Erectile Dysfunction After Radiation

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With the rapid advancements in radiation and imaging technologies since the development of IMRT in the early 2000s, impotence has become one of the last major side effects of men who undergo radiation to cure their prostate cancer. Here, Medical Oncologist Mark Scholz, MD, discusses the sexual side effects of radiation and steps that men can take to try and mitigate these side effects.
0:26 What are the sexual side effects of radical treatment with radiation? ("radical," meaning that the radiation is administered to the entire prostate gland.)
2:09 What is the proper dosage and timing of drugs like Cialis?
4:29 What is the timeline for erectile dysfunction after radiation?
5:39 Is there anything patients can do prior to radiation treatment to reduce the probability of having erectile dysfunction?
7:10 Why do the side effects of surgery happen immediately, while impotence from radiation can occur a year or more after treatment?
8:41 Can focal therapy help mitigate sexual side effects from prostate cancer treatment?
9:46 You have mentioned using injection therapy after surgery as an attempt to have regular erections as a form of maintenance to prevent penile atrophy; is the same true for radiation?
10:58 When would a patient start injection therapy to try and prevent penile atrophy?
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Опубликовано:

12 фев 2023

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Комментарии : 61

@AaronHogue-kz4ic 4 месяца назад

Great video, and as a Prostate Cancer Survivor, I had external beam radiation and 20 months on Lutron. I have found that taking 5 mg of tadalafil or Cialis at night before bed. With approximately 14oz cup of water. Will give you an non sexual erections before you have to go and urinate. But, that a good thing because it means you are still getting erections at night. And, now that I’m not talking Lupron shots anymore, I’m still do the same thing and I am getting firmer erections more frequently. I can still have sexual function with my penis, no problems at all. Now it’s not like it used to be before Prostate Cancer treatments. But, yet still very very functional any time of the day. Because I take the 5mg of Cialis and water every night before bed. Also it’s been 18 months since I received radiation treatments. My age is 54 years old. And I hope that helps someone out, thanks.

@maxjones494 2 месяца назад

Did you have a lot of side effects from External Beam? I'm debating between EBRT & SBRT (5 Day Treatments, instead of 5 weeks) I also have to do hormone therapy for 4 months.

@AaronHogue-kz4ic 2 месяца назад

@@maxjones494 No not really, but I would say make sure you keep your skin down there well lotions. I got skin burnt, because I forgot to lotion well every day. like they told me to, I just forgot to do that.

@richardcook4352 Год назад

The problem is that the doctor (surgeon) may not be forthcoming with information if you don't ask very specific questions. You need to know all of the possibilities before even asking the questions.

@meltuc2594 4 месяца назад

I’m a 14 year survivor of prostate removal due to cancer. I had 33 radiation treatments. Couldn’t get it up for my partner after the treatments so she left. Well I found a new partner for 3 years and I had more sex than I had in a very long time. By the way I didn’t need and still don’t need the Viagra. It’s all about having a new exciting partner who makes it rise naturally. At. 71 finding a lady who is sexually active is the biggest challenge.🤬

@chrishobson129 Год назад

Hey Alex thanks for your dedication and efforts with PCRI. You and Dr. Scholtz make a great team!

@odysseyt1204 Год назад

Thanks for this content. My treatment ADT(12 months)+Radiation+Brachytherapy - Biggest regret is that no one mentioned one word about atrophy. That is unfortunate and could have been managed very easily. Still have sexual function but…. Any Urologists reading this - talk about this with your patients and take action.

@dwinsemius 9 месяцев назад

I was fortunate to have a radiotherapist who suggested "penile rehabilitation" starting *before* the radiotherapy.

@bjhelder 9 месяцев назад

I consider it malpractice and criminal to not tell men about this before treatment. They KNOW it will happen and most men are completely unaware.

@michaelanthony386 6 месяцев назад

@@bjhelder🎯

@predickament 2 месяца назад

I had radiation therapy and for me I was very unhappy about the atrophy! I lost about 4” in length and my testicles became the size of garbanzo beans!! I was rather large but with this loss, I was too embarrassed to get naked in front of a partner again. I’m elderly now, but I felt the treatment was similar in effect to a mastectomy for women. I would have liked to have been warned about this! So it amounted to the end of sex

@dmcarden 8 дней назад

@@predickament years ago i took finasteride to reduce the size of my enlarged prostate and lost size. I stopped after two months when I saw the effect on my organs. I started taking cialis every day to try and stretch it out i think..eventually went on TRT to help.

@user-zi1ed5jg6e 3 месяца назад

The most important takeaway from this video is that you as the patient need to make an informed decision. And, it’s your treatment decision not the Dr or anyone else’s decision. I would like to hear discussion here around the choice of refusing treatment with higher quality of life for a shorter number of years to live vs eradication of cancer with your remaining years diminished in quality.

