By Dr. David Samadi
Prostate cancer can significantly affect various aspects of a man’s life, including sexual health and fertility. Beyond causing erectile dysfunction and urinary incontinence, prostate cancer treatments often lead to fertility issues. While this may not concern men who have completed their families, those who wish to have children in the future need to be well-informed about preserving their fertility. Understanding the potential impacts and available protective measures is crucial for these men to plan effectively for their future family-building aspirations.
Prostate cancer can affect a man’s ability to conceive because the prostate gland plays a vital role in semen production. Semen is the fluid that transports sperm through the penis during ejaculation. Treatments such as surgery, radiation, or chemotherapy that target the prostate can significantly impact this process, potentially hindering a man’s ability to father children in the future.
Impact of Prostate Cancer Treatment on Fertility
Treatments for prostate cancer can temporarily or permanently affect fertility, depending on factors such as the patient’s age, overall health, and the specific treatment used. It is important for men with prostate cancer who wish to conceive a child to discuss fertility concerns with their doctor before starting treatment.
Common Prostate Cancer Treatments and Their Effects
Surgery
- Procedure: Often involves the removal of the prostate gland and seminal vesicles.
- Impact: Without these glands, semen production ceases, preventing sperm from being ejaculated.
- Related Surgeries: Procedures for bladder, colon, and rectal cancers can also damage the prostate and related structures, potentially leading to infertility or erectile dysfunction
Radiation Therapy
- Procedure: Utilizes high-energy beams to target and kill cancer cells in the prostate.
- Impact: Radiation in the pelvic area can reduce sperm count and testosterone levels and potentially destroy sperm cells. The duration of damage can vary from short to long term.
Chemotherapy
- Procedure: Administers drugs through an IV to target rapidly dividing cells, including sperm cells.
- Impact: It can lead to infertility, with the risk influenced by the patient’s age, the type of chemotherapy, and the dosage.
Hormone Therapy (Androgen Deprivation Therapy – ADT)
- Procedure: Inhibits the production of male hormones like testosterone, which can fuel prostate cancer growth.
- Impact: ADT can slow tumor growth but also impair sperm production.
Preserving Fertility
There are several strategies to protect fertility before starting prostate cancer treatment:
Sperm Banking
- Process: Semen samples are collected, analyzed, and frozen for future use.
- Recommendation: Ideal for those who want to ensure they can father children post-treatment.
Testicular Shielding
- Process: Uses a protective lead cover to shield testicles from radiation during therapy.
- Benefit: This procedcure can reduce risk of radiation damage to sperm.
Testicular Sperm Extraction (TESE)
- Process: Small incision is made in the testes to extract sperm.
- Benefit: Extracted sperm can be used for fertilization or stored for future use.
Conclusion
Prostate cancer and the treatments to beat it back can significantly impact fertility. Understanding these effects and discussing options with your oncologist treating prostate cancer can help you make informed decisions to preserve your ability to have children in the future. Taking proactive steps right from the start can enable men to maintain their health and fertility while undergoing cancer treatment effectively.
Dr. David Samadi is the Director of Men’s Health and Urologic Oncology at St. Francis Hospital in Long Island. He’s a renowned and highly successful board certified Urologic Oncologist Expert and Robotic Surgeon in New York City, regarded as one of the leading prostate surgeons in the U.S., with a vast expertise in prostate cancer treatment and Robotic-Assisted Laparoscopic Prostatectomy. Dr. Samadi is a medical contributor to NewsMax TV and is also the author of The Ultimate MANual, Dr. Samadi’s Guide to Men’s Health and Wellness, available online both on Amazon and Barnes & Noble. Visit Dr. Samadi’s websites at robotic oncolo gy and prostate cancer 911.