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      Radiation Therapy and Erectile Dysfunction

      Radiation Therapy and Erectile Dysfunction – What Men Go Through

      There are many life threatening conditions we are often faced with in our daily lives some of these condition are hereditary while others affects us in the process of growth and development. The most painful thing is that often these conditions leave behind a long life scar that remain to be a constant reminder of the devastating painful condition the victims have been through. Let us take for instance the  cancer as a medical condition, and its treatment procedures. Actually the process of treating prostate cancer is one such condition that is able to transforms one’s life negatively and by extension the lives of those around the individual patient.

      Radiation therapy is a well-known cause of erectile dysfunction (ED). The procedure (therapy) uses high levels of radiation to damage cancer cells’ DNA primarily to destroy them or reduce their growth and multiplication, in doing so the therapy helps in minimizing harm to the unaffected surrounding healthy cells. Prostate cancer is treatable by:

      • Pelvic external beam radiotherapy
      • Seed implants (brachytherapy)

      Considering the pervasiveness of prostate cancer and the reduction in the mean age at diagnosis, it has become necessary to openly discuss the modalities of treating sexual dysfunctions emanating from radiation therapy as a method for treating prostate cancer. Great achievements have made by the experts over the last two decades to minimize the negative effects associated with radiation. It is also worth noting that, the advent of 3D conformal x-ray therapy and brachytherapy (seeds) have gone some way towards reducing radiation-induced erectile dysfunction, even though some men continue to suffer from this problem. Nonetheless at this point in time, it is still not very clear what the true incidence of sexual dysfunction is after brachytherapy and it remains to be seen whether newer techniques such as intensity modulated radiation therapy (IMRT) will improve upon impotence rates.

      Radiation therapy can cause erectile dysfunction in three ways. That is to say:

      • Arterial blockage can occur due to the development of a condition called endarteritis obliterans plus other more subtle changes can occur including direct damage to the lining of the blood vessels.
      • Radiation-induced nerve damage may occur. It has been established that there is a reduction in the number of erection-inducing nerves in the penis following exposure to low doses of radiation.
      • Direct erection tissue damage may occur and this can lead to leakage of blood from the erectile bodies (venous leak).

      In radiation therapy there are two primary determinants of erectile dysfunction and they include:

      • Dose of radiation (how much)
      • Field of radiation (how wide)

      Doses greater than 20 Gy (2000 rads) are frequently associated with large vessel injury meaning that, patients being treated with radiation for prostate cancer are receiving in excess of 70Gy. The wider the field of radiation, the less likely are blood vessels to recover. Given that the erection (cavernosal) artery is the only artery giving rise to erection, radiation exposure to this system may severely limit blood flow into the penis. It is therefore necessary that when you have been taken through this treatment procedure, you will need to seek medical help from the erectile dysfunction experts. I will therefore take this moment to introduce to you doctor Dalal Akoury an experienced medical professional in this line for more than two decades now. Calling her for an appointment will be the starting point and upon evaluating your condition in private and confidence she will administer the correct treatment which will leave you well, comfortable and full of fulfilled sex life again.

      You may have not known and so it is essential to understand the penile anatomy and how it relates to the prostate gland.

      • The prostate gland sits above a band of muscle (urogenital diaphragm) and it is separated from the back portion of the erectile body (crus) only by a distance of less than one centimeter.
      • The urethra (urine channel) passes between the two erectile bodies into the bladder and as it does this it is known as the bulb of the penis.
      • It is important to understand that the bulb plays little if any role in the development of or maintaining erectile firmness and it is the tissue within the true erectile bodies (corpora cavernosa), which when damaged leads to erectile dysfunction.

      Various studies have established that during 3D conformal x-ray therapy a significant dose of radiation is delivered to the back portion of the erectile bodies that is about 30% of the entire dose of radiation received by the prostate. Radiation therapy in the pelvis area of men can cause ED in 3 possible ways:

      • Arterial damage may block blood flow or damage the lining of the blood vessels that carry blood to the penis
      • Nerves in the pelvic area may become permanently damaged
      • Erectile tissue may be damaged, reducing blood flow to the penis or causing leakage of blood from erectile tissue (venous leak) during an erection

      Some of the sexual side effects after radiation therapy may include the following:

      • Inability to achieve or maintain an erection (erectile dysfunction)
      • Weaker, less satisfying orgasms
      • Pain during ejaculation (although this usually goes away within several weeks)
      • Dry orgasm or retrograde ejaculation (orgasm without the discharge of semen)
      • Less semen ejaculated

      How soon after having Radiation Therapy are men likely to have ED?

      Even with the most precise radiation therapy, men may experience some ED for the first few months after treatment. Many of the sexual side effects of radiation are slow and gradual, and may take as long as six months to several years to appear. Unfortunately, radiation-induced ED is usually permanent.

      There are a number of treatments available like early post-treatment evaluation and early institution of a trial of drug treatment as soon as the patient experiences any trouble with his erectile function. Besides these various therapies can also be applied:

      • First line therapy includes management of related medical conditions and psychological support combined with oral therapy.
      • Second line includes vacuum erection device therapy, penile injection therapy, and transurethral prostaglandin suppository administration.
      • Third line therapy is penile implant surgery.

      Does anti-androgen therapy make ED either better or worse?

      Hormone treatment (also called androgen deprivation therapy or androgen suppression therapy) for prostate cancer attempts to stop, block or remove the production of testosterone and all androgens to slow down or stop the progression of cancer. When hormone therapy is used, it is common for sexual problems to occur within the month following the beginning of therapy. Other common sexual side effects with hormone treatment include:

      • Inability to get or keep an erection (ED)
      • Difficulty climaxing
      • Orgasm without discharge of semen (dry orgasm)
      • Weaker, less satisfying orgasms

      Having understood the magnitude of the side effects of prostate cancer treatment using radiation therapy, it will be very painful to jump into another health condition after struggling with prostate cancer. For the problems that may be associated with sexual dysfunction reach out for doctor Dalal Akoury for instant and professional medical attention today. You must not battle with erectile dysfunction because help is only a phone call away.

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