@daisuke6072 Год назад

I believe it is worth taking Cialis when radiotherapy is taking place as a kind of prophylactic to assist the nerves and blood flow maintaining functionality.

@corgiowner436 Год назад

Want to say that even short term ADT can have profound effects. After 4 months of Orgovyx I was impotent and suicidal on the recovery. I will never be the same physically or psychologically. You might want to address the effects of not ejaculating or having pre-emissions on a man’s psyche. It’s just casually mentioned but the quality of arousal and orgasm is greatly diminished.

@robwells230 Год назад

I agree...was forced into getting a Six month ELIGARD shot just before starting 5 WEEKS OF IMRT. ....ADT side effects destroyed my quality of life to such an extent that I refused any further ADT. I was never informed about how little the prescribed Two years of chemical castration would add to my overall survival. ....Nor was I warned that the six month shot would keep me castrated for months longer, and that there's a 20 percent chance that my testosterone level would never recover, and that I might remain castrated for life, another NARCO MEDICO CARTEL Eunuch MY T level remains well below CASTRATE LEVEL and my PSA remains at 0.006 which is excellent after radiation I have lost all trust in my oncologist at the Alberta Cross Cancer institute, and now have no followup care. I spent the winter in CDMX, Mexico and self monitored my PSA AND TESTOSTERONE on my own by going to a local lab for monthly tests which cost less than C$10 per test. ....on the positive side, I modified my diet and did a lot of walking and lost 40 pounds without effort.

@robwells230 10 месяцев назад

Your story exposes the lack of FREE AND FULLY INFORMED CONSENT before treatment . Doctors and these videos often become slick sales pitches for extremely expensive drugs with the reliability of USED CAR SALESMEN. At least you were prescribed Orguvyx instead of Lupron type injections. These pills have less cardiovascular risk and testosterone recovery is much faster and predictable. Men are never informed that their six month Lupron shot will keep them CASTRATED for months, years, or forever in twenty percent of older men. The NARCO MEDICO CARTEL is more concerned with making billions by destroying your quality of life, or even driving you to suicide. ADT IS CHEMICAL CASTRATION, A CRUEL AND BARBARIC TORTURE.

@Shawny460 9 месяцев назад

I totally agree with you!!!

@Trucker-0172 3 месяца назад

Totally agree both my Urologists didn’t say anything but a line item mention of ED

@blackknight125 Год назад

Thanks for all your videos it helps a lot I had surgery I say was good for me no matter the cost it took a part of me and it took some time for me to get it however I got thru it had a ipp implant not to long ago every body is different please every male take your time if it's okay me I did not have time 85 percent of my prostate was filled with cancer make sure it is what's good for you god bless pcri

@dappa311 Год назад

How old are you and id it spread?

@sametaltun4327 Год назад

Thank you very much for this video! There is always a hope!

@MrGuitar1458 Год назад

Great information as always. 5 mg daily works well for both BPH symptoms and ED. Radiation does appear to have a slight edge over surgery for prostate cancer as far as sexual side effects.

@ibrahim_17 Год назад

Awesome video this is what I needed.

@Akasiiii Год назад

Good information. Thank you!

@John-the-Bass Год назад

Good information, thanks a lot.

@aysekaya5262 Год назад

nice video. very informative!

@TheBloodCrazed Год назад

Another great video

@joeswartz6181 2 месяца назад

After my prostate operation I recovered and my erection was normal.then I was told I need rediation...ok my operation was in 2010....erection was normal radiation was done in 2020 till today 2024 my erection is gone... and cialis and Viagra dont work I used injection and that was better I don't know what to do....I'm I obsolete???

@kevinvitale8980 Год назад

The pills not only did not work well, they made me feel bad. Pump didn’t work. The needle injection is the only thing that worked. BUT… I had hormone treatment which wiped my libido away.

@gregmatzinger7758 Год назад

How long were you on Lupron (or similar)? I’m on second 4-month shot and want to stop, if possible. Hot flashes disrupt sleep every night and libido is way way down. Finished 45 radiation treatments a few weeks ago. I believe my urologist wants me to get at least one more shot for a total of 12mos on it

@kevinvitale8980 Год назад

@@gregmatzinger7758 My hormone treatment (lupron) was for 18 months. As Dr. Sholz says, each man is different and maybe you only need the 12 mos. I did get hot flashes out of nowhere throughout the hormone treatment period. Always when I was awake, so I found them just a little nuisance. I had 31 radiation targeted treatments with a new hospital and new doctor, who was phenomenal. The hospital and doctor I had the prostatectomy wanted their standard care was going to be a blanket radiation. NOPE. Much success in treatment. You got this.

@gregmatzinger7758 Год назад

Thank you for the info and the good vibes!

