Men's Health Patient Care

The Connection Between Prostate Cancer and Erectile Dysfunction

Men's health doctor in white coat with stethoscope

Prostate cancer is a condition that begins in the prostate, often resulting from genetic mutations. There are many options for diagnosing prostate cancer, and its progress or stage determines treatment options. Symptoms or complications of prostate cancer include progressive problems with urination, blood in urine, body pain and erectile dysfunction (ED).

When a patient experiences ED as a complication of prostate cancer, there are new aspects to their treatment that must be considered. Because this topic is often private for patients, physicians are trained to discuss this condition with the greatest level of sensitivity and work alongside patients to achieve positive outcomes.

Prostate Cancer Definition, Symptoms and Complications

What is prostate cancer?

The prostate is a small gland in the male reproductive system that produces seminal fluid. The prostate is located just below the bladder and in front of the rectum.

Cancer beginning in the prostate occurs when abnormal cells begin to grow out of control in the prostate tissue, often first detected as an unusual lump in the tissue. The tumors beginning in these organs can spread to lymph nodes, tissues and other organs in the lower abdomen as the cancer progresses.

After skin cancer, prostate cancer is the most common cancer among people assigned male at birth and one of the leading causes of cancer death among men in the United States. This is largely because many prostate cancers are detected late, when treatment is most difficult. With early detection, prostate cancer is very curable.

The risk of developing prostate cancer increases with age. Regular screenings (if you’re eligible) are vitally important. Screening also increases the likelihood of catching prostate cancer in its earlier stages, when it is easier to treat.

What are the symptoms of prostate cancer?

Symptoms differ between patients, but those experiencing early stages of prostate cancer may experience the following:

  • Weak or interrupted (“stop-and-go”) flow of urine
  • Sudden urge to urinate
  • Frequent urination (especially at night)
  • Trouble starting the flow of urine
  • Trouble emptying the bladder completely
  • Blood in the urine or semen
  • Pain or burning while urinating
  • Pain in the back, hips, or pelvis that doesn’t go away

Common complications for prostate cancer include urinary incontinence, metastasis and conditions involving the function of the penis, such as erectile dysfunction (ED).

Cross section illustration of male reproductive system, prostate, bladder, and rectum. Cancerous prostate gland is highlighted.
The prostate is located below the bladder and anterior to the rectum, and cancer developing in this organ is known as prostate cancer.

Prostate Cancer and ED

What is erectile dysfunction?

Erectile dysfunction or ED is the consistent inability to achieve an erection sufficient for satisfactory intercourse. Although not all people with ED identify as men, as many as 30 million Americans have ED. Most men with ED are sexually active, but they are usually having problems with how they may expect their body to respond or function during intercourse.

If a patient is experiencing ED, there is a 90% chance that something known as an “organic cause” is responsible for the condition. An organic cause for ED would be any underlying medical condition that affects the blood supply or nerves to the penis, resulting in ED. The patient may not know they have diabetes, high blood pressure, a heart condition, cholesterol levels over 300 or prostate cancer. Most people who have these major medical problems have ED before they show symptoms of these conditions.

How does prostate cancer lead to erectile dysfunction?

Prostate cancer does not directly cause ED, but treatments for prostate cancer can cause a patient to experience this condition. In fact, ED is one of the most common side effects after any kind of prostate cancer treatment.

Treatments for prostate cancer can decrease your body’s ability to create testosterone. Low testosterone can impact your libido and ability to achieve and maintain an erection.

Other treatments, such as prostatectomy, can affect the blood vessels and nerves responsible for causing erections. If these structures in your body experience trauma, it can make it more difficult for them to work properly, causing ED.

Prostatectomy, or surgery to remove the prostate, can also affect your ability to produce ejaculate. If you do not have ED after prostate cancer treatment, it is still common to be unable to ejaculate during sex.

Finding Help for Erectile Dysfunction

Discussing sex-related conditions or prostate health can be uncomfortable, but understanding these conditions and how they affect overall health is critically important for every patient experiencing ED. Once a health care provider knows that the patient has this problem, they can prescribe medicines that often take immediate effect or refer the patient to a specialist for other treatment options.

Even if you choose not to treat the ED with direct therapies, going to the doctor will help you uncover any of these underlying medical problems. Identifying the organic cause and prostate cancer treatment can help relieve the symptom of ED.

Treatments for prostate cancer that may also indirectly improve ED include surgery, radiation therapy, systemic therapy and focal therapy. Detailed information about treatment options is available through Siteman Cancer Center.

Treating Prostate Cancer and ED at Washington University

Washington University Division of Urology and the Washington University cancer specialists at Siteman Cancer Center help treat patients experiencing these related conditions. Washington University offers a multidisciplinary approach, which employs the combined expertise of urologists, interventional radiologists, endocrinologists and psychologists when it comes to making a diagnosis and developing a treatment plan for ED. Siteman has a number of innovative treatment options for prostate cancer.

For more information about Washington University Division of Urology, please visit the Division of Urologic Surgery website. To schedule an appointment with a Washington University Urologist, please fill out the online appointment form or call 314-362-8200. To get in touch with cancer specialists at Siteman Cancer Center, fill out the appointment request form. Newly diagnosed patients also may call the registered nurses in our Patient Care Coordination Center, toll-free at 800-600-3606 from 8 a.m.-4:30 p.m. weekdays.