Cancer Treatment and Sex for Men

Hester Hill Schnipper, LICSW, OSW-C Program Manager, Oncology Social Work

MARCH 20, 2018

  It is sometimes shocking to recognize the glaring omissions in my posts. Today's example is the broad topic of sexual concerns for men with cancer. Since I primarily work with women, I have had much more experience with these conversations with women. Sometimes, working with couples, the man part is part of the discussion, and I certainly have had some men patients through the years and talked with them about this important part of life. The three most common cancers for men are prostate, lung, and colorectal. Prostate cancer almost always brings some sexual challenges as both radiation and surgery can result in ED. Even men with early prostate cancer who safely opt for watchful waiting, may experience some issues that are less directly related to physical change and more associated with psychological concerns. We all know that the brain is the number one sex organ, and, if you are scared and sad and worried, it is difficult to be one's most studly or sexy. That is no different than the impact on women (although I would choose a slightly different vocabulary).

  Broadly speaking, the issues are fertility and potency. As compared (in my non-doctor fashion) to women's issues, there are differences in both. Fertility preservation is simpler and does not involve lots of hormones or surgery. Potency is different that women's libido and capacity to have orgasms. Obviously, it is much more obvious and impacts both partners.

  Per above, some surgeries directly impact potency because nerves are severed. There are various techniques that can be used to encourage erections; the most common are injections or penile implants. Both ideas make a lot of men initially shudder, but they can work well. The other common worry about cancer treatment and sexuality is that the ability to make new sperm may be reduced and/or sperm may be damaged. When the goal is future fatherhood, sperm banking is widely available and pretty simple and can be done prior to the initiation of cancer treatment in almost all circumstances.

  This is an introduction to a very comprehensive article from Cancer Net. Here is the start and a link to read more:

Fertility Concerns and Preservation for Men

Many cancer treatments affect fertility. This effect can be temporary or permanent. Fertility is your ability to father a child. Infertility is when you are not able to father a child.

Before treatment begins, talk with your health care team about how treatment could affect your fertility. Also, ask about your options for preserving fertility.   

How cancer treatments affect fertility

Fertility problems from cancer or cancer treatment occur in 2 main ways:

  • Damage to endocrine glands or endocrine-related organs. Endocrine glands and endocrine-related organs include the testes, thyroid, and adrenal glands. These glands and organs release hormones that stimulate puberty and control fertility.

  • Changes in the part of the brain that controls the endocrine system.

There are several concerns from treatment affect fertility for men:

  • Damage to the sperm.

  • Lowered ability to make new sperm.

  • Low or no production of semen. Semen is the fluid made in the prostate that carries sperm during sex.


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