Updated by: Lara Bonner Millar, MD
Many men may have difficulty obtaining or maintaining erections after various forms of cancer treatment. Surgery and radiation therapy to the pelvic area, hormonal therapy, chemotherapy, and various medications may all significantly impact a man's ability to obtain/maintain an erection. Erectile dysfunction can cause significant angst and/or anxiety for the man and his partner.
Since this is a common complaint after cancer treatment, you should feel at ease that your physician has seen many patients with similar problems. You should not hesitate to discuss these concerns with your physician. After a thorough history and physical exam, your doctor may recommend specific testing or changes in your medications. There are medical treatments to help patients restore and maintain erections. Only your physician can determine if you will benefit from a specific treatment. These treatments may include the following:
- Vacuum Constrictive Devices (VCDs): This is a pump that you place over the penis. As air is pumped out of the cylinder, blood is drawn into the penis to produce an erection. A ring slides over the base of the penis to keep the blood in the tissues to maintain an erection for up to half an hour.
- Oral Medications: A number of oral medications are now available to help patients attain and maintain an erection. These medications include Viagra®, Cialis®, and Levitra®.
- Penile Injections: Drugs may be injected into the side of the penis, which promote blood flow. The most common drug used for injection is Prostaglandin E1 (Caverject). The medication typically needs to be adjusted to the correct dose based on how long the erection is maintained.
- Muse System: This system also utilizes Prostaglandin E1. Instead of an injection, a small suppository is placed into the urethra (opening in the penis where urine & semen exit) using a specialized applicator.
- Penile Prosthesis (Implants): There are various types of penile prostheses which a man can consider. Some are malleable rods that are placed in the penis. Most men now utilize a type of inflatable prostheses, which can be inflated and deflated as needed.
- Sex Therapy: This is recommended for patients with anxiety based erection problems. Typically the patient and their partner are both involved in the therapy sessions.
Lifestyle interventions such as weight loss, exercise, and smoking cessation, may also help.
There are advantages and disadvantages with each type of treatment. There are also different side effects for each treatment. If you are experiencing erectile dysfunction, you should discuss the pros and cons of each treatment option with your physician.
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