Sex After Hormone Replacement Therapy Or Chemotherapy
Doctors who treat cancer with medicines such as chemotherapy or hormone therapy are typically medical oncologist. Both of these treatments come in the form of drugs and/or chemicals. Often hormone replacement therapy and chemotherapy are useful when other prostate cancer treatments have failed or the cancer has spread.
Seminal vesicles invasion means the tumor has spread to the seminal vesicles which are attached to the prostate gland. To prevent the spread of cancerous tumors Seminal Vesicle-Sparing procedures are often employed.
Hormone replacement or chemotherapy are sometimes used to complement other prostate cancer treatments and are not necessarily treatments of last resort in all cases. Because of the variety of drugs and chemicals, the impact on sexual function differs tremendously.
Changes In Penis Size
Some men notice that their penis is shorter after surgery . Some men notice other changes such as a curve in their penis or a narrower area. We don’t know for certain why these changes happen, but it could be because of low oxygen levels in the penis, caused by not having erections. Other treatments such as hormone therapy with radiotherapy may also cause changes to the size of your penis.
Encouraging blood flow to the penis after surgery may help prevent this. In particular, using a vacuum pump, either on its own or with PDE5 inhibitor tablets could help maintain your penis size and improve erections.
Keeping your penis active after surgery
Although you may not be ready or recovered enough for sex, you can still start treatment for erection problems in the weeks immediately after surgery. It could be taking a low-dose PDE5 tablet once a day or using a vacuum pump, or sometimes both together. The treatment along with masturbation encourages blood flow to the penis. This can help keep your penis healthy. You may hear this called penile rehabilitation. Think of it in the same way as having physiotherapy if you had injured your arm or leg. Starting treatment soon after surgery may help improve your chance of getting and keeping an erection. But it may not work for every man.
Remission And The Chance Of Recurrence
A remission is when cancer cannot be detected in the body and there are no symptoms. This may also be called having no evidence of disease or NED.
A remission can be temporary or permanent. This uncertainty causes many people to worry that the cancer will come back. Although there are treatments to help prevent a recurrence, such as hormonal therapy and radiation therapy, it is important to talk with your doctor about the possibility of the cancer returning. There are tools your doctor can use, called nomograms, to estimate someones risk of recurrence. Understanding your risk of recurrence and the treatment options may help you feel more prepared if the cancer does return. Learn more about coping with the fear of recurrence.
In general, following surgery or radiation therapy, the PSA level in the blood usually drops. If the PSA level starts to rise again, it may be a sign that the cancer has come back. If the cancer returns after the original treatment, it is called recurrent cancer.
When this occurs, a new cycle of testing will begin again to learn as much as possible about the recurrence, including where the recurrence is located. The cancer may come back in the prostate , in the tissues or lymph nodes near the prostate , or in another part of the body, such as the bones, lungs, or liver . Sometimes the doctor cannot find a tumor even though the PSA level has increased. This is known as a PSA-only or biochemical recurrence.
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Men’s Psychological And Culturally Diverse Adaptation To The Sexual Side Effects Of Prostate Cancer Treatment
Psychological effects.
The quality of life research in prostate cancer emphasizes the importance of sexual functioning as a part of overall well being., After prostate cancer treatment, beyond the loss of erections, men’s responsiveness to visual, desire-inducing stimuli can diminish,, and their libido can decrease. All men continue to have orgasms , but some report absent, less intense or even painful orgasms. Some men report feeling sad and tearful about the loss of erectile functioning. Their self-regard is diminished and they experience the changes in sexuality as a loss of quality of life.,
Several qualitative studies described patient reports of loss of manhood and loss of familiar self that can come with the sexual side effects of prostate cancer treatment., Men also experienced loss of the capacity to respond to sexual cues, sexual fantasies, and spoke with nostalgia about past sexuality and loss of self-worth. Some men avoided sexual encounters for fear of failure or embarrassment. For others, the loss of erections was synonymous with the loss of the meaning of life. Men in these studies did not confide their emotional pain, even when family support was available, although some confided in other men with prostate cancer. Instead, men coped by maintaining their competent roles, for example, being an engineer.
Cultural diversity and adaptation
The impact of prostate cancer on couples’ relationships
Effects on partners and relationships
Couples’ sexuality
Preserving Sexual Function With Sabr
SAbR, also known as stereotactic body radiation therapy or SBRT, involves applying a precisely targeted dose of radiation directly to the tumor and sparing nearby healthy tissue, including the nerves and blood vessels involved in sexual function. Its a convenient treatment that takes place over only five outpatient visits.
