Small Percentage Of Men Complain Of Shortened Penis After Prostate Cancer Treatment
The Huffington Post UK | Posted: 04/01/2013 11:42 GMT | Updated: 04/01/2013 15:00 GMT
A small percentage of men have complained of a shortened penis after prostate cancer treatment, research reveals.
In a study conducted by researchers from Dana-Farber/Brigham and Women’s Cancer Center in Boston, some men have lamented that the change in their penis has interfered with intimate relationships and caused them to regret their choice of treatment.
The study’s findings, which are being published in the January issue of the journal Urology, are based on surveys completed by physicians of 948 men treated for prostate cancer and who had suffered a recurrence of the disease.
Complaints were more common in men treated with radical prostatectomy (surgical removal of the prostate) or male hormone-blocking drugs combined with radiation therapy, according to the study.
No men reported a perceived shortening of their penis following radiation therapy alone.
Twenty-five men complained of smaller penises after treatment – 3.73% for surgery, 2.67% for radiotherapy plus androgen deprivation therapy (ADT), and 0% for radiotherapy alone. Radiotherapy included both radiation administered by an external x-ray machine, and brachytherapy – the implantation of radioactive seeds directly into the prostate.
The scientific team, led by radiation oncologist Paul Nguyen, MD, and medical student Arti Parekh, said it is the first study to link men’s perceptions of a reduction in penis size to lowered life satisfaction, problems in emotional relationships, and misgivings about the specific form of prostate cancer treatment they chose.
Nguyen said that the potential side effect of a smaller penis is well-known among physicians and surgeons.
“But it’s almost never discussed with patients, so it can be very upsetting to some men when it occurs,” he added. “Patients can deal with almost any side effect if they have some inkling ahead of time that they may happen.”
The report’s authors said physicians should discuss the possibility with their patients so that they can make more-informed treatment choices.
There were no direct measurements of penis size either before or after treatment, said the researchers. Nor did the patients’ physicians specifically ask about this side effect; the issue was brought up by patients in conversations with their doctors. For this and other reasons, the authors of the new study suggest that the problem is likely more common than reported in the survey.
“Prostate cancer is one of the few cancers where patients have a choice of therapies, and because of the range of possible side effects, it can be a tough choice,” said Nguyen. “This study says that when penile shortening does occur, it really does affect patients and their quality of life. It’s something we should be discussing up front so that it will help reduce treatment regrets.”
The likelihood and magnitude of penis shortening as a consequence of treatment have not been well studied, said the researchers.
However, Jim Hu, MD, a surgeon at the University of California, Los Angeles Medical Center and a co-author of the study, said: “Previous studies have concluded that there is shortened penis length following prostatectomy. This is most common with non-nerve sparing surgery, as this may result in fibrosis and atrophy of erectile tissue due to damage to nerve and vascular structures.” The present study did not find much difference on that score.
Experts Predict Revolution In Prostate Cancer Treatment
The study’s subjects were men enrolled in a registry called COMPARE that collects data on patients whose prostate cancer shows signs of recurring after initial treatment. Of the 948 men in the study, 22% were younger than 60 and the majority were in their 60s, 70s and 80s. Just over half – 54% – had undergone surgery to remove their cancerous prostate, while 24% received radiation therapy combined with hormone-blocking treatment, and 22% had radiation therapy alone.
In an editorial comment accompanying the report, Luc Cormier, MD, PhD, of Dijon University Hospital in France said the study “is really of interest because of the number of patients and that it included other treatment methods in addition to radical prostatectomy.”
The surveys of the men did not report on their sexual functioning. Cormier observed that “sexual activity needs to be thoroughly measured owing to the obvious relationship with the patients’ perception of penile length.”
Prostate Diaries 
As stated, most men don’t want to discuss, let alone admit to the definite change the treatment for prostate cancer can make; nor do I think that it is fully discussed prior to the treatment. One is given a book to read, in which “all” things are discussed, but having been a ‘reader”, that particular subject didn’t seem to share the the same level as life or not. Of course that was before the prostatectomy and 42 sessions of radiation, and subsequent ‘other” treatments.
My Uncle was diagnosed at 54 with prostate cancer, and chose to enjoy life to the fullest; be that fishing with his grandchildren, drinking with his poker buddies or loving my Aunt. He lived for thirty-one years, only the last three months were difficult and painful.
My husband, whom I thought would never consent to radiation and chemotherapy, readily agreed to whatever the doctor offered. At age 62, he embarked on a journey for which there is no “GPS” because each case is diferent. He read and understood the ramifications of what would happen, but even he didn’t expect the “difference” and now, seven years later, the residual effects of radiation on his system. And while the radiation is still destroying tissue, the doctors urge yet another course of chemical assistance. But I digress, if husbands and wifes would be asked and answer honestly about their sexual relationship after treatment, (that is, if they enjoyed one another before) they would have to admit that the diminished size makes a difference, the man does feel emotionally strained and uncomfortable speaking with his wife, let alone another man. So in my opinion, their never will be an accurate survey on how men deal with sex treatment.
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There should be a correction on the last sentence; their, is of course, there and I meant to say, how men deal with sex after treatment. Thank you kindly.
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I just want to get back my control over my bladder. Damn, I am sure getting fed up with no control. Sigh!
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