From your sex life to treatment options: Navigating life after a prostate cancer diagnosis

Unlike many other health issues that can be treated or managed with a simple operation or generic form of treatment, many men are faced with a daunting prospect after receiving a prostate cancer diagnosis.

According to the Cancer Council, it is estimated that more than 24,200 males were diagnosed with prostate cancer in 2022. The average age of diagnosis is 69 years old.

Prostate cancer is the most commonly diagnosed cancer in Australia, and it is estimated that one in six males will be diagnosed by the time they are 85.

While there’s a considerable debate over how vigorously doctors should be testing or trying to diagnose the cancer, many men are unsure what actually happens when they’ve had a biopsy and after they are diagnosed.

In light of this uncertainty that can plague those diagnosed with prostate cancer and in recognition of Prostate Cancer Awareness Month, Starts at 60 delves into what individuals can anticipate after receiving a prostate cancer diagnosis.

Urologist Joseph Ischia explains that a number of factors determine what happens next.

“Once you have a diagnosis of prostate cancer, it really depends a lot on what that biopsy showed and what their PSA [prostate-specific antigen] is, what age they are and how fit they are,” Ischia says.

“All those things go into us deciding what we do next. The reason there are so many factors is not all prostate cancers are the same.”

Prostate cancer can vary in how aggressive it is and it’s not uncommon for patients with low-grade or low-risk cancers to be told they don’t need to undergo treatment. Then there are those that, if left untreated, can cause major health problems or even death.

“You don’t want to put him through all the rigmarole of cancer treatment if it’s not going to give him the benefit long term,” Ischia says, using an example of someone at the age of 80 who has been diagnosed.

“It’s got its side effects associated with it and the like. So that’s another factor that comes in.”

Another factor surgeons consider is whether the cancer has spread beyond the prostate. For those with no spread, it’s common to receive surgery or radiation as treatment. In cases where it has spread, patients are likely to receive hormone treatments, possibly combined with therapy.

“I think that confusion is what makes it so difficult for men to just get an idea of what to do,” Ischia says.

“With prostate cancer, there’s such a wide variety, there’s no cookie-cutter solution for everybody.”

In addition to the treatment, there are a number of considerations and challenges patients may face, including navigating their sex life post-treatment.

Isiah McKimmie is a leading Australian, Sexologist, Sex Therapist and Couples Therapist and tells Starts at 60, “there can be various impacts on someone’s sex life as a result of prostate cancer and treatment.”

“These can include lowered libido, erectile dysfunction and penis shrinkage. Surgery can damage nerves that assist with erections. Radiation and hormone treatments can impact erectile function over time. Low libido can be due to both hormonal changes, but also due to anxiety about changed sexual function,” she says.

“Taking steps for sexual rehabilitation as soon as you can after treatment gives you the best chance of regaining sexual function. Research shows the earlier you take action, the higher chance you have of regaining sexual function.

“Essentially, you need to increase blood flow to the penis and attempt to get erections in a ‘use it or lose it’ approach. Speak to your doctor or surgeon for advice on the best option for you. You may benefit from meditation or other support.”

However, McKimmie highlights that the effects of prostate cancer and its treatment are not reserved solely for the patient.

“Prostate cancer and treatment can have impacts on a partner also. Keeping communication open and working as a team to address the impacts can lesson the impacts on both the patient and their partner,” she says.

IMPORTANT LEGAL INFO This article is of a general nature and FYI only, because it doesn’t take into account your personal health requirements or existing medical conditions. That means it’s not personalised health advice and shouldn’t be relied upon as if it is. Before making a health-related decision, you should work out if the info is appropriate for your situation and get professional medical advice.