New Life - But What About Sex?

Erectile dysfunction can challenge men after colorectal cancer

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) Beating colorectal cancer can be rejuvenating when a man can enjoy life more fully again. But if he experiences erectile dysfunction from his treatment, he may not know where to turn.

A study looking at the outcomes and experiences of men following colorectal cancer treatment found that caregivers need to do a better job of addressing these men's needs by preparing them for sexual dysfunction problems and helping them treat those issues.

"Be willing to talk to your caregiver if you have erectile dysfunction."

Lead author George Dowswell, a research fellow on the Cancer and Chronic Disease Team at the University of Birmingham in England, led the study that focused on the experiences of 28 men treated for colorectal cancer.

Among men in the U.S., colorectal cancer is the third most common cancer, according to the Centers for Disease Control and Prevention.

In 2007, the most recent year that information is available, over 72,000 men were diagnosed with the cancer, and just over a third of them died from it.

But for the other two thirds who beat the cancer, it's common for many to experience erectile dysfunction after treatment.

Because of how common erectile dysfunction is for men who have been treated for the cancer, Dowswell and his colleagues wanted to determine how different men wanted to address their difficulties with producing or maintaining an erection.

They first contacted 378 patients who had been diagnosed with colorectal cancer between January 1998 and December 2008 and were treated at the same hospital group in the West Midlands in England.

Although 167 men agreed to be interviewed from this group, Dowswell's team selected 28 who represented a wide range of backgrounds and had different treatment histories. The researchers wanted to be sure they heard perspectives from a diverse group, including minority views.

The men varied in terms of their age, socioeconomic group, relationship status, type of adjuvant therapy used, their severity of erectile dysfunction and whether they had a stoma, or a surgical opening in the body sometimes conducted during a man's treatment.

The men ranged in age from 34 to 80 years old, and the majority (24 men) were white and had had surgery for their cancer.

A total of 17 men were in sexual relationships - all but one were heterosexual - and 11 of the men reported having sex within the previous six months.

The researchers conducted in-depth interviews in person with each man between March and June 2009.

The questions covered the men's beliefs regarding erectile dysfunction, its impact on their self-perception and their relationships, how satisfied they were with information they received about it, and how they felt about their treatment.

Although most of the men, a total of 19, believe their erectile dysfunction had been caused by their cancer treatment, another 12 believed it was psychological, and 6 thought it was caused more by their age or health.

The men said their highest priority had been fighting their cancer before and during their treatment, but afterwards, the difficulties they had in getting an erection became very stressful, affecting their mental and physical health as well as damaging their self image and hurting their relationships.

The researchers found that most of the men did not attempt to help themselves or to ask for help with their sexual dysfunction, primarily because they felt embarrassed, lacked confidence, didn't want to look stupid or hoped their doctor would bring it up first.

Many of them, Dowswell's team found, not only lacked knowledge about the condition but also had not been prepared for dealing with it following their cancer treatment.

The researchers determined that men undergoing treatment for colorectal cancer are not provided the same level of information regarding potential erectile dysfunction challenges post-treatment compared to patients being treated for prostate cancer.

In fact, it was not unusual for men in this study to have felt offended by their caregivers or simply neglected or misled by them when it came to sexual dysfunction issues.

Therefore, the researchers recommended that more strategies be developed to take into account that various needs of men experiencing this sexual dysfunction and the many different ways the men may want to handle their personal health situations.

The study appeared in the October 2011 issue of BMJ. The research was funded by the National Institute for Health Research. The authors declared no conflicts of interest.

Reviewed by: 
Review Date: 
April 13, 2012
Last Updated:
April 17, 2012