Sex after prostate surgery? Men, know your options

Prostate cancer and erectile dysfunction: Eight out of 10 men affected post-surgery

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Call for talk around prostate removal with eight in ten surgeries linked to erectile dysfunction.

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Prostate cancer patients need to be better informed about support and treatment options say experts, with eight-in-10 men experiencing sexual problems after having their prostate removed.

New research, led by Cancer Council NSW, has found more than 80 per cent of men who have had radical prostate surgery experience erectile dysfunction.

The study followed more than 2000 men for up to 15 years and found 83 per cent of those who had non-nerve sparing radical prostatectomy surgery reported high levels of erectile dysfunction, compared with 62 per cent in the active surveillance group and 43 per cent of men of the same age without prostate cancer.

It also found that just over a quarter (27 per cent) of men who had surgery for localised prostate cancer reported persistent urinary incontinence, which was notably higher compared to those having other forms of treatment.

Cancer Council NSW head of prostate cancer research, Associate Professor David Smith, said the findings showed that the impact of a diagnosis often extended beyond short-term clinical outcomes and highlighted the need for improved patient care and informed choices.

"Men who have had prostate cancer surgery often think side effects they experience such as reduced sexual function are normal signs of ageing. But our study allowed us to compare patients and survivors with a group of ageing men without cancer.

"The quality of life differences were striking, particularly for men who had surgery to remove their prostate. Men need to know they have options, in treatment decisions and support services."

Associate Professor Smith said when it comes to ensuring the best possible treatment outcomes, including longer term quality of life, it is essential men are fully informed of all their options and can weigh up the risks and benefits of a decision in consultation with their doctors based on all the evidence.

"Radical prostate surgery can be the best and only option for some men with prostate cancer," he said. "There are, however, other options, depending on pathology, staging and the overall circumstances of an individual patient.

"Clinical practice guidelines and decision aids are available and include consumer versions. Use of guidelines leads to improved clinical and quality of life outcomes, by guiding optimal care and minimising the harms and side effects of treatment."

More than 16,700 men will be diagnosed with prostate cancer in Australia this year alone and A/Prof Smith said survival rates are increasing due to improved detection and treatment.

"There is an increasingly urgent need for clinicians to work together across disciplines, not only to monitor, manage and treat the cancer, but to ensure the man being treated is supported.

"When it comes to prostate cancer, all appropriate treatment decisions should be discussed and considered through shared decision making between the clinician and patient.

"This discussion should include what to expect post-treatment and what preferences men have in relation to the risk of side effects.

"Additionally, we hope that after treatment, clinicians might be able to initiate frank conversations about sexual function, set out realistic expectations for recovery, and refer men to sexual and psychosocial counselling when needed."

For more information go to cancercouncil.com.au or call Cancer Council NSW on 131-120.

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