Male Erections and Ejactulation Following Prostate Cancer Treatment – What’s the Real Deal?

I must admit it is a bit unusual when taking on the task of writing a book about a subject that – through personal experience – and now research – I have become a subject matter expert. I have to be honest and say up front, I never really wanted this knowledge – for that matter I didn’t want to find out that I was diagnosed with Prostate Cancer at age 47. But, everything happens for a reason…and I guess that mine role is to be open about the experiences and provide a reality check for men and their families.

Now…some three years later as a Prostate Cancer survivor, I am conducting interviews with men from all around the world about their experience with prostate cancer. My goal…to produce a book and perhaps CD or audio recordings that will explain the realities about Prostate Cancer – what options are available and what you can really expect when it comes to treatment and side effects.

Let me caution – I am not a doctor, not involved in the medical community and don’t represent any drug company that may be trying to persuade you or someone you love to seek a certain option. I am a professional speaker who, just by chance, found out he had prostate cancer.

So, the purpose of this blog is to provide up to date information to men and their partners about Prostate Cancer and the emotional issues that you may face. You may not want to hear what is written, but I promise that it will be practical, useful and accurate. That said…let’s talk about prostate cancer, erections and sex.

Before I began tonights blog I was on the phone with Richard S. – he gave me permission to use his name – although I can’t begin to imagine how many Richard S’s there are in the world. Sorry, I digressed! Anyway, Richard was diagnosed less than a year ago with Prostate Cancer and in May had his treatment of choice – HIFU (High Intensity Focused Ultrasound) a treatment I considered.

Like most of the men I’ve interviewed for this book (I am still conducting interviews if you would like to share your experience contact me), if nerve sparing techniques were used and the prostate cancer was localized, the ability to gain an erection was reasonable. The problem is very few will define for you want an “erection” is after surgery. Now I can hear some folks now saying – “What’s he talking about, I know what an erection is?”

FACT: Not that my research is complete, but thus far no one I’ve talked to has told me that the erection they achieved following treatment was as satisfying of substantial as before their treatment. I ask this question: “On a scale of 1 to 10 with 10 being an erection like you had when you were 17 years old, what number would you assign as erection strength before treatment?” Most men answer between 8 and 10. Then I ask the same question, but this time assign the number after treatment. The answer from Prostate Cancer survivors who have had nerve sparing treatments varies between 3 and 7. Rarely do I find any one who will suggest that they are able to achieve an erection like before.

REALITY CHECK: It is true, an erection can be achieved, but more than likely it will take more stimulation to achieve and maintain or it will take medication or pumps to enhance the erection effort. One does not have to have a #10 erection in order to achieve an orgasm or to achieve penetration during sexual intercourse. However, it is practical to say that while an erection may be possible, do not expect things to be the same – based on my research they generally are not.

SIDE NOTE: As most will tell you the ability to achieve an erection is as much psychological as it is physical. As a Prostate Cancer survivor, if you are stressed about sexual performance, you will find that stress, anxiety, and other emotional strains will hamper your ability to perform and hence challenge your healing. For that reason, I elected to use Hypnotherapy and it worked. If you have questions about that, feel free to contact me – I’ll be happy to share the details.

EJACULATION: Gentlemen – after surgical or, in some cases HIFU, treatment you will not have a ejaculation – you have an orgasm, but nothing generally comes out. Richard S. shared with me that no one told him nor did he find out this fact on the internet. I suppose I was luck as my Doctor prepared me for that fact. He said that orgasm was likely but that it would be a “dry orgasm.” I asked him what that meant…to which he replied nothing would come out. It would feel the same, but there would be no semen released.

Guys…prepare for this. Some men have reported that it was not an issue for them. Other men have shared that they have yet to get over the lack of an ejaculation. I understand that. Now I am quite confident that some will be less than happy with my next comment, but I have made a commitment to be frank and candid in the entries I write. For all our lives since we reached the age of sexual maturity, we have had a ejaculation when orgasm was achieved. Whether that orgasm was released internally (through sexual intercourse) or externally, it was released. Some have said that the release or ejaculation was like “marking one’s territory.” It is quite natural. The inability to continue to “mark the territory” is disconcerting to many and something to prepare for.

In other words guy – you won’t need one of these (unless you are using it for other purposes).

