Sexual problems after a diagnosis of prostate cancer are common, no matter what kind of treatment is given.
Dear Dr. Roach: I am a 73-year-old who underwent successful treatment for prostate cancer, using hormone suppression and radiation in 2015. After the treatment concluded, my testosterone level increased back to 435 ng/dL, and my PSA remained below 0.1 ng/mL. I was once again able to perform sexually, although not at the same frequency I did before treatment.
With radiation, sexual troubles tend to start well after the radiation is finished, up to two years afterward. This is thought to be due to long-term damage by radiation to the nerves, arteries and other structures. Since you are well past the period of time where sexual dysfunction due to radiation is expected to occur, I’d be concerned that your testosterone has fallen, as you suspect.
If your testosterone is low, then a decision to try testosterone replacement needs to be carefully considered. Some evidence suggests that it is pretty safe and unlikely to cause the cancer to recur, but many prostate cancer experts recommend against it. Only your urologist or oncologist can answer this for you. Most of my patients in your situation elect to try testosterone replacement.
Dear Dr. Roach: I live downwind from a wildfire. I smelled the fire faintly when I went outside for my walk this morning. Is there a point when it’s counterproductive to exercise outside if there’s a fire, especially when it’s further away, as opposed to closer ones? We’ve had ones that made my eyes burn when I went outside; I obviously stayed inside until the fire was contained. I have been diagnosed with mild chronic obstructive pulmonary disease and would appreciate some guidance.
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