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Conditions: Prostate Cancer

Prostate Removal and Continued Sexual Satisfaction

Feelings of anxiety, depression, and sexual dissatisfaction are common among men who have been surgically treated for prostate cancer, even a year after treatment, according to recent research from the Mayo Clinic.

More specifically, the study found that higher levels of anxiety were associated with depression and low sexual satisfaction and suggests that counseling may improve the quality of life for these men.

“The 10-year survival for a man undergoing surgery to remove localized prostate cancer is greater than 95 percent,” said researcher Alexander Parker, PhD in a press release. “Given that the majority of men who undergo prostatectomy for prostate cancer will not die from their disease, we are concerned about what life will be like for these patients decades after diagnosis and treatment.”

Dr. Parker added, “What is interesting from a sexual health standpoint is we observed that anxiety was not linked to poor erectile function per se but was linked to low levels of sexual satisfaction. If our results can be confirmed by other investigators, it would suggest that anxiety is not affecting some men’s ability to perform sexually but perhaps more their ability to enjoy their sex life.”

Erectile dysfunction is a common sexual complaint after prostate cancer surgery. This is because the prostate gland is surrounded by nerves and blood vessels that are critical for erections. Surgeons try their best to spare as many nerves as possible, but there are no guarantees that complete sexual function will be maintained. For some men, sexual problems are temporary and penile rehabilitation may help. For others, the issues are long-term. Either way, the adjustment can be frustrating, affect men’s self-esteem, and be a challenge for partners as well.

Treatments for Erectile Dysfunction Related to Prostate Removal

Treatments exist for erectile dysfunction and a man’s urologist can help determine which is best for him. But how can we help our patients with anxiety? Here are some steps we can encourage to start the process.

  • Counseling. Chances are, your patient’s cancer care team includes a counselor or therapist who specializes in issues facing cancer patients. If he is not already taking advantage of these services, encourage him to do so. Assure him that all conversations are confidential and that there’s nothing wrong with seeking some extra help.
  • Sex therapy. While a counselor can help with cancer-related anxiety, a sex therapist may be able to help with specific sexual adjustment issues. For example, a man might need some help in discussing his sexual difficulties with his partner.
  • Support groups. Some cancer centers offer support groups where a man can open up with like-minded individuals who are having similar experiences. In a support group, men can vent their frustrations and offer each other practical solutions, all in a safe community.
  • Involving the partner. It’s important to keep the partner in the loop and help her or him understand what is happening with the patient. Explain that the patient may feel like his manhood has been compromised because of erectile dysfunction or that he may be anxious about his ability to satisfy his partner. Some couples find it helpful to attend counseling sessions together or to use online counseling services.
  • Communication and social activity. Many men withdraw from their friends, families, and partners during and after cancer treatment. They may not want to discuss how they’re feeling or feel too overwhelmed. They may also worry about how those close to them will react. However, staying in touch with loved ones and engaging in social activity can help a man see his support network. It can also get his mind off of his problems, even if it’s just for a few hours.
  • Exercise. Staying physically active can do wonders for relieving anxiety and depression. Any exercise program should be started under a doctor’s guidance, however.
  • Sexual adjustments. A man may feel that that he’s a sexual failure if he can’t have erections like he used to. Help him remember that there is more to sex and intimacy and that by keeping an open mind and making adjustments, he and his partner can still have a satisfying sex life. This is another area where communication is crucial. Partners need to tell each other what works and what doesn’t. A sex therapist may be able to offer further suggestions.

The Mayo Clinic’s findings were presented at the World Meeting on Sexual Medicine in Chicago last August. The study was partially funded by a grant from the Sexual Medicine Society of North America.

Resources

American Cancer Society

Simon, Stacy

“Sex Counseling After Prostate Treatment Helps Couples”

(October 12, 2011)

http://www.cancer.org/cancer/news/news/sex-counseling-after-prostate-treatment-helps-couples

“Sexuality for the Man with Cancer”

(Last medical review and revision: October 28, 2011)

http://www.cancer.org/treatment/treatmentsandsideeffects/physicalsideeffects/sexualsideeffectsinmen/sexualityfortheman/index

Harvard Health Publications

“Penile rehabilitation after prostate cancer surgery”

http://www.harvardhealthcontent.com/newsletters/69,N0111b

Mayo Clinic

“Prostate Cancer Surgery Can Lead to Anxiety, Depression, Quality of Life Issues”

(Press release. September 24, 2012)

http://www.mayoclinic.org/news2012-jax/7100.html

Sexual Medicine Society of North America

“Nerve-sparing Prostate Surgery & Orgasms”

(March 16, 2012)

https://www.sexhealthmatters.org/news/nerve-sparing-prostate-surgery-orgasms

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