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| Vol.22, No.5 |
| March 15, 2000 |
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Cancer and Sexual Problems Focus of Study at M. D. Anderson While men with prostate cancer usually experience sexual difficulties after treatment, they often shy away from help for their concerns. A new study under way at The University of Texas M. D. Anderson Cancer Center seeks to learn more about how to encourage such patients to find treatment. The trial is led by Dr. Leslie Schover, associate professor of behavioral science at M. D. Anderson, and an expert in sexual problems that men and women experience after genitourinary and gynecologic cancer treatment. Dr. Schover received a grant from the American Cancer Society totaling more than $270,000 to conduct the study. "Even though a majority of men who receive treatment for prostate cancer have sexual problems, less than 25 percent of these men seek help and we want to know why," says Dr. Schover. "The goal of this project is to learn how to design a program that will encourage more men to seek help for sexual problems, and to make sure that men and their partners find treatments that restore a satisfying sex life." The study will involve about 2,250 men who will complete a mail-in survey. Some also will take part in phone interviews. With the patient's permission, his wife or sexual partner may participate in a separate interview. The group will be asked about their sex lives and why they have or have not sought help for sexual problems. According to Dr. Schover, most of the problems men experience after prostate cancer are related to their specific treatments. Surgery to remove the entire prostate, a prostatectomy, damages nerves that control blood flow to the penis, creating erection problems in 50-80 percent of patients having the procedure. Despite efforts to spare these nerves during surgery, only those men who are under 60 and have very good erections before surgery have a good chance of recovering fully functional erections. Most other men need to use some type of medical treatment, ranging from Viagra to a surgical implant. Erection problems are less common but still frequent following radiation therapy. Problems develop more slowly, often showing up within six months to two years after treatment. These erection problems are probably caused by scarring of tissue near the prostate, reducing the blood flow available to the penis, says Dr. Schover. Men who use hormonal therapy to control more advanced prostate cancer have a different kind of sexual problem. The loss of testosterone reduces a man's desire for sex. Eighty to 90 percent of men receiving this type of treatment have sexual difficulties. "There are successful treatments for erectile dysfunction, and counseling is very important in encouraging couples to stay sexually active." she says. Counseling also may help couples feel more comfortable with modern medical treatments for erection problems. Based on the results of this study, Dr. Schover hopes to develop a program that will make more men aware of the treatment available and ensure more men actively seek help for sexual dysfunction. - KRIS MULLER
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