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Enhanced sexual well-being for men with Prostate Cancer

Paul Edwards

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The following item by Dr Prue Cormie, a Senior Research Fellow at Edith Cowan University Perth, was first broadcast on the ABC on the Science Show on Saturday
31 May 2014.  We are grateful to the ABC and Dr Cormie for permission to publish a transcript.


Men think about sex a lot.  On average every 45 minutes, which is more often than they think about food or sleep.  So it's not surprising that sexual dysfunction is the most frequently identified issue of importance among prostate cancer survivors.  Significant reductions in sexual well-being occur in up to 90% of men with prostate cancer.  And only a third regain pre-treatment levels.


Current management options include drugs such as Viagra, penile implant surgery, or the injection of drugs directly into the penis.  Now, not only do these strategies have low levels of uptake and compliance, but they exclusively target erectile function, with no consideration of the many factors that drive sexual dysfunction.


There is a critical need for better management options, ones which comprehensively counteract the unique variety of factors contributing to sexual dysfunction following prostate cancer.


Now, the good news is we've discovered such a treatment. Exercise. Now, in a world-first we took a set of men with prostate cancer and we divided them into two groups, one which maintained their normal lifestyle or usual care, while the other participated in a supervised exercise program, involving twice-weekly group based sessions. These sessions involved resistance exercise which required men to lift weights, as well as a aerobic exercises such as walking and cycling.


After just three months the men involved with the exercise program had a 50% greater level of sexual activity.  Fifty percent!  This difference was driven primarily through changes in sexual desire, with a larger proportion of men in the exercise program maintaining a high level of libido.


In a subsequent study we again observed a targeted exercise program to minimise declines in sexual function, this time during the initial phase of prostate cancer treatment where that impairment is most pronounced.


So what is it about exercise that works?   Well, exercise prompts improvements in many of the side effects of prostate cancer treatment that contribute to sexual dysfunction.   We observed enhanced sexual well-being to be accompanied by significant improvements in a range of factors, such as body composition, especially gains in muscle mass to counteract body feminisation, as well as improvements in fatigue, depression, anxiety, strength, fitness and quality of life.   By conducting interviews with these men we discovered that enhanced masculine self-esteem was an additional driver of improved virility.


So with this research we've established that exercise is an effective medicine that can be prescribed to counteract the devastating sexual dysfunction caused by prostate cancer treatments.


[Edit: Yet again, exercise, the wonder medicine!!]

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