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Prostate Cancer

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Question: What does treatment for prostate cancer consist of, and does it affect a male's ability to have sex? A very close friend of ours has been diagnosed with prostate cancer (it really *isn't* my partner or me!) and we were wondering what his treatment options might be. If the prostate gland is removed, does that eliminate the ability to have sex? Probably best to have an older person answer this: it's pretty obvious by the question that this is going to be completely out of the realm of experience for most of the teenagers.

Answer: It can, but new surgical techniques have reduced the risk. I was diagnosed with it about a year ago, but a second opinion from Johns-Hopkins said no. At least not yet. Anyhow, there are a number of different treatments that depend on the age of the patient and the stage of the disease. At my age, 50, and the very early preliminary diagnosis, removal was recommended. There is a new procedure called the da Vinci procedure that is minimally invasive and less likely to lead to the nerve damage that causes impotence. However, it is still a risk, as well as a risk of urinary incontinence. And even if you are not impotent, your orgasms will be dry - seminal fluid is produced by the prostate. There are also other procedures, such as implanting radioactive 'seeds' into the prostate. It is my understanding that the risk of impotence from that or any other radiation procedure is higher than da Vinci surgery, but less than with traditional surgery. Chemo and broader irradiation can be recommended in more advanced cases. My brother had the daVinci procedure, and he is able to have sex. He uses a penile constriction band to maintain an erection; I don't know whether he had any ED problems before. He is able to have orgasms, but as I said, they are dry. Sometimes, again depending on the age,the stage, and how aggressive the cancer, they will recommend leaving it alone. Don't bank on that, though. Here's a link with info on the daVinci procedure. Tell your friend my thoughts and prayers are with him. I know how scary this is. I have to have regular biopsies to keep track of mine, and every time I go through hell waiting for the results. If you Google 'prostate cancer stories' there are lots of personal stories on the web.

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