Whether patients undergo surgery, hormonal therapy, or radiation therapy as active treatment of prostate cancer, all can have treatment-related sexual side effects. As many as 20% to 80% of men can expect to experience some disruptions to their usual sexual function after prostate cancer treatment, which can include changes in sex drive, erections or orgasms.
The good news is these changes to a man’s sex life, while common, can be managed with the appropriate education and resources. Men should expect that their sexual function will be affected. They will have to make some accommodations in their sexual experiences and relationships but no one has to give up their sex life as a condition of managing prostate cancer.
Talking with your health care provider about sexual rehabilitation after (and even before) prostate cancer treatment can be an important step for you and your emotional health, your relationship with your partner, and overall sense of wellbeing throughout your recovery, says Dr. Daniela Wittmann, a social worker and certified sex therapist with the U-M Prostate Cancer Survivorship Clinic.
While bringing up concerns about one’s sex life might seem uncomfortable or even trivial after cancer, Wittmann says that reestablishing sexual function and sexual relationships are often inseparable pieces of restoring quality of life. She notes the individuals and couples she counsels often say they appreciate the consideration given to their sex lives. Acknowledging and addressing their concerns about sex and intimacy makes them feel like they are being viewed as a whole person, rather than just a cancer patient. If this is something that matters to you and your partner, the important thing is to start the discussion with your provider.
The role of partners
While men may experience changes in their sexual function following prostate cancer treatment, there are ways they can continue to take pleasure in sex and preserve loving connections with their partners. Depending on the issue, this might mean incorporating sexual aids or learning new positions. It always means that it is important to learn to talk more frankly about sex and which aspects of it are most important to them as a couple.
Restoring sexual function to the degree possible and protecting sexual relationships can strengthen relationships as men and couples go through prostate cancer survivorship. It also provides a way of coping with the stresses of dealing with the cancer and its treatment, or perhaps even a relapse of illness. Wittmann says many couples find their relationships strengthened as a result of having to work through sexual difficulties together. Finding contentment in your relationship, whether sexually, physically, or emotionally, is what’s most important and professional therapists can help you reach those goals together.
Having support from your partner, setting realistic expectations, and keeping up good communication with both your partner and providers will help immensely. Fortunately, you and your partner have options when it comes to working through sexual function and intimacy issues after prostate cancer treatment.
Take the next step:
Visit the series of fact sheets developed by U-M faculty in collaboration with fellow members of the Michigan Cancer Consorium to help men and their loved ones manage health concerns after prostate cancer treatment.
Learn more about the U-M Comprehensive Cancer Center’s Prostate Cancer Survivorship Clinic.
Find out more about services offered at the Center for Sexual Health at the U-M Health System’s East Ann Arbor Health Center.
Daniela Wittmann, Ph.D., LMSW, is a clinical assistant professor in the U-M Department of Urology and the research lead in the UMHS Department of Social Work. She has 30 years of experience in individual, couple and family psychotherapy with patients with chronic illnesses including cancer and severe mental illness. She has been a certified sex therapist since 2008. Dr. Wittmann is leading a project to develop a web-based tool to help prostate cancer survivors and their partners through sexual recovery. The project, which is funded by the Movember Foundation and involves other experts in post-treatment sexual rehabilitation from across the U.S. and the world, will focus on helping men and couples work towards reaching satisfaction in post-treatment sex life as defined by the couples.
The University of Michigan Comprehensive Cancer Center’s 1,000 doctors, nurses, care givers and researchers are united by one thought: to deliver the highest quality, compassionate care while working to conquer cancer through innovation and collaboration. The center is among the top-ranked national cancer programs, and #1 in Michigan according to U.S. News & World Report. Our multidisciplinary clinics offer one-stop access to teams of specialists for personalized treatment plans, part of the ideal patient care experience. Patients also benefit through access to promising new cancer therapies.