Helping men with prostate cancer avoid erectile dysfunction

Reported by Susan Aldridge, PhD, medical journalist

Scans can help plan treatment so that men with prostate cancer are less likely to suffer from erectile dysfunction.
Prostate cancer is being diagnosed, increasingly, among men in their 50s. While erectile dysfunction (ED), a possible complication of prostate cancer treatment, is always a concern, it is particularly important for these younger men. The problem is that nerves controlling erectile function can be severed during surgery for prostate cancer. But ED can also occur, for no obvious reason, after radiotherapy too.

A team at the University of Michigan has now taken a closer look at ED after radiotherapy, assuming it to be an issue with blood supply. They say that the conventional computed tomography (CT) scan does not show the bottom of the prostate gland and makes a potentially damaging assumption about where it is relative to the penis.

In the current study, magnetic resonance imaging in addition to CT has shown how the distance between the prostate base and the penis actually varies between 0.5 to 2.0 cm. Using this combined approach means that treatment can be planned to take in the whole prostate, but avoid the blood vessels below, which affect erectile functioning. This approach is likely to be very helpful - for at present one man in two who has radiation therapy for prostate cancer finds he cannot have sex afterwards without having medication such as sildenafil.

Source
Journal of Radiation Oncology, Biology, Physics January 2005

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