Prostate Cancer Treatment

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Introduction

The treatment of prostate cancer is normally accompanied by some undesirable side effects such as bowel and urinary incontinence, and most commonly, erectile dysfunction. According to Klein (2000), of all these any other side effects, it is the erectile dysfunction (ED) that is the most common and the one that bother’s most men because they fear that it may negatively interfere with their sex lives.

Yeung, Escalante and Gagel (2009) observe that most of the post-prostate cancer treatment men fear that the treatment may not only significantly reduce the quality of their lives, but may also result in an increase in anxiety, depression and strains in their relationships with their partners.

It is with such concerns that the issue of sexual treatment after prostate surgery has become meaningful and significant in the field of the psychology of sexuality. Even though the chances of these individuals developing sexual dysfunction after the treatment are high, it is not all lost for such patients because there are some forms of treatment that have been developed to help them regain their sexual functions.

Background

There is still no evidence that suggests that prostate cancer causes sexual dysfunction (Yarbro, Wujcik & Gobel, 2010) but several studies have revealed that the methods utilized in treating prostate cancer can actually lead to erectile dysfunction. Erectile dysfunction may psychologically make it difficult for one to have intimacy even without penetrative sex, and this can in turn result in other negative effects.

According to an article published by Bivins (2008), prostate cancer treatment methods including cryosurgery, removal of prostate gland by surgery, hormone therapy, and radiation therapy, combined with other determining factors during the recovery period all contribute to the chances of a post-prostate cancer treatment individual developing ED and sexual dysfunction. As noted by Suls, Davison and Kaplan (2010), some of the treatment methods have a higher chance of resulting to ED compared to the others.

Statement of the issue

While it is true that the treatment of prostate cancer affects sexual performance, there are several treatments available that could help affected couples get intimate, even without vaginal intercourse.

Definition of terms

Erectile Dysfunction: According to Melman and Newnham (2011), erectile dysfunction is the inability of the penis to erect even with stimulation.

Sexual dysfunction: According to Mulhall (2009), sexual dysfunction is the inability to have sexual intimacy.

Penetrative or vaginal sexual Intercourse: Mulhall (2010) defines penetrative sexual intercourse as intimacy which entails sexual contact between the female and male sexual organs.

Literature review

Melman and Newnham (2011) point out that before treating sexual dysfunction problems, it is first of all important to distinguish between the physically and psychologically causes of sexual dysfunction and that it is only from the psychological causes that an individual can fully recover.

Melman and Newnham (2011), also observe that it is normal for men who have undergone prostate cancer treatment to suffer from ED for some period of time, usually for two years or slightly more. This inability to sustain an erection may lead to frustrations and anxiety, especially if there is some pressure to perform from his partner, and these may make it difficult to share intimate moments.

The psychological situation of the men during the recovery years plays an important role in determining if they will fully recover from sexual dysfunction because by harboring negative thoughts regarding full recovery, one can actually lose the desire to get intimate with his partner (Penedo, Antoni & Schneidermann, 2008). As observed by Ganz and Horning (2007), the loss of the desire to get intimate with one’s partner after prostate cancer treatment is in many times multi-factorial, rather than a purely hormonal problem.

The authors point out that risk factors associated with cancer treatment including post-treatment fatigue , nausea or pain, perceiving oneself as less attractive for sex after cancer, genital blood flow, and loss of sexual pleasure due to change in skin sensitivity, to mention but a few, can reduce an individual’s desire for intimacy, even if does not involve penetrative sex..

Given the numerous challenges that can affect sexual activity following treatment of prostate cancer, oncology nurses and other health care providers should educate couples on other viable ways of getting intimate without penetrative sexual intercourse. Intimacy without sexual intercourse can be just as satisfying as penetrative sex especially if the communication between the couple is good. A couple that openly expresses their feelings to each other can easily find numerous ways of working out their intimacy needs (Torrey & Stoiber, 2008).

One of the most important things that a couple can do as soon as possible is to readjust their expectations regarding intimacy. In instead of comparing the post-treatment intimacy to the pre-treatment intimacy, the couple should focus on how to make the present, post treatment sexual life more enjoyable (Hennenfent, 2005). Yet another treatment plan for post-cancer couples is to begin Sensate Focus Exercises which teach couples how to derive sexual pleasure from touching.

These exercises relieve the couple from the pressure to have penetrative sex and therefore help to refocus the minds of couples from the ED problems that they are facing (Pachana, Laidlaw & Knight, 2010). These exercises can also lay the foundation for new ideas of intimacy in a relationship. As observed by Rainey and Rainey (1995), women miss casual touching as much as (sometimes more than) penetrative sex. Couples should therefore engage in physically touching each other as a way of getting intimate.

Evaluation and critique

From the above literature review, one thing that comes out clear is that the biggest concern after treatment of prostate cancer is intimacy among affected couples. While the sexual performance of most affected men changes following the prostate cancer treatment and they may never be able to have sex and orgasms as they used to before the treatment, couples can still get intimate after prostate cancer without engaging in penetrative sex.

Summary and future directions

Given that prostate cancer treatment interferes with the sexual performance, in particular vaginal intercourse, the affected couples should seek help from health care providers who specialize in sexuality on ways of continuing with their intimacy.

References

Bivins ( Feb, 2008). After the prostate cancer diagnosis. Ebony,63 (4) 50-52

Ganz, P.A. & Horning, S. (2007). Cancer survivorship: today and tomorrow. New York, NY: Springer.

Hennenfent, B. (2005). Surviving prostate cancer without surgery. Roseville, IL: Roseville books.

Klein, E.A. (2000). Management of Prostate Cancer. Totowa, NJ: Humana Press.

Melman, A. & Newnham, R. (2011). After prostate cancer: A what-comes-next guide to a safe and informed recovery. New York, NY: Oxford University Press.

Mulhall, J.P. (2009). Sexual Function in the prostate cancer patient. New York: Springer.

Pachana, N., Ladlaw, K. & Knight, B. (2010). Casebook of clinical Geropsychology: International Perspectives on practice. New York, NY: Oxford University Press.

Penedo, F.J., Antoni, M.H. & Schneiderman, N. (2008). Cognitive-Behavioral Stress management for prostate cancer recovery. New York, NY: Oxford university Press.

Rainey, D & Rainey, B. (1995). Moments together for couples: devotions for drawing near God and one another. Ventura, CA: Gospel light

Suls, J.M. Davidson, K.W. & Kaplan, R.M. (2010). Handbook of health Psychology and Behavioral Medicine. New York, NY: Guilford Press.

Torrey, E & Stoiber, C. (2008). Surviving prostate cancer: what you need to know to make informed decisions. New York, NY: Yale University Press.

Yabro, C.H., Wujcik, D., & Gobel, B.H. (2010). Cancer Nursing: principles and practice. Sudbury, MA :Jones & Barlett Learning.

Yeung, S.J., Escalante, C.P & Gagel, R.F. (2009). Medical Care of Cancer Patients. Shelton, CT: PMPH-USA.

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