@elitetrader5468 Год назад

Tadalafil 2.5 mg po daily works fine for many as well.

@suewanner395 9 месяцев назад

After 18 +months of adt plus radiation will the injections work for Ed. Viagra had not worked , thanks. So most patients stop adt after 18-24 months? My doctors say I can never get off of them! Also have testicular pain that they don’t seem to want to address other then castration.

@guyshirra824 Год назад

I have undergone HT and RT and there are two issues for me: 1. zero testosterone 2. zero libido and erectile function. No 1 concerns me most (my wife and I are both mid 70s). How long should I wait after conclusion of HT to consider testosterone treatment?

@robwells230 Год назад

I asked my Doctor how long before I could go on Testosterone Replacement therapy. She barked NEVER.. ....SO,, I will not be seeing her ever again. I'm planning to wait another year, then self administered testosterone injections that can be bought super cheap in Mexico over the counter. Sadly, I have been betrayed by the medical profession.

@michaeldelucia7352 Год назад

Does Viagra and Cialis exasperate reoccurrence of PC?

@basilbarnett7546 Год назад

My problem is, that my doctor has removed my prostate and had to remove one set of the nerves and I've had no erection in 3 years, what is my best option

@JerryEgge Год назад

I’m in the same boat. However, I just listen to the other video on Erectile Dysfunction after Surgery. It was very useful!

@basilbarnett7546 Год назад

@@JerryEgge what all have you tried

@JerryEgge Год назад

I asked my oncologist for some suggestions (a Dr at the Mayo Clinic). I was surprised that she flatly told me to talk with my surgeon. No help. I haven’t done anything to address this problem. I just because contentment two months ago. That was a big milestone. Now that I’m not dealing with that issue, my concern has has been on my erectile function. The literature says it can take up top 18 months. I’ve assuming my testosterone level is very low because I’m on a Mediterranean diet. I’m sure that doesn’t help. Anyways, that’s were I’m at. Thanks for asking.

@basilbarnett7546 Год назад

I've tried basically all the pills and pumps for 3 years and they have done nothing for me, and I also had my prostate removed and 1 set of nerves too, but I recently had my urologist to prescribe (TRY-MIX) injection shots, 💉 I hate needles, but it is worth every shot. My erections are very hard and it lasts for about 3 hours of erections, I hope this helps you and your partner. I was reluctant at first, because of how much I hate the needles. It is worth the money too, I paid 115 dollars for 25 shots, and I'm totally sold on this. God bless.

@JerryEgge Год назад

My situation is exactly the same. It’s been 14 months for me now and no signs of any erectile function yet. I haven’t tired anything yet. I’m going to try the shots.

@crabwho1584 7 месяцев назад

Drs an not trained in this part of the most important part of a man’s life

@robwells230 Год назад

If men hope to maintain sexual function, it is absolutely necessary to get oxygenated blood into the penile tissue at least every day. Even when the ADT chemical castration takes away sex drive, desire, and erections, every effects needs to be made to prevent permanent penile atrophy. Often, when physical stimulation isn't enough, mental and visual stimulation can help obtain erections and good blood flow. Adding pornography to your toolkit may help a lot, as does daily Cialis, penile injections, and or vacuum pumps. Use it or say goodbye to sex forever

@robwells230 11 месяцев назад

If radiation therapy doesn't destroy your erectile function, then the added ADT CASTRATION certainty will. ......men are seldom provided with necessary information and support on how to prevent or mitigate the inevitable permanent penile atrophy that results from lack of oxygenated blood in the penis that normally comes from nocturnal erections. .......Curing cancer should not have to come only by destroying sexual function and quality of life.

@robwells230 10 месяцев назад

I disagree that penile injections are only for desperate situations. They are cheap, easy, convenient, painless, very effective, and very fast acting. For many, injections are much preferred over slow acting pills, and for most men, have no side effects. Try it, you may love the results, and so will your partners

@darrellturner560 4 месяца назад

@@robwells230 You are not wrong that Drs are not forthcoming with this important piece of information. I'm almost a year after radiation treatment and hormone blocker. I'm deverstated now and can only hope with daily exercise I can regain erectile function hoping m old boy isn't damaged forever. So angry with the urologist.

@MrJ6789 Год назад

The doctor is not be truthful and clear as possible to your questions. If you notice his answers to her questions aren’t really telling us anything. Why not ask the doctor what’s causing ED? Answer surely isn’t old age. Possibly blood not getting to the penis. What could cause that? Possibly cholesterol in your arteries that restricting blood flow. Maybe also Cardiovascular Disease, Testosterone decline, Nitrous oxide levels, lack of exercise maybe. Getting hormone treatment such as giving a man estrogen treatment to lessen his risk of cancer thereby making him more feminine and reducing his testosterone levels surely is not going to help him ever cure ED. We need honest leadership.