Radiation Prostate Cancer and Male Fertility
Prostate cancer is currently the most common form of cancer among men, with as many as one in six men in the United States being diagnosed. Many men who are diagnosed with prostate cancer choose to undergo a type of internal radiation therapy known as brachytherapy which places radioactive beads into the prostate tumor to target specific cancer cells. While the treatment is quite successful in the treatment of prostate cancer, and is used especially in younger men who are diagnosed with prostate cancer, there are a number of sexual side effects which may accompany this treatment. For younger couples who are still trying to have children, this may cause some problems in expanding the family.
Erectile Dysfunction Caused by Brachytherapy
One of the most common side effects of radiation seeding is the inability to either achieve or maintain an erection. This occurs because the nerves in the man's pelvis which trigger the blood flow into the penis may have been damaged by the radiation. Depending on the man's age and health, the erectile dysfunction caused by brachytherapy may resolve itself over time, and may also respond well to erectile dysfunction drugs such as Viagra or Cialis. Needless to say, should the erectile dysfunction which results from radiation be serious and lasting, a couple may need to look at other methods to become pregnant such as IUI or IVF.
Changes in Sperm Following Prostate Cancer Surgery
Changes in the prostate gland will also affect semen, and studies have shown that men who have undergone brachytherapy will produce significantly less fluid during ejaculation. While it is known that less fluid is produced, there are few studies which have tried to determine whether the remaining sperm is fully mobile and fertile. Men who want to have a family, and know they will be undergoing brachytherapy with all its possible fertility issues should consider banking their sperm prior to their cancer treatment.
Fertility Possible Following Radiation Seeding
Fertility evaluations on men who have undergone brachytherapy have occasionally shown semen which seems relatively normal, and these men have gone on to father children with no adverse consequences. Less than fifty percent of men who undergo brachytherapy bank their sperm prior to their radiation surgery, mostly because they were not provided with the necessary information and counseling. Sperm can be frozen almost indefinitely and for the man who desires a family, this is a good option.
Men who suffer from erectile dysfunction following prostate surgery may benefit from electro-ejaculation which is electrical stimulation which induces ejaculation. For men who have no sperm in their ejaculate, the sperm can sometimes be surgically obtained through the testes. This technique works in approximately 50-60% of men who undergo it. Another technique, known as microsurgical epididymal sperm aspiration, surgically removes sperm from the duct outside the testes through which it typically travels.
Fertility Preservation Facts
Couples should thoroughly discuss with their oncologist their concerns about future infertility prior to any treatment being administered. If the doctor has recommended a radical prostatectomy, make sure the newest nerve-sparing techniques will be implemented, and that your doctor is well versed in this type of surgery. Often there will be a reproductive endocrinologist on staff who can provide you with the information you need in order to make an informed decision about how you will preserve your fertility following prostate cancer treatment. Occasionally, sperm retrieval can take place at the same time as the surgery, and it can be frozen for later IVF or IUI fertility treatments. Of course a diagnosis of prostate cancer can be very frightening and confusing for a couple, but if you want a family badly, make sure you explore all options available to you.
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