Earlier this year, the American Cancer Society estimated that about 15 million Americans were living with cancer in 2016.
On top of that, more than 161,000 men are expected to be diagnosed with prostate cancer in 2017, representing 19% of new cases. Lung and bronchus (air passages of the lungs) cancer comes in next, with almost 117,000 new cases expected (14% of new cancer diagnoses). Colon and rectal cancer ranks third, with over 71,000 cases (9% of new diagnoses).
Fortunately, survival rates have increased over the years. In 1975, only 68% of men with prostate cancer survived for five years. In 2012, the rate increased to 99%. Five-year survival rates for colon cancer rose from 50% to 66% during that same time period.
Higher survival rates are good news. But with that good news comes adjustments. For sexual relationships, there can be challenges. In fact, of those 15 million people mentioned above, about 46% have sexual problems due either to cancer or the treatment of cancer.
Male cancer patients and survivors often face sexual dysfunction, sometimes in the short term, and sometimes for years.
In today’s post, we’ll go over some of those challenges, why they occur, and what men can do.
What might happen in the short term?
Some of the sexual issues men may develop immediately after treatment include:
- Reduced sexual interest
- Fatigue and trouble moving
- An inability to resume sexual activity
- Depression and anxiety
- Difficulties working and earning a living
- Relationship problems
- Changes in family roles
You’ll notice that not all of these issues are directly sexual, but they still apply. A man who is chronically tired or in pain may not have the energy for sex. If he can no longer work, he may feel anxious about providing for his family. If his partner or children have had to care for him, he may feel like a burden to those he loves and become depressed. All of these issues can affect his sex life, and it’s not uncommon for them to overlap.
What about the long term?
Over months or years, the following issues may develop:
- Erectile dysfunction
- Ejaculatory disorders
- Low desire
- Poor body image
- Sexual pain
- Relationship issues
What causes these sexual problems to occur?
They may result from the cancer itself or the treatment. Here are some considerations:
- Location and extent. If a man’s cancer affects his genitals, or if it has spread to other parts of the body, he may be more likely to develop sexual dysfunction. Example: A man who has had both testes removed due to testicular cancer will not be able to produce the hormone testosterone, which is important for desire and erections.
- Types of therapy. Surgery, radiation, hormone therapy, and chemotherapy can affect a man’s body in different ways. Examples: Surgery can affect ejaculation and urinary function. Hormone therapy could dampen libido. Chemotherapy may leave a man exhausted.
- A healthcare provider’s expertise. Men with cancer usually have several providers working for him as a team. Some may be more experienced than others. Example: A man with prostate cancer might have his prostate gland surgically removed. But nerves needed for erections lie very close to the prostate. Surgeons can do their best not to disturb these nerves, but it’s a painstaking process.
- Age. Some sexual problems are more prominent as men get older, especially if they have other health conditions that contribute. Examples: A man’s risk for erectile dysfunction increases as he gets older, regardless of whether he has had cancer. Diabetes and heart disease, which can also impair erectile function, are common in older men.
- Sexual function before cancer treatment. Good sexual function before treatment is more likely to be preserved after treatment. Example: If a man could get and maintain firm erections before he had cancer, he has a better chance of recovering erectile function after treatment.
What can men do?
Sexual challenges related to cancer may seem overwhelming. But men should know that they are not alone. Here are some suggestions for coping:
- Talk to your cancer team. Keep your healthcare providers updated. Your team can offer solutions that are tailored to you. That might mean medication for erectile dysfunction or counseling for anxiety.
- Talk to your partner. You don’t need to keep your feelings bottled up inside. If you miss the intimacy you once shared, say so. If you need something specific from him or her, don’t hesitate to speak up.
- Ask for help. If you’re feeling fatigued, ask a family member or friend to help out with household chores, shopping, or childcare. Many people want to help, but they aren’t sure how. This is an opportunity to let them know.
- Consider a support group. Talking – either in person or online - to other men who have “been there” is a valuable way to share information, get tips, and feel some camaraderie.
- Try to maintain a healthy lifestyle. You may not feel up to exercising, but ask your doctor about ways to stay active. Following a healthy diet is important, too. Involve your partner or friends so that fitness or meals are more fun.
- Get together with friends. Your social network will be a tremendous source of support. It can take your mind off things, too. If you feel up to it, have some buddies over to watch a big game or go out to a funny movie – whatever you enjoy.
- Consider a sexual therapist. A sexual therapist specializes in enhancing communication with your partner and setting realistic goals for sex. Even without having undergone cancer treatment, there are tremendous societal pressures and unrealistic expectations surrounding sex.
There is more ground to cover on cancer and sex, but we hope this has been a helpful introduction for men. In the coming months, we plan to discuss more topics, so be sure to watch this space.
American Cancer Society
“Sex and the Man With Cancer”
Stein, Kevin, PhD, et al.
“Physical and psychological long-term and late effects of cancer”
(Full-text. First published: April 1, 2008)
Broderick, Gregory, MD with Brian Alexander
“Private Parts, Private Reactions” (Summer 2011)
No link available.
Sexual Medicine Society of North America
Broderick, Gregory, MD
“Sexual Function in Male Cancer Survivors”
(Presentation slides. May 12, 2017 in Boston)
No link available.