Knowledge | Prostate Cancer Treatment and Fertility: An Important Impact
The prostate is an important part of the male reproductive system. Located below the bladder and in front of the rectum, it is about the size and shape of a walnut. It primarily produces semen, the milky fluid that carries sperm and leaves the body through the penis during ejaculation. Prostate cancer can disrupt normal prostate function and have lasting effects on male fertility.
Prostate cancer becomes more common with age, especially after 50. Risk is also higher among men with a family history and Black men. Early prostate cancer may cause no obvious symptoms, while advanced disease may cause sexual dysfunction such as erectile dysfunction (ED), which can affect fertility. However, prostate cancer treatment is often the main cause of fertility problems.
1. How Prostate Cancer Treatment Affects Fertility
Fertility may be affected temporarily or permanently depending on the treatment, age, and health of the patient. Fertility concerns should be discussed with a doctor before treatment begins.
Main treatments include:
Surgery: Surgery often removes the prostate and two small glands called seminal vesicles, which together help carry semen out of the body. After removal, sperm can no longer leave the body naturally, resulting in infertility. Other pelvic surgery for bladder, colon, or rectal cancer can also damage nearby nerves and organs and cause infertility or erectile dysfunction.
Radiation therapy: High-energy radiation kills cancer cells. Although directed at the prostate, radiation involving the sexual organs or abdomen, including the testicles, bladder, or lymph nodes, may lower sperm count and testosterone, or kill sperm directly. Effects may be short-term, long-term, or permanent.
Chemotherapy: Intravenous medicines kill rapidly dividing cells, including sperm-producing cells, so chemotherapy often affects sperm production. The effect depends on age and the type and dose of medicine.
Hormone therapy: Also called androgen deprivation therapy (ADT), it slows cancer growth by suppressing androgens such as testosterone. It may also suppress sperm production and affect fertility.
2. Preserving Fertility
Several measures may help protect or preserve sperm for future use:
Sperm cryopreservation: Before treatment, men with prostate cancer or another condition that may affect fertility can freeze sperm. A laboratory collects a semen sample, evaluates it under a microscope, and freezes suitable samples for future use.
Testicular shielding: During radiation therapy, a protective lead shield may cover the testicles to reduce radiation damage to sperm. Also called gonadal shielding, it may reduce fertility risks.
Testicular sperm extraction (TESE): If sperm cannot be saved through ejaculation, it may be surgically extracted from the testicle. A small sample of testicular tissue is removed and examined for sperm. If found, sperm may be used for assisted reproduction or frozen for future use.
Knowledge | Prostate Cancer Treatment and Fertility: An Important Impact
Knowledge | Prostate Cancer Treatment and Fertility: An Important Impact
The prostate is an important part of the male reproductive system. Located below the bladder and in front of the rectum, it is about the size and shape of a walnut. It primarily produces semen, the milky fluid that carries sperm and leaves the body through the penis during ejaculation. Prostate cancer can disrupt normal prostate function and have lasting effects on male fertility.
Prostate cancer becomes more common with age, especially after 50. Risk is also higher among men with a family history and Black men. Early prostate cancer may cause no obvious symptoms, while advanced disease may cause sexual dysfunction such as erectile dysfunction (ED), which can affect fertility. However, prostate cancer treatment is often the main cause of fertility problems.
1. How Prostate Cancer Treatment Affects Fertility
Fertility may be affected temporarily or permanently depending on the treatment, age, and health of the patient. Fertility concerns should be discussed with a doctor before treatment begins.
Main treatments include:
Surgery: Surgery often removes the prostate and two small glands called seminal vesicles, which together help carry semen out of the body. After removal, sperm can no longer leave the body naturally, resulting in infertility. Other pelvic surgery for bladder, colon, or rectal cancer can also damage nearby nerves and organs and cause infertility or erectile dysfunction.
Radiation therapy: High-energy radiation kills cancer cells. Although directed at the prostate, radiation involving the sexual organs or abdomen, including the testicles, bladder, or lymph nodes, may lower sperm count and testosterone, or kill sperm directly. Effects may be short-term, long-term, or permanent.
Chemotherapy: Intravenous medicines kill rapidly dividing cells, including sperm-producing cells, so chemotherapy often affects sperm production. The effect depends on age and the type and dose of medicine.
Hormone therapy: Also called androgen deprivation therapy (ADT), it slows cancer growth by suppressing androgens such as testosterone. It may also suppress sperm production and affect fertility.
2. Preserving Fertility
Several measures may help protect or preserve sperm for future use:
Sperm cryopreservation: Before treatment, men with prostate cancer or another condition that may affect fertility can freeze sperm. A laboratory collects a semen sample, evaluates it under a microscope, and freezes suitable samples for future use.
Testicular shielding: During radiation therapy, a protective lead shield may cover the testicles to reduce radiation damage to sperm. Also called gonadal shielding, it may reduce fertility risks.
Testicular sperm extraction (TESE): If sperm cannot be saved through ejaculation, it may be surgically extracted from the testicle. A small sample of testicular tissue is removed and examined for sperm. If found, sperm may be used for assisted reproduction or frozen for future use.
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