Although prostate cancer is the leading cause of cancer in men, little attention has been paid to the effects of therapy on male sexual function.

Some men make their treatment decision for prostate cancer contained to the prostate gland based on how the treatment may affect their ability to continue active sexual function. This treatment may include either radical surgery or brachytherapy, where radioactive seeds are placed directly into the prostate gland.

The authors of a new study said that despite the problems after treatment, the majority of the patients who received brachytherapy treatment were able to maintain a normal sex life. And for those with severe difficulty, medication was effective in resolving their problems.

What are the effects of treatment with the radioactive seeds on sexual function for men with prostate cancer? The question is answered in part by a study reported in the International Journal of Cancer (Vol. 96: 313-319).

Gregory Merrick, MD, from the Schiffler Cancer Center in Wheeling, W.Va., and colleagues carefully reviewed the sexual histories of 34 men who received brachytherapy to determine the sexual function of the men before therapy. They were studied for about 13 months after treatment.

The researchers found that one out of three men had severe problems with erections at some time after the seeds were placed in the prostate, including some who had problems immediately after the treatment.

Twelve of the men in this study were impotent, but only four of them used Viagra. All four improved with the medicine. For all the men in the study, three out of four were able to maintain their sexual function after brachytherapy treatment.

There were other problems associated with the treatment. Nine of the men had pain with orgasm.

In four patients, this pain persisted for an average of three months. For the other five men, the pain persisted for an average of 10 months. Five men had blood in the sperm, and this continued in two of them. Thirteen men had decreased intensity of their orgasm, and this did not improve with time.

The exact cause of these problems is not known, wrote the authors, and probably results from several factors, including nerve damage, problems with blood flow, local trauma from the needle placement and radiation, as well as psychological issues.

The authors concluded, "The documentation of sexual function following prostate brachytherapy may provide an opportunity to refine treatment technique and ultimately to improve quality-of-life outcomes."