Hundreds of patients have been treated with SAbR at UT Southwestern over a period of more than 10 years, mostly funded by a U.S. Department of Defense grant. We published mature, prospective data using SAbR for low- and intermediate-risk prostate cancer showing impressive rates of potency preservation. In addition to SAbRs benefits for sexual health, the treatment appears as effective as other options at eliminating prostate cancer, and it compares favorably in a number of additional areas, such as:
Bowel function
Fatigue and inconvenience of therapy
Urinary incontinence
Many of the advances in SAbR that have made these milestones possible have been developed here at UT Southwestern, and its time for the next step: getting the word out about its remarkable potential benefits.
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Recovering From Prostate Surgery
During the surgery, the doctor will insert a catheter into the patients penis. This thin, flexible tube will help to drain urine until the patient is healed enough to urinate on their own. The catheter will typically remain for about one or two weeks after the surgery.
The patient can usually leave the hospital within a day or two, but the incision site will likely feel sore for a few days after. The patient will most likely not be able to drive for at least a week, but should be able to return to normal activities within a few weeks.
During the recovery, the patient may experience several side effects including:
- Urinary tract infection
- Temporary loss of bladder control
- Infertility
- Ejaculatory dysfunction
- Erectile dysfunction
After the surgery, its possible to experience erectile dysfunction for a few weeks, a year, or even longer in some cases. This is because the surgery might potentially injure one of the nerves, muscles, or blood vessels that are involved with getting and maintaining erections. There are other factors that could influence the severity of the erectile dysfunction during recovery as well and so it can be difficult to predict how any specific person may recover from the surgery.
The Prostate Cancer Foundation has reported that about half of all men undergoing nerve sparing surgery will regain their pre-surgery function within the first year of the surgery.
- Age
- Sedentary lifestyle
What Changes Can You Expect
- Ejaculation will cease:Without a prostate gland or seminal vesicles, you will no longer experience ejaculation. Even though your orgasm may feel different, it will still be pleasurable.
- Leaking urine during sex:This is possible but does not happen to all men. Its harmless and temporary.
- Performance anxiety:Dont underestimate the emotional roller coaster of prostate cancer surgery and recovery. Its normal to worry about sex after prostate cancer. Being open and honest with your partner will help.
Keep in mind that your overall health, age, and present ED status are all factors in your recovery to sex after prostate surgery.
Less commonly, the prostate cancer tumor may bulge to one or both sides of the prostate gland, making nerve-sparing surgery extremely difficult or impossible.
Dr. Samadi will help you understand your exact prostate cancer status and the position and size of your tumor. In some cases, a nerve graft can be performed to regenerate the penile nerves for sex after prostate surgery.
- Changes in mood and libido:The psychological impact of surgery can be significant this will leave you tired and irritable, not in the mood for sex so you will need to move towards intimacy slowly and your desire will return back to normal.
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Erectile Dysfunction Following Radical Prostatectomy
Assuming the management of erectile dysfunction requires expert diagnosis and treatment.
Diagnosis includes sexual function history, general medical history, psychosocial history, medication history, physical examination, and appropriate laboratory testing.
Treatment follows diagnosis, and we provide a range of treatment options through the Clinic. Minimally invasive treatment options range from oral medications to medications administered directly to the penis to a mechanical vacuum device applied to the penis. Invasive treatments include implants or vascular surgery. We are particularly expert in the surgical treatment of patients with erectile dysfunction. The range of conditions we manage include penile prosthesis complications, penile vascular abnormalities, penile curvature, and abnormally prolonged erection consequences.
Psychological treatment is an important adjunct to managing erectile dysfunction. If our diagnosis suggests a psychological association with your erectile dysfunction, we may recommend that you pursue counseling with a qualified psychologist available through the Clinic.For instance, there may be relationship problems that negatively affect sexual functioning with your partner. Referrals can be made to the Johns Hopkins’ noted Sexual Behaviors Consultation Unit.
Nutrition And Dietary Supplements
Some studies have suggested that eating a healthy diet that is rich in vegetables and lower in animal fats might be helpful, but more research is needed to be sure. However, we do know that a healthy diet can have positive effects on your overall health, with benefits that extend beyond your risk of prostate or other cancers.
So far, no dietary supplements have been shown to clearly help lower the risk of prostate cancer progressing or coming back. In fact, some research has suggested that some supplements, such as selenium, might even be harmful. This doesnt mean that no supplements will help, but its important to know that none have been proven to do so.
Dietary supplements are not regulated like medicines in the United States they do not have to be proven effective before being sold, although there are limits on what theyre allowed to claim they can do. If you are thinking about taking any type of nutritional supplement, talk to your health care team. They can help you decide which ones you can use safely while avoiding those that could be harmful.
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Types Of Prostate Cancer Treatments
For men who have undergone prostate cancer surgery, for example, many surgeons recommend avoiding sexual activity for at least several weeks in order to allow for proper healing. Radiation therapy, hormone therapy, and chemotherapy do not necessarily preclude men from returning fairly rapidly to their prior level of sexual activity.
