Dr. Drew Meets Prostate Cancer

He watched it for a year, and then he had it removed. Dr. Drew’s recent encounter with prostate cancer is, alas, a common story written by an all-too-familiar cancer. Trusting the intuition of his doctors, he played his cards beautifully and has undoubtedly trumped his opponent for good.

Sex and the Prostate

What drew me to this story was that Dr. Drew, famed sexual rehabilitationist, contracted a cancer whose treatment has notorious sexual side effects. And he went for it. Whole hog.

The Naked Truth

What are the facts about the sexual side effects of prostate cancer treatment? Here are the “know before you go” essentials:
1. Regardless of whether surgery or radiation therapy is chosen, most men will experience erectile dysfunction early on after treatment. Simply put, the nerves and blood vessels that control erections are delicate, and any “trauma” to the area can alter the natural state of things, at least for a while.
2. Within a year, if nerves are spared during surgical treatment, virtually all men will see improved erectile function. Conservatively, 50% of men undergoing nerve-sparing prostatectomy will return to their baseline erections after 1 year. Know also that excellent treatment options are available for treatment-related erectile dysfunction to help get things back in order.
3. Return-of-erection rates vary widely among individuals, depending on the extent and location of the cancer, the surgeon’s experience, underlying health issues and how honestly the outcomes are reported. Whether or not a robot was used for surgery matters less than who is doing the surgery.
4. After radiation therapy for prostate cancer, the pattern of erectile dysfunction differs from surgery: initially, erections may be better than after surgery, but they may degrade over time, as scar tissue develops due to radiation.
5. Erectile dysfunction rates 15 years after cancer treatment are similar and pretty much universally present in men regardless of whether surgery or radiation treatment is chosen.
6. Men with pre-existing erectile dysfunction (or those having risk factors for it) fare worse after cancer treatment than those without, regardless of the chosen therapy.
7. Fertility is uniformly impaired after prostate cancer treatment. With prostate surgery, a vasectomy is performed and several reproductive organs removed. Thus, the ejaculate is dry and sperm-free. With radiation therapy, fertility is generally impaired due to scar tissue induced by treatment.  There is reasonable preservation of fertility with brachytherapy (radioactive seed placement in the prostate) however.
As you deal with prostate cancer in your life, be it now or in the future, consider taking the stance of Dr. Drew, as expressed by Ann Martin: “You got to accentuate the positive, eliminate the negative, and latch on to the affirmative. Don’t mess with Mr. In Between.”