Prostate cancer and intimacy: tips and advice

What is prostate cancer and how is it treated? 

Prostate cancer is the second common cancer in men in the US, behind lung cancer, with more than 230,000 new cases diagnosed each year, mainly in men over the age of 50.

The prostate is a gland in the male reproductive system, located below the bladder and surrounding the urethra. It produces part of the seminal fluid essential for the mobility of spermatozoa.

Prostate cancer generally develops slowly, and can remain asymptomatic for years. However, some cases can be more aggressive and require rapid treatment. 

The main treatments for prostate cancer include:

• Radiotherapy: the use of radiation to destroy cancer cells. It can cause urinary irritation, intestinal problems and erectile dysfunction.
  
• Hormone therapy: involves blocking the action of male hormones (androgens) that promote tumor growth. It can lead to hot flushes, reduced libido and increased fatigue.
  
• Radical prostatectomy: total surgical removal of the prostate gland. Potential side effects include erectile dysfunction and urinary problems.
  

The choice of treatment depends on a number of factors, such as the patient's age, general state of health and the stage of the cancer. It is recommended to discuss the options with a healthcare professional to determine the best treatment for each situation.

Over and above the treatments and their effectiveness, prostate cancer can have significantly affect patients' sex lives. The disease and its treatment can affect sexuality in different ways, both physically and psychologically.

How does prostate cancer affect intimacy? 

Prostate cancer and its treatment can have a significant impact on men's sexuality, which can affect the life of the couple.

Erectile dysfunction 

Surgery and radiotherapy can damage the nerves responsible for erection, causing frequent erectile dysfunction after prostate cancer. Their severity depends on age, previous sex habits and the treatment received. After prostatectomy, recovery can take from a few weeks to two years, with or without medical treatment.

Troubles with ejaculation 

Treatment for prostate cancer can lead to changes in ejaculation. For example, radical prostatectomy results in an absence of outward ejaculation, known as ‘dry orgasm’. Although sexual pleasure may be different, it tends to improve with time.

A drop in libido 

Hormone-based treatment for prostate cancer can lead to a drop in sexual desire by lowering testosterone levels. After prostate cancer, libido can also be affected by psychological factors, such as anxiety and concerns about sexual performance.

Such physical and psychological consequences of prostate cancer can also upset a couple's relationship. 

How can prostate cancer affect your couple? 

Prostate cancer not only affects the patient, but can also upset the dynamics of the couple.

Here are some examples of how this disease can affect a couple's relationship:

The impact on intimacy 

Treatments described above can change a couple's sex life. These changes can lead to frustration, misunderstanding and sometimes emotional distance between the partners.

Emotional consequences

The stress of the diagnosis, uncertainty about the course of the disease and the side-effects of treatment can affect communication within the couple. The partner may feel powerless in the face of the situation, while the patient may experience loss of self-confidence.

To preserve the couple's equilibrium, open communication is essential. Psychological support or couple therapy can help manage these changes more effectively and strengthen the emotional bond despite the illness. 

How can you maintain healthy sex life after prostate cancer? 

For many patients and their partners, maintaining sexuality after prostate cancer is a real concern. Fortunately, there are a number of solutions to mitigate the side effects of treatment and improve the couple's relationship.

Let's take a look at these solutions:

Drug treatments

There are phosphodiesterase type 5 inhibitors, such as sildenafil (Viagra®) or tadalafil (Cialis®), which can help improve erectile function.

Medical devices 

The use of vacuum pumps or penile rings can make it easier to achieve and maintain an erection.

Intracavernous injections

Injecting medication directly into the penis can induce an effective erection, even in cases of nerve damage.

Implants

As a last resort, penile prostheses may be considered to restore the rigidity required for satisfactory sexual activity.

To maintain a fulfilling intimate life after prostate cancer, support should be provided by a multidisciplinary care team:

• Urologists assess sexual problems and suggest appropriate solutions, such as drug treatments or medical devices.
  
• Sexologists help to understand and manage the psychological and emotional impact of the disease, promoting greater acceptance of the changes to the body.
  
• Couple therapists play a key role in improving communication between partners, helping to express fears and strengthen bonding.

These professionals can help you deal calmly with the challenges of post-treatment sexuality and explore solutions tailored to each situation. In addition, offline and online patient support groups provide invaluable opportunities for sharing experiences and advice.

In a nutshell 

After prostate cancer, there are a number of ways to regain a fulfilling intimate life. Treatments, medical devices and specific medical support can improve erectile function.

Patient support groups such as Carenity.us also offer a place to exchange ideas and share experiences. It is possible to rebuild a fulfilling sexuality and a improve your relationship with your partner.

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