Here’s How Men With Bladder, Colorectal and Prostate Cancer Can Treat Sexual Dysfunction

Advocacy Groups | <b>FORCE</b>

Treatments for bladder, colorectal and prostate cancer may cause sexual dysfunction in men. Here, an expert provides insight into how patients and survivors may improve their sexual health.

Treatments for colorectal, bladder and prostate cancer may negatively affect a man’s sexual health. According to an expert, it is important that patients and survivors understand what treatment options are available to help improve their quality of life.

Andrew Matthew, lead psychologist and co-lead of the Genito-Urinary Survivorship Program at Princess Margaret Cancer Centre in Toronto, stated that sexual dysfunction is prevalent in 90%, 60% and 60 to 80% of men with prostate, bladder and colorectal cancer.

The distress caused by sexual dysfunction, according to Matthew, may lead to a significant decrease in health-related quality of life in these patients. Of note, it is the single most impactful aspect on a patient with prostate cancer’s quality of life, he added.

During his presentation at the 12th Annual Joining Forces Against Hereditary Cancer Conference he explained that sexual dysfunction may include and impact:

  • Sexual response: decreased sexual desire, erectile dysfunction, orgasm, or absence of ejaculate.
  • Body image and penis changes: urinary/fecal incontinence, ostomies, loss of body hair, or penis/testicular changes in shape and size.
  • Intimacy and relationships: partner sexual health concerns.
  • Sexual satisfaction.
  • Fertility.
  • Hot flashes, night sweats, heart palpitations, change in blood pressure, fatigue and salivary dysfunction.
  • Psychosocial: sexual performance, impact of masculinity and sexual distress.

Matthew added that 62% of patients are interested in receiving help for sexual dysfunction, but that only 15% ask for help. He said that patients should know that no question is too personal for their doctor and that the issue of sexual health should be normalized.

Treatments for Sexual Dysfunction

Some treatments for erectile dysfunction that Matthew highlighted included oral medications (which are 30 to 60% effective), intracavernous injections (an injection into the base of the penis; 85% effective), intraurethral suppositories (small pills that are injected into the penis; 57% effective), vacuum erection device (80% effective) and penis implants, which induce an 85% satisfaction rate in users.

Matthew provided the audience with insight on some of the treatment methods patients and survivors may use for their sexual dysfunction. “If the light stays on for more than four hours call your erectrician,” he said for those who may be taking oral medications. As for those considering penile injections, “The bark is worse than the bite,” he said, meaning the thought of getting an injection into the penis is worse than the actual injection.

For patients who may struggle with body image due to an ostomy, Matthew mentioned that the ostomy pouch should be fitted correctly to the individual, and that emptying the appliance prior to sexual activity is important. Patients can also consider stoma caps and mini bags, as well as designer pouches. Additionally, Matthew recommended certain sexual positions that could help avoid interfering with the bag and using a pouch deodorant that may help with odor if it is a problem during intimate moments.

Psychologically, patients should have a broader sense of appearance beyond the physical aspect, re-evaluate the importance of physical appearance and have compassion for themselves, Matthew explained.

“You are more than your physical body and one of the important sex organs, of course, is your brain and not to forget that,” he said.

The Toughest Sexual Side Effect

Some patients may also struggle with a loss of libido, or sex drive. Matthew mentioned that he thinks this is one of the toughest sexual side effects to treat. Loss of libido can come from the removal of testosterone during a patient’s treatment and the solution for combating this is acceptance, adjustment and adaptation.

Psychological factors such as fatigue, lack of sexual confidence or performance anxiety may also affect sex drive. Matthew said patients should challenge the negative thinking related to erectile dysfunction and body image and allow for the perception of sexual activity to change and not solely focus on the act of penetration.

Matthew also highlighted the impact that sexual dysfunction can have on a patient’s masculinity. He said it’s important for patients to understand that “they are more than a penis” and to be proud in their roles as a father, partner, or caregiver.

Moreover, he noted that sexual dysfunction is caused organically due to cancer treatments, meaning it is out of their control.

“I remind patients that they didn’t put up their hand and ask for bladder cancer or prostate cancer,” he said. “Having cancer is not (their) fault and if having cancer is not (their) fault then any sequela of that — treatment, side effect profiles, of course, are not (their fault).”.

It is critical that couples avoid assumptions, communicate and work as a team to tackle any sexual side effects, according to Matthew. There is also the option of seeking professional help, such as consulting with a sex therapist.

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