(By comparison, there were 232,000 new diagnoses of breast cancer the same year, with 40,000 deaths — 17 percent.) Doctors treat most early prostate cancers in one of three ways: surgical removal of the gland (radical prostatectomy), radiation from an external source (external beam) or insertion of a radioactive pellet (seed implantation). Whether you have prostate cancer or not, ED risk increases with age. National Cancer Institute researchers followed 1,187 men for five years — 901 had surgery, 286 radiation.
Local commissioners and/or providers have a responsibility to enable the guideline to be applied when individual health professionals and their patients or service users wish to use it.They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities.This guideline includes recommendations on: We reviewed the evidence in October 2016, through an exceptional review, and we are updating the recommendations in 3 areas of the guideline.How we develop NICE guidelines This guideline updates and replaces prostate cancer: diagnosis and treatment (CG58) and denosumab for the treatment of therapy-induced bone loss in non-metastatic prostate cancer (TA194).A special surgical approach called nerve-sparing prostatectomy can push your ED risk below that of radiation.
Studies report "functional" erections in 60 to 80 percent of men who have nerve-sparing surgery.
Just don't expect miracles: At best, nerve-sparing surgery leaves men with erections not quite as firm as they were before surgery.
In addition, nerve-sparing surgery may not be possible if the tumor is located near a nerve line.
(That's because conventional surgery sometimes preserves the nerves.) After nerve-sparing surgery, however, the drugs helped about 50 percent of the men.
Bottom line: For the best chance of preserving sexual function, opt for nerve-sparing surgery, then use erection medication. So even when prostate-cancer treatment damages or destroys the erection nerves, those that govern orgasm usually remain intact.
Michael Castleman, publisher of the website Great Sex After40.com, writes about sex for AARP.