Tan Weizhen

weizhen@mediacorp.com.sg

When impotence is a major concern

Prostate Aw areness Month

Eveline Gan

eveline@mediacorp.com.sg

Will I die?

That was Albert Ang’s (not his real name) first thought when the doctor diagnosed him with Stage 1 prostate cancer last year.

The 44-year-old businessman was so distraught by the diagnosis that he almost blacked out. When Albert found out that the early-stage cancer could be treated, his next thought was: Will I ever be able to have sex with my wife again?

The prostate, a walnut-sized gland that is part of the male reproductive system, is located under the bladder and surrounds the urethra (the tube which carries urine from the bladder to the penis).

Although prostate cancer typically

Benign prostatic hyperplasia

Experts from the Singapore Urological Association will talk about the symptoms, treatment options and dangers of leaving this condition untreated. Conducted in English and Mandarin.

Date: Saturday

Time: 1pm to 5.30pm

Venue: 303-305, Suntec Convention Centre

Fee/Registration: Free. Registration required. Call 9358 9701 (English), 93589601 (Mandarin) or log on to www.pam.sg

Exercise as medicine

Learn from a sports physician, physiotherapist and orthopaedic surgeon on how exercise can be used to improve health and prevent musculoskeletal injuries.

Date: Saturday

Time: 9am to 11.30am

Venue:

Level 1Tan Tock Seng Hospital Theatrette,

Fee/Registration:

required. Call 6357 7708 or 6357 8266Free. Registration

HEA LTH LIST INGS

occurs in older men above the age of 50, younger men in their 40s, as in Albert’s case, are not immune to it.

Like many sexually active men who undergo prostate cancer treatment, Albert’s concerns about impotence are not unusual.

Speaking to T

Prostate cancer is now the third most common cancer among men in Singapore, based on a data released by the Singapore Cancer Registry for 2005 to 2009. In that period, 2,669 men here were diagnosed with the disease — a figure which has climbed steadily in the past decades.

With current conventional treatment options, early-stage sufferers usually either surgically remove their entire prostate gland or undergo radiotherapy, said Dr Simon Chong, consultant at Tan Tock Seng Hospital’s (TTSH) department of urology. Dr Chong is also the organising chairman of the Prostate Awareness Month 2011 campaign that begins this month.

In patients where the cancer has spread beyond the prostate gland, added Dr Chong, treatment involves lowering the male hormone, testosterone. This is done by either using medication or surgically removing both testes, which are the main source of testosterone.

“The resulting low testosterone state can affect the man’s sex drive and potency,” he said.

Fortunately for Albert, early detection meant that he did not have to undergo the latter treatment. To get rid of the cancer, his prostate gland was removed via a less invasive keyhole surgery.

However, surgery itself has common side effects such as incontinence and impotence, added Associate Professor Christopher Cheng, a senior consultant at Singapore General Hospital’s department of urology.

Explaining why impotence is a common problem with surgery, Dr Chong said: “The nerves that effect erection course very closely at the side of the prostate gland, and are easily affected by either surgery or radiotherapy. In men with high-risk cancers, these nerves are not preserved (in a bid) to ensure complete removal of the cancerous prostatic tissue.”

Even with nerve-sparing surgical techniques, Assoc Prof Cheng said that the nerve and blood supply to the penis are “invariably disturbed” during surgery.

Dr Chong added: “Usually, we tell patients that there is a 60 to more than 90 per cent chance of erectile dysfunction persisting one year after treatment by surgery or radiotherapy, without the use of medications.”oday on condition of anonymity, Albert said in Mandarin: “I spoke to my wife about (the possibility of not regaining sexual function), and she told me not to worry as we already had three kids. She didn’t care if I would not be able to perform after my treatment, as long as I could be cured. But, at the back of my mind, I felt very guilty towards her.”

Hope for a normal sex life

Nonetheless, Assoc Prof Cheng said there is still hope for men to reclaim intimacy after prostate cancer treatment.

“There are many remedies for sexual function. But first, the cancer is the primary concern and needs to be well taken care of. Subsequently, options like medications, injections and devices can help restore an active sex life,” he said.

The possibility of a man’s sex life returning to normal after prostate cancer treatment depends on several factors, added Dr Chong.

What his sexual function was before treatment?

The treatment he received, and if there are other factors such as anxiety or psychological effects of surgery.

If he had good sexual function to begin with, the chances of his sex life returning to normal will be higher.

A year after surgery, Albert said he is thankful that he is able to still enjoy a healthy sex life.

“It’s slightly different, but I am grateful that I can still enjoy sex with my wife, thanks to my doctors’ expert surgery skills. Of course, it also helps that my wife has also been very supportive during this tough period,” he said.

Albert added that he also hopes that more men will go for regular checkups, regardless of their age.

“Early detection saved my life. Now I treasure my life so much more. I’m working hard so that I can retire early and take my wife on vacations,” he said.