The New Love and Sex After 60 by Robert N. Butler

Author:Robert N. Butler [Butler, Robert N.]
Language: eng
Format: epub
ISBN: 978-0-307-78917-4
Publisher: Random House Publishing Group
Published: 2011-04-13T00:00:00+00:00

Prostate Cancer

Cancer of the prostate, a much more serious disorder than BPH, occurs largely in men over sixty. Its cause is still unknown. It does not appear that men with BPH have higher rates of prostate cancer than those without BPH. Most such cancers are not detected until men are in their seventies. Cancer of the prostate is the second leading cause of cancer deaths in men, killing 32,000 annually. Each year 180,000 men are diagnosed with prostate cancer. Studies reveal that almost half of all men under age seventy have at least microscopic prostate tumors and 80 percent to 90 percent have such signs by age eighty and older, although most older men die of other conditions first. The probability of developing prostate cancer in one’s lifetime is about 8 percent for American men. A family history of prostate cancer doubles the risk, especially if more than one relative had the disease, and if it had been acquired at a relatively young age (as in the fifties). A high-fat diet appears to be a risk factor. African American men tend to develop a more lethal prostate cancer, for reasons yet unclear.

Early detection is critical. The five-year survival rate is 100 percent for men whose cancer at the time of diagnosis is confined to the prostate. However, the rate decreases to 30 percent survival the first five years for those whose cancer has spread to other parts of the body.

When detected early, many cases can be successfully treated with surgery and/or radiation (delivered externally or implanted as “seeds”) or other treatments. Most men choose surgery; however, a high percentage of men (60 percent or more) have some degree of erectile dysfunction afterward. While all methods are effective against the cancer, surgery may be more curative, especially in the younger patient. About 25 percent of men choosing surgery will also require radiation, because of evidence that the cancer has spread. Originally radiation as the first line of defense was thought to be more protective of potency; however, it has now been found that a significant number of men who undergo this treatment—30 to 60 percent—do experience permanent impotence. Both surgery and radiation may also result in urinary incontinence.

Cryosurgery is another option. This procedure involves freezing the cancerous tissue by pumping cold gas into probes that have been inserted into the prostate.

Chemotherapy (cis-platin or vincristine) and hormone therapy are also commonly used in the treatment of prostatic cancer. During the course of chemotherapy, problems with erections and desire may emerge, but they do disappear after the therapy has stopped. Hormone therapy involves either bilateral orchiectomy (removal of both testicles) or hormones (e.g., Lupron, a hormone that turns off the pituitary gland and thereby reduces testosterone), or a combination of both. The intent of hormone therapy is to eliminate the testosterone that feeds this cancer. Side effects can include a decrease in sexual desire and difficulties in erection. Oral sildenafil (Viagra), penile injections, or vacuum devices can counteract the impotence (see this page–this page), but testosterone treatments should not be given.

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