Sexual Difficulties and Cancer in Men

• Who is affected?
• What factors affect sexual adjustment in individuals with cancer?
• How long might sexual problems persist?
• What sort of problems may arise and how common are they?

Who is affected?

Between 10 and 88% of patients diagnosed with cancer experience sexual problemsfollowing diagnosis and treatment.This varies according to the location and type of cancer, and what kind of treatment is used.

The concept of sexuality encompasses body image, mood, self esteem and sense of emotional connection and intimacy. Each of these facets may be affected directly and indirectly by cancer and its treatment. Concerns regarding body image have been reported by men with prostate, laryngeal, blood, head and neck, and skin cancers.

Sexual problems are reported in patients with cancer that does not directly affect sexual organs, including lung cancer, Hodgkin’s disease, and laryngeal and head and neck cancers. On this basis, it is recommended in Australian clinical practice guidelines that, regardless of cancer site, issues of sexuality related to cancer and its treatment should be discussed with health professionals.

What factors affect sexual adjustment in individuals with cancer?

Factors affecting sexual adjustment in men with cancer include:

• Altered body image due to weight changes, hair loss or surgical disfigurement;
• Change in hormonal status due to treatment: Changes in sex hormones (androgens such as testosterone) affect libido and ability to orgasm; and
• Treatments that directly impact on pelvic organs and sexual function: Sexual activity, satisfaction and desire may be significantly affected by radiotherapy in the regions of the pelvis, prostate and lower abdomen.

There has been limited research on other factors that may affect sexuality in men. Research in women has found the following factors play a role in sexual adjustment:

• chemotherapy may interfere with the production of testosterone thus affecting sexual response and desire;
• pre-existing problems in sexuality or relationships; and
• age.

Although not yet proven by research, it is possible that these factors may also play a role in the sexual adjustment of men affected by cancer.

How long might sexual problems persist?

Sexual problems following cancer may persist long term. Sexual dysfunction has been found to occur in men with testicular cancer many years after diagnosis. After bone marrow transplantation for the treatment of Hodgkin’s disease, sexual dysfunction may persist for up to 12 months.

What sort of problems may arise and how common are they?

Loss of libido (sexual drive), change in sexual activity and decreased orgasm/satisfaction occurs with the following cancers:

• Head and neck: 39% of patients with minor disfigurement, and 74% with major disfigurement, experience a reduced sexuality.
• Laryngeal: Associated with a significant decrease in sexual activity in 60% of cases.
• Prostate: 43–51% of cases experience problems.
• Lung: 48% of cases experience problems, and 27% experience severe problems.

Erectile dysfunction and ejaculatory difficulties (premature, retrograde, or dry) are associated with the following cancers:

• Colorectal (with stoma): 62–88% of patients with colorectal cancer experience erectile dysfunction.
• Testicular: 25–70% of cases experience problems.
• Prostate: 71–91% of patients who have had radical prostatectomy and 41–62% who had radiation therapy experience problems
• Hodgkin’s disease: 50% experience problems.

Concerns about existing or potential sexuality problems are associated with anxiety, and may be a major source of stress in the lives of individuals with cancer.

More information

For more information on prostate cancer, including diagnoses, types of treatments, and some useful tools, videos and animations, see Prostate Cancer.

For more information on cancer, including breast, prostate, kidney and stomach cancer, see Cancer: Overview.

 

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