CAUTION: I have reported in other blog entries that some men experience the release of urine during sex. This may occur before or during orgasm. It seems, from my research, to be limited in scope – most men are not reporting this issue. But there are some of us, myself included, that have experienced this – and I am told from the Doctors that it is not that unusual. Interestingly enough, most women that I have interviewed were not put off by that – the issue with urine release was more a problem for the man. If this is a problem, one practical thing is to avoid heavy drinking immediately before sex and certainly empty one’s bladder before sex is practical.

As always…these entries are intended to stimulate discussion. Please feel free to comment as your comments will certainly help others.

Prostate Cancer Treatment Options – Talking About A Deep Freeze?

First, don’t get your hopes up on this treatment, there are some issues that will take some time to warm up (pun intended) here.

A report in a Scottish newspaper reveals some startling ideas about the treatment of prostate cancer.  According to the report, GLASGOW (Scotland) doctors have introduced a revolutionary cancer treatment using ice to kill cancer.

Today, a Glasgow man became the first patient to opt for an advanced technique that promises fewer side-effects and an even chance of a cure.

Professor Hing Leung leads the National Specialist Prostate Cryotherapy Service, which carried out its first procedure at the New Beatson cancer centre at Gartnavel.

The surgery, under a general anaesthetic, involves inserting between six and 12 hollow needle-like probes into the prostate gland before passing Argon gas through them, rapidly freezing the organ to -40C.

The surgical team monitors the ice formation using ultrasound and, as soon as the organ is frozen, they defrost the area with another gas before repeating the procedure.

Professor Leung said: “Placing the probes is a bit like playing the old game battleships. The strategy is to cover the whole area using only a few points.

“The critical thing is the speed at which you bring the temperature down.”

The rapid freezing kills prostate and tumour cells, but the fact the frozen area is thawed soon after, coupled with passing warm fluid through the tube from the bladder, helps prevent damage to the surrounding area, reducing side-effects.

For those Americans who read this…the process is not new.  This is what has commonly been referred to as Cryotherapy which has been done since the early 1990’s.  The primary difference here is the method used to freeze the prostate.  Cryotherapy uses ultra-thin needles to produce ice balls of extreme sub-zero temperatures. The doctor uses ultrasound to accurately guide insertion of the needles, precisely control the size and shape of the ice balls and monitor the freezing.

According to the Prostate Cancer Institute:

Cryotherapy is an option for prostate cancer patients who want to avoid major surgery or the risks of “watchful waiting.” Cryotherapy can treat prostate cancer patients in the intermediate and high risk groups (stage T2c or above) as well as those who have failed previous radiation treatment.

Recent publications showing 10-year data demonstrates safety and durable efficacy of cryotherapy for treating prostate cancer. Morbidity following the procedure is mild in comparison with other treatments, with the exception of sexual function impairment.

The most significant questions that men would have regarding this form of treatment (assuming the cancer is gone) relates to the side effects – Incontinence and Impotence. An excellent article is featured on emedicine from Web.MD that I’ll summarize here.  The link will be provided below…

Cryotherapy impairs the penile arterial blood supply (Aboseif, 1997) and damages the cavernosal nerves responsible for erectile function (El-Sakka, 1998). This combined neurovascular insult results in impotence in 40-100% of treated patients (Bahn, 2002), depending on such factors as the use of multiple freeze-thaw cycles, the size of the ice ball generated, preoperative potency, the instruments used to assess potency, and the follow-up interval since treatment. Greater nerve regeneration is possible after cryotherapy than after surgery or radiation therapy; accordingly, some patients have reportedly recovered erectile function as many as 2 years after treatment. One report indicated that 95% of subjects who were potent before cryotherapy became impotent and that 5% regained their potency at a mean of 16 months (Bahn, 2002).

Ouch… Postprocedural potency is the quality-of-life domain for which cryotherapy remains clearly inferior relative to other local treatment modalities for prostate cancer. Until the return-of-potency rate improves, the risk of impotence will likely continue to be an impediment to wider use of this treatment approach among patients for whom erectile function is important.

SUMMARY:  If prostate cancer has been effectively treated and erectile function is important…don’t use this route!

Issues with incontinence are essentially the same…significant problems.

CONCLUSION: The recent release is an old treatment with a repackaged method of delivery.  It could be VERY EFFECTIVE as a follow up treatment method for me who have had a primary treatment method that failed.  But, I would certainly seek multiple medical opinions if you are considering this for your primary treatment following an initial diagnosis for prostate cancer.

YOUR COMMENTS ARE WELCOME!

LINK PROVIDED HERE