There are a number of different causes of penile cancer, both mental and physical. Many men who have prostate cancer and undergo treatment for it report experiencing penile dysfunction, in varying degrees of severity. Although it is not frequently-talked about, this is very common and with the right treatment, does not have to be a permanent affliction.

Does prostate cancer cause penile dysfunction?

Firstly, it is important to note that in patients who experience prostate cancer and penile dysfunction, prostate cancer is usually never the direct cause. Erectile dysfunction is usually a side effect of the treatments used to cure prostate cancer1. These treatments can include:

  • Radiation therapy
  • Hormone therapy
  • Surgery to remove the prostate

Some patients undergoing these treatments might not experience penile dysfunction at all, while others may experience it to varying degrees. Erectile dysfunction caused by prostate cancer treatment is often a delayed side effect, which may be why many people fail to make the causal connection between the treatment and the issue.

Radiation Therapy

Patients who undergo radiation therapy for prostate cancer will generally not see penile dysfunction straight away. Normally, this side effect only occurs approximately six months after you start radiation2. This is one of the most common side effects and is more severe the longer that your radiation treatment is. When radiation is aimed at your pelvic region (not just for prostate cancer, but for other conditions in the area), the blood flow to your penis might be limited, and you may experience a decrease in testosterone, which can reduce the ability to get mentally and physically aroused.

Hormone therapy

Hormone therapy reduces the level of testosterone in the body, and erectile dysfunction can occur as early as two weeks after therapy begins3. Penile dysfunction does not occur in all patients, but there are a number of different symptoms, and men might experience some or all of them4. Some men find that they no longer have any sexual interest, while others may find that they still have a regular libido, but can no longer physically maintain an erection. The good news is that this type of erectile dysfunction is usually only temporary and will go away when you finish hormone therapy, and your body begins to produce regular amounts of testosterone again.

Surgery

Surgery to remove your prostate can sometimes immediately result in erectile dysfunction5. Nerves can be damaged during the process, something which is sometimes unavoidable due to the size of cancer. This type of treatment can also sometimes result in “retrograde ejaculation”, where semen travels into the bladder instead of out of the penis during an orgasm6. Generally these forms of erectile dysfunction are permanent, but they can be managed with the right support so that you can still enjoy sex.

Always speak to your doctor about your concerns when you are creating a treatment plan

If you are concerned about experiencing any form of penile dysfunction as a result of prostate cancer treatment, bring it up with your care team. If you are concerned about it happening after surgery, sometimes it may be possible to create a treatment plan that reduces the risk of permanent damage. In cases where this is not possible (for example if the only treatment option is surgery, where nerves are likely to experience permanent damage), your medical team can still offer you support throughout the entirety of your treatment process. This way if you do begin to experience any form of penile dysfunction, you can receive swift and accurate support.

Penile dysfunction caused by prostate cancer treatment can be treated

In most cases, erectile dysfunction that occurs as a result of prostate cancer treatment is only temporary, and generally goes away after about a year7. In cases where nerves are damaged (resulting in irreversible damage), there are still treatment methods available that can alleviate the symptoms, allowing you to enjoy a healthy sex life.

If you are concerned about penile dysfunction, or any other side effects caused by your prostate cancer treatment, do not hesitate to talk to medical professionals. You will see better results if you seek help sooner rather than later, and your medical team can offer you all of the necessary support to help treat this condition.

Endnotes

  1. https://www.webmd.com/prostate-cancer/guide/impotence-prostate-cancer
  2. https://www.mayoclinic.org/diseases-conditions/cancer/in-depth/cancer-treatment/art-20045422
  3. https://www.webmd.com/g00/prostate-cancer/guide/impotence-prostate-cancer?i10c.ua=1&i10c.encReferrer=&i10c.dv=25
  4. https://www.mayoclinic.org/diseases-conditions/cancer/in-depth/cancer-treatment/art-20045422
  5. https://www.webmd.com/g00/prostate-cancer/guide/impotence-prostate-cancer?i10c.ua=1&i10c.encReferrer=&i10c.dv=25
  6. https://prostatecanceruk.org/prostate-information/living-with-prostate-cancer/sex-and-relationships
  7. https://www.pcf.org/about-prostate-cancer/prostate-cancer-side-effects/erectile-dysfunction/