Sex during treatment

OurVoice Vol.4 - No.2

I will be undergoing radiation treatment for prostate cancer, and have a question about sex. Is it necessary to abstain from sexual activity during the treatment?

This is a question I’m frequently asked by my own patients. Usually, their concerns are about the effects of intercourse on their own treatment or on their partner’s health.

There’s absolutely no danger from intercourse for men or their partner during external beam radiotherapy. Men often suffer fatigue during the course of treatment, however, and may experience bladder cramping towards the end. Treatment also irritates the prostate and this might make ejaculation painful. All these factors, plus the stress of therapy, may temporarily reduce interest in sex, but it will improve within a few weeks of completing treatment. Anxiety will only worsen the situation. If you’ve lost interest in sex or are having difficulties with erections during treatment, the best thing is to try to simply relax and wait until the side effects have subsided. On the other hand, if you’re interested and able, then it’s perfectly fine to go ahead.

The situation is a bit different following brachytherapy, since the radioactivity is implanted directly into the prostate. While a man who has brachytherapy is never radioactive enough to harm his partner, it’s possible ?though rare ?that one or more of the radioactive seeds can be expelled from the prostate with the initial ejaculations following the implant. It’s therefore recommended that men use a condom for the first two or three ejaculations after the procedure, to capture any loose seeds that might have found their way into the seminal vesicles.

The same advice goes as after external beam therapy ?it makes sense to wait until you’re comfortable before resuming intercourse. This will usually be within about a week of having the radiation treatment.

Dr. Charles Catton is a Radiation Oncologist at Princess Margaret Hospital in To-ronto, Ontario.