Prostate cancer is the most common type of cancer to occur in men, but there are still a lot misconceptions. A question men often have is whether they will experience ED after prostate cancer. Prostate cancer itself actually has few side effects, especially in the early stages, and does not usually result in erectile dysfunction. Most often, it is the treatment of prostate cancer that results in difficulty achieving erections.
ED after prostate cancer treatment.
Nearly all men undergoing treatment for prostate cancer will experience some degree of erectile dysfunction after treatment. This is because the systems that cause erections—nerves, blood vessels and hormone balances—are very delicate, and prostate cancer treatments are often traumatic to these systems.
Erectile dysfunction after prostate cancer treatment can be mild or severe, and it can be temporary or permanent, depending on the particular treatment technique, stage of the cancer and skill of the doctor or doctors performing the treatment. Common treatments are surgery to remove the cancer, radiation therapy, cryotherapy and hormone therapy.
Each of these treatments has their own unique advantages and disadvantages, as well as their own set of side effects, and it is important to know what to expect so you can be as prepared as possible after your treatment.
ED caused by surgery.
A common treatment of prostate cancer is surgery to remove the cancerous tissue. During this operation, there is a chance that the nerves triggering erection can be damaged. The odds of this depend on the type of surgery, skill of the surgeon and stage of the cancer. In some cases, it may be unavoidable. Even if there is no damage to the nerves, the trauma of surgery can result in erectile dysfunction immediately following the operation. If there is little to no nerve damage, the erectile dysfunction will likely go away within the first year or two following the operation. If the nerves were unable to be spared, the erectile dysfunction is likely to be permanent.
Possible side effects of surgery include:
- Partial or complete loss of orgasm
- Pain with orgasm
- Loss of penis length
- Inguinal (groin) hernia
ED caused by radiation therapy.
During radiation therapy, radiation is used—either externally in a procedure similar to getting an x‑ray, or internally with injected radioactive pellets about the size of a grain of rice—to destroy cancer cells or slow their growth. The radiation can also damage surrounding tissues, including the nerves triggering erection. In this case, symptoms of erectile dysfunction will not appear until six months to a year after treatment and are usually permanent. Newer techniques are more accurate and can limit this damage and side effects.
Side effects to radiation can include:
- Bladder inflammation leading to frequent and/or painful urination
- Sore skin in the treated area
- Loss of pubic hair
- Difficult urination due to narrowing of the tube between bladder and penis
- Frequent or loose bowel movements
- Inflammation of the rectum
- Rectal leaking/bleeding
- Abdominal cramping
ED caused by cryotherapy.
Cryotherapy (also called cryosurgery or cryoablation) is the use of extreme cold to freeze and destroy cancer cells. Probes are inserted into the area and very cold gases are circulated to freeze the area. Like radiation and surgery, this treatment can result in damage to nearby tissues, including the nerves in the area, resulting in erectile dysfunction immediately after treatment. Even if there is no permanent nerve damage, the trauma caused by the insertion of probes can result in temporary erectile dysfunction.
Common side effects include:
- Blood in urine for a few days
- Soreness where the probes were inserted
- Swelling of penis or scrotum
- Pain or burning from the bladder and intestines
- The need to empty the bladder or bowel more often
- Urinary incontinence
ED caused by hormone therapy.
With hormone therapy, hormones are used to shrink or slow the growth of prostate cancer. Because hormone treatments lower the amount of testosterone in the patient’s body, they can make it difficult or impossible to achieve erection. They can also lower the patient’s libido. These effects usually occur within two to four weeks after treatment. The severity and permanence of erectile dysfunction varies depending on the type of hormone treatment.
Since testosterone affects many of the body’s systems, this therapy comes with a wide array of side effects, including:
- Shrinkage of testicles and penis
- Hot flashes, which may get better or even go away with time
- Breast tenderness and growth of breast tissue
- Osteoporosis (bone thinning), which can lead to broken bones
- Anemia (low red blood cell counts)
- Decreased mental sharpness
- Loss of muscle mass
- Weight gain
- Increased cholesterol
Treating ED after prostate cancer.
In all of these cases, vacuum therapy can be an effective solution for erectile dysfunction. Because vacuum therapy relies on physical forces to gently draw blood into the penis and create an erection, it will be effective even if there is severe nerve damage from surgery, radiation or cryotherapy.
Other erectile dysfunction treatments can also work, but because they rely on the body’s own systems, their effectiveness is greatly diminished if there is nerve damage. In the case of hormone treatments for prostate cancer, vacuum therapy solutions can still create erections. However, they will not increase desire for sexual intercourse. Bottom line: When it comes to sex after prostate removal, vacuum therapy can be an effective tool.
For more information about vacuum therapy solutions to erectile dysfunction, explore our blog posts. Also, download our free ebook, Prostate Cancer and ED: What You Need to Know.