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Pinhole Surgery Reduces the Risks of Erectile Problems after Prostate Cancer

The 14 February is well known amongst lovers as Valentine’s Day, but it is also National `Think About Sex Day’. Unfortunately, for many men who are impotent the physical side of maintaining a sexual relationship can be both difficult and distressing.

Impotence is one of the greatest fears of the male population with sexual prowess inherently linked to male identity. The ability to achieve an erection can result from both physiological and psychological causes. Age, stress, depression and certain illness can all result in loss of sexual function, but it is usually a temporary phase and of no great concern. However, the side effects of some surgical procedures can cause impotence. For example, radical prostatectomy (surgical removal of the prostate) for the treatment of prostate cancer can result in over 60% of patients losing their ability to have a natural erection.1

Prostate cancer is the most common male cancer in the UK, accounting for almost 1 in 4 of the male cancers. Each year, nearly 32,000 men in the UK are diagnosed with prostate cancer and more than 10,000 die from it.2 This form of cancer predominantly affects men over the age of 65, but surprisingly men as young as 40 can be affected and this is become more and more common. The illness is also more common in men of Afro-Caribbean descent.

Impotence is often an undesired side effect of surgery for prostate cancer. Rick Popert, a urological surgeon at Guy’s and St Thomas’ NHS Foundation Trust in London: “Obviously when you are dealing with prostate cancer, your primary aim is to remove the cancer and in many cases surgery is the best option. Unfortunately, however careful the surgeon is, the actual physical process of surgery can damage the nerves which control erections. When this happens it is, of course, very distressing for the patient and their partner. Oral medication tends not to work in these circumstances and mechanical methods of achieving an erection, for example, self injection treatments or vacuum pump devices, will be needed. For much older men, whilst still important, this may be less of an issue, but we are seeing a lot more young men now in their 40s who do not want to lose their potency and their fertility.”

Brachytherapy (more commonly known as pinhole surgery) is an alternative form of prostate cancer treatment for localised cancer i.e. cancer that is restricted to the prostate and has not spread elsewhere. It involves implanting tiny radioactive seeds into the prostate to destroy the cancer cells. With pinhole surgery, the risk of impotence is greatly reduced compared to traditional surgery with only 10% of patients experiencing some degree of erectile dysfunction.1 In addition, as it is normally a day case procedure, patients can usually go home the same day and return to work within a few days compared to a much longer post-operative recovery period with radical surgery. Unfortunately, brachytherapy is not universally available in the UK. Figures show that 1 in 6 men are denied access to this treatment due to lack of funding from PCTs3 and only 1,000 procedures are carried out annually compared to 50,000 in the USA.

Says Chris, a 61yr old prostate cancer patient, “I chose to have brachytherapy rather than undergo surgery as it offers a much lower risk of impotence even though it was not available in Devon where we lived. It was a joint decision between my wife and I. We have been married for 32 years and sex is still a very important part of our relationship.”

Editor’s Notes
National Think about Sex Day has been organised by the Sexual Dysfunction Association www.sda.uk.net

Relevant websites
www.prostatebrachytherapyinfo.net/

The Prostate Brachytherapy Advisory Group is supported by an unrestricted educational grant from Oncura

References
1. www.prostatebrachytherapyinfo.net
2. Comptroller and Auditor General. Tackling Cancer: Improving the patient journey. HC 288 2004-2005. 2005. London, National Audit Office
3. www.channel4.com/news/dispatches/health/health_lottery

File Download:
think-about-sex-day-finalpressrelease_14-feb-2.doc

Contact:
Sally Robinson, PR Consultant
sally@etalpr.co.uk

Date Added: 14-02-2008

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