However, there can be side effects as a result of these treatments that make sex difficult or impossible. These possible side effects include fatigue and erectile dysfunction. So even if you’ve been given the go-ahead by your doctor, you may find it necessary to redefine what sex means for you and your partner and to explore new or alternative sources of pleasure.
If you have been treated with implanted radioactive seeds , your doctor will likely give you a certain time frame wherein sexual activity should be avoided due to the presence of radioactivity within your prostate. Most men can have sex one to two weeks after their seed implant. Men should wear a condom for the first two months after their seed implant. This break in sexual activity is also meant to allow for proper healing following the implantation procedure.
How Will Treatment Affect My Ability To Orgasm Or My Fertility
Surgery for prostate cancer can affect both your orgasms and your ability to have children. The prostate gland normally adds a fluid called semen to sperm to nourish and protect it. Youll no longer make semen after surgery, which means your orgasms will be dry. Radiation therapy can also reduce the amount of fluid you ejaculate. Without semen, you wont be able to father children. If youre concerned about fertility, you can bank your sperm before your surgery.
After surgery, orgasms will also feel different. You wont have that normal buildup of sensation before you have an orgasm. Youll still be able to feel pleasure, though.
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Availability Of Data And Materials
The datasets generated and/or analyzed during the current study are not publicly available due to the large size of the transcripts from each interview and sensitivity and specificity of some of the information from the interviews, but the demographic information and some of the de-identified descriptions can be made available upon reasonable request to the corresponding author.
Sex After Prostate Cancer: Treatment Choice Matters
Sexual function is one of the first thingsmany men think about if theyre diagnosed with prostate cancer. However, itsrarely the first, second, or even third thing they discuss with their partnersand doctor. Occasionally, a patient will ask me about it, but many men getembarrassed and wait until their doctor brings it up often when their partneris in a separate room.
Sex is a natural part of life for people intheir 60s and 70s and increasingly has remained so with improved lifeexpectancy and focus on active living. Men and their partners should beconcerned about sexual function, or potency, after prostate cancer treatment. Changesin sexual health are a huge factor in quality of life after prostate cancer andshould be considered when weighing your options.
In fact, its so important that my colleaguesand I are leading the charge on a multicenter randomized clinical trial solely focusedon preserving sexual potency after radiation therapy for prostate cancer. TheProstate Oncologic Therapy While Ensuring Neurovascular Conservation clinical trial involves stereotactic ablative radiotherapy, or SAbR, and anovel technique that we are hopeful will reduce patients risk for erectiledysfunction and other sexual side effects.
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S Men Can Take To Improve Or Recover Orgasms
This doesnt mean that some men dont have difficulty experiencing orgasm after radical prostatectomy. The missing sensation of fullness and the lack of ejaculate are big changes. But there are some things you can do to correct the problem, according to Dr. Kacker.
Men can achieve an orgasm on their own with manual stimulation or with a partner through manual or oral stimulation. Just remember that an erection is not needed. Using a vibrator on the head of penis is often helpful. Vibration can stimulate the nerves in the penis and increase the signals being sent to the brain.
The Three Parts Of Male Orgasm
Kacker starts by pointing out a common misconception that erections are necessary for male orgasm. They arent. Men can have experience orgasm without an erection. The converse is also true, of course: men can have an erection without having an orgasm.
When discussing orgasm and radical prostatectomy, its useful to think of the male orgasm as having three separate parts, says Dr. Kacker.
First, secretions from the testicles, the prostate, and the seminal vesiclessmall, slender glands near the prostateflow into the urethra, the tube-like structure that carries semen through the penis and out the body. The emission of those fluids creates a feeling of fullness and a sensation of inevitability.
Second, theres ejaculation, which is accompanied by contractions of the pelvic floor muscles, the group of muscles used to hold in intestinal gas and urine.
And third is the mental componentall of the processing the brain does of incoming sensory signals from penis and pelvis that contribute to the mental experience of build up and release.
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What Can I As A Partner Expect
One of the effects of prostate cancer treatment is erectile dysfunction or impotence. This means that your partner may not be able to have erections that are hard enough for him to have sex with you or that he may not be interested in sex because of the medicine he is taking to treat his prostate cancer. This affects not only the man, but you, too, as his intimate partner. If you are the partner of a man with erectile dysfunction, it can be difficult to cope with changes in your sexual relationship. Sometimes men struggle to come to terms with changes in their body image or their ability to perform sexually. This can sometimes result in him staying away from intimate situations where he may feel under pressure to make love. As a partner you may feel rejected by what seems like a lack of sexual interest or intimacy. This may not have anything to do with his feelings for you, but is a result of his cancer treatment. Erectile dysfunction can be difficult for both of you. You may want to reassure your partner that:
- Sex is not as important as long as he is healthy and that he is no less of a man to you
- You will work through it with him
- You understand his feelings
- He is important to you
It may help if you explain to your partner how important nonsexual touching and intimacy such as kissing and cuddling is to you.