Prostate cancer is the most commonly diagnosed cancer among men, with over 52,000 cases diagnosed each year. It occurs when cells in the prostate (a small gland just below the bladder) begin to grow uncontrollably. Men over the age of 50 are most at risk of developing prostate cancer, and also black men and those with a family history of the disease.
In some cases, the cancer cells are slow growing and the condition will be actively monitored rather than treated. However, more aggressive cases may require surgery, radiation therapy, hormone therapy or chemotherapy. One of the common side effects of these treatments is erectile dysfunction (ED).
Managing ED after prostate cancer
ED becomes more common with age, but prostate cancer treatment significantly increases the risk. In the case of surgery, this can be because of stress or damage to the nerves and blood vessels that are necessary for the erection process. This can occur even if nerve-sparing techniques are used.
Radiation therapy can gradually damage the erectile tissue and reduce function over time. Hormone therapy that is used to slow the rate of prostate cancer can cause low testosterone levels, which can reduce the libido and erectile capacity. According to Prostate Cancer UK, 76 per cent of men who are treated for prostate cancer experience ED.
Fortunately, ED can be treated or managed. Early intervention is the best strategy, so it’s important to overcome any discomfort and share your concerns with your healthcare team. They may be able to guide you towards counselling or psychosexual clinics if you are struggling mentally and emotionally.
One of the first lines of medical treatments you may be offered is sildenafil (Viagra). This is an oral treatment that is taken daily or half an hour before you want to have sex. For convenience and discretion, many men prefer to set up an online sildenafil subscription service rather than make regular trips to a pharmacist.
AI breakthrough for effective prostate drug treatment
The Guardian reports that an ‘exciting breakthrough’ has been made for men who have more advanced prostate cancer. One of the most advanced and effective drug treatments for men with prostate cancer is abiraterone. It has already extended the lives of hundreds of thousands of men who are living with prostate cancer.
However, it does have a risk of side effects in some men, including a slightly increased risk of diabetes, heart attacks, high blood pressure and liver abnormalities. Therefore it is very helpful for clinicians to know who will respond best to the drug, and which patients would benefit from other forms of treatment.
A new AI test has been developed by a team from the US, UK and Switzerland that shows whether patients have biomarker positive or negative scores to indicate suitability for treatment. For men with biomarker positive scores, abiraterone cuts the risk of death by half. It also spares biomarker positive men from undergoing unnecessary treatment.
The study co-leader Prof Gert Attard, of the UCL Cancer Institute, told The Guardian: “This study shows, in a very large cohort of patients, that novel algorithms can be used to extract information from routinely available pathology slides to tailor these treatments to specific patients and minimise over treatment whilst maximising the chance of cure.”
Nick James, professor of prostate and bladder cancer research at the Institute of Cancer Research in London and a consultant clinical oncologist at the Royal Marsden NHS foundation trust, and study coleader, said: “Abiraterone costs just £77 per pack, compared with the thousands of pounds that new drugs cost.”
He added: “I truly hope that this new research – showing precisely who needs the drug to live well for longer – will lead to NHS England reviewing their decision not to fund abiraterone for high-risk prostate cancer that has not spread.”
An NHS spokesperson said: “Following a full evidence-based assessment, expanding access to this drug for non-metastatic prostate cancer has been identified as one of the top priorities for investment once the necessary recurrent funding is available to support its use.”
Symptoms of Prostate cancer
The main symptoms of prostate cancer can include:
- Difficulty urinating or a weak urine stream
- Frequent urination, especially at night
- Blood in urine or semen
- Painful ejaculation or pelvic discomfort
However, early-stage prostate cancer often presents with no symptoms at all, which is why regular PSA (prostate-specific antigen) tests are recommended for men over 50.
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