunction in cancer patients may result from biological, psychological and social factors. Among different types of cancers, prostate cancer is the most frequent male malignancy in Western countries. Radiation therapy together with radical prostatectomy is the most effective treatment for localized disease. According to the surgical technique applied, percentages of erectile dysfunction (ED) after surgery vary from 30 to 100%. Published rates of ED following external-beam radiotherapy vary from 7–80%, and even after brachytherapy this percentage may be as high as 60%. The etiology of ED after radiotherapy of prostate cancer is multi-factorial. Vascular, neurogenic and psychogenic factors are often reported, though a vascular mechanism seems more likely to be involved. The damage after surgery seems to be neurogenic, though other factors have to be considered as well. The oral drugs sildenafil, tadalafil and vardenafil are effective to treat ED in about half of the patients after radiotherapy, but such practice is reportedly lower because of several factors such as age, surgical techniques used and comorbidities. More importantly, medical treatments along with patients' emotional aspect can lead to sexual problems in cancer patients. In this regard, patients need adequate counselling on post treatment sexual life so that they can enjoy a normal sexual life.