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Is Erectile Dysfunction A Sign Of Prostate Cancer?

Prostate cancer like any other cancer is the abnormal growth of cells forming a tumor in the prostate gland. It is the 3rd leading cause of death and the most common cancer in men. Prostate gland is a male reproductive gland that produces prostatic fluid that helps in the greater motility of the sperms for the fertilization of the egg.

Prostate is located anterior to the rectum and inferior to the urinary bladder, encircling the urethra. Although, prostate may have other cancers, including small cell carcinomas, sarcomas, transitional cell carcinomas, neuroendocrine tumors; adenocarcinomas are the most common tumors found in relation to the prostate gland.

Adenocarcinomas originate from gland cells, which are responsible for making prostatic fluid.

What is the relation between prostate cancer and erectile dysfunction? It is well known that erectile dysfunction is an undesired complication or side-effect of prostate cancer treatment, especially radical prostatectomy secondary to the damage of nerves responsible for erection. However, there still exists confusion whether erectile dysfunction is a sign of prostate cancer or not. Prostate cancer and erectile dysfunction, both share common risk factors including smoking, alcohol and obesity increasing the risk for both these diseases. In some men, erectile dysfunction may be found in people with prostate cancer due to shared risk factors, anxiety or stress related to the cancer diagnosis as erectile dysfunction may often be a psychological or neurological presentation. However, erectile dysfunction is not a direct sign or symptom of prostate cancer as prostate cancer does not directly impair cavernosum to lead to ED. Although, it can be a secondary symptom of prostate cancer causing prostatic hypertrophy leading to urinary symptoms that might lead to secondary reduction in sex drive due to severe LUTS (lower urinary tract symptoms).

Recent studies have shown a relation between erectile dysfunction and occult prostate cancer and they consider it best to get a patient with erectile dysfunction screened for prostate cancer regardless of the age of the patient. Studies have correlated erectile dysfunction to advanced prostatic cancer. It has also been noted that patients with pre-operative erectile dysfunction have poor outcomes of prostate cancer post radical prostatectomy.

Men above the age of 50 years are at a greater risk of getting prostate cancer having African American and Caribbean ethnicity. The risk also increases with a family history of prostate cancer, prostate inflammation, vasectomy and sexually transmitted diseases. Environmental factors including smoking, Agent Orange chemical exposure, obesity and higher consumption of dairy products and red meat may contribute to the risk of getting prostate cancer in men.

Prostate cancer can be caused by gene mutations either acquired or inherited, including in BRCA1 and BRCA2, RNASEL, HOXB13 and MLH1 and MSH2. It has also been attributed to increased level of testosterone levels.

Prostate cancer may present with little to no symptoms, initially, along with urinary and other symptoms in later stages. The urinary symptoms may include hematuria, dysuria, urinary incontinence, weak urinary stream, increased frequency or increased urge to urinate. Other prostate symptoms include painful ejaculation and blood in semen. Prostate cancer has a propensity for metastases and if that occurs then there can be symptoms related to the site of metastases such as pain or paresthesias of leg, hips, bone pain or swelling of hip or leg area.

Erectile Dysfunction

Erectile dysfunction is a sexual disorder in which a man is persistently unable to get or maintain an erection during sexual intercourse. Erectile dysfunction may be caused due to decreased blood flow, nerve supply and decreased androgens. There may be certain factors that may lead to erectile dysfunction, which include smoking, alcohol intake, obesity/overweight, sedentary lifestyle, ill-managed diabetes, hypercholesterolemia, cardiovascular diseases, anxiety, hypertension, hormonal disorders, substance abuse, certain drugs and depression to name a few. In addition, to being a physical condition, erectile dysfunction can also be a psychological condition. Although, it is a treatable condition, not many men reach out for treatment due to embarrassment.

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Is Erectile Dysfunction A Sign Of Prostate Cancer?