Many with ED after prostate cancer don't seek help

Many prostate cancer survivors who have sexual difficulties post-treatment have never tried erectile dysfunction therapies, such as Viagra, a new study shows.

The likelihood that a man will seek treatment for erectile problems varies with the type of prostate cancer treatment he received, the researchers found.

While past research has shown that only about half of prostate cancer survivors with erectile dysfunction seek treatment, there is little information on how much a man's interest in sex might affect his likelihood of trying such therapies, Dr. Martin G. Sanda of Harvard Medical School in Boston and colleagues note.

To investigate, Sanda and his team surveyed 650 men four to eight years after prostate cancer treatment, along with 74 men without prostate cancer, the "control group."

Half of the men with erectile dysfunction after prostate cancer treatment said it bothered them only a little or not at all, the researchers found.

Men who had their prostate glands completely removed - a procedure known as radical prostatectomy - and experienced erectile problems were the most likely to seek treatment - just 23 percent never tried erectile dysfunction therapy.

However, 48 percent of men with erectile dysfunction after treatment with brachytherapy, in which small radioactive "seeds" are implanted in the cancerous area, did not pursue treatment for their erectile problems, and 61 percent of men who had sexual problems after undergoing external beam radiation did not seek therapy.

The men who were able to achieve erections sufficient for intercourse were actually nearly three times as likely to seek treatment to improve function compared with men who could not have intercourse.

One explanation for the differences according to type of prostate therapy could be that men generally experience a sudden loss of ability to achieve an erection after radical prostatectomy, and then erectile function gradually improves. However, erectile function declines more gradually after radiation therapy, which may make these men less likely to seek treatment and their doctors less likely to recommend it.

"Additional study is clearly warranted to clarify whether radiotherapy patients are simply more accepting of treatment-induced declines in sexual function or if their less frequent use of such assistance measures represents an important, and unmet, healthcare need," Sanda and his colleagues conclude.

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SOURCE: Urology, July 2006.