Homosexual and bisexual prostate cancer patients have to wait for six months after treatment until they have anal sex again, new guidelines say.
A group of surgeons who issued the recommendation said that having sex too soon after major surgery risks bleeding, infection, and pain.
Currently, many gay and bisexual prostate cancer patients walk away without any advice because doctors do not ask about their sexual orientation.
But gay or bisexual men who get anal sex run the risk of physical damage in the weeks following their treatment.
Those treated with radiation have to wait the longest – six months – to avoid harming themselves or their partners.
Patients with homosexual prostate cancer have to wait up to six weeks or more until they have anal sex again to prevent the risk of bleeding, infection and pain, top surgeons have said (stock image)
Initial counseling of its kind is based on the opinions of 15 cancer doctors and 11 surgeons in the UK.
Sean Ralph, a radiographer from the Clatterbridge Cancer Center NHS Trust near Liverpool, was part of the team that drafted the guidelines.
He said: “We have discovered that most oncologists and surgeons do not ask patients about their sexual orientation or sexual practices.”
Mr. Ralph said that “means that some men do not get the right advice and support they need to remain a safe and satisfying sex life.”
He added that men are normally advised to have sex again shortly after prostate cancer treatment to maintain their erectile function.
Some prostate cancer treatments can damage the nerves and blood vessels needed for an erection.
“However, the increased chance of participating in anal sex means that some groups of patients – especially gay and bisexual men – have different risks, such as the possibility that anal sex causes physical damage after prostate surgery or radiotherapy,” Mr. Ralph said. .
The team concluded that after surgery to remove the prostate – a radical prostatectomy – sex should be avoided for six weeks.
Following external radiation radiotherapy, patients should avoid sex for two months to reduce the risk of pain or long-term complications such as rectal bleeding, the guidance said.
WHAT ARE THE WAITING TIMES OF THE DIRECTIVES?
According to guidelines established by doctors and surgeons, men who are being tested or treated for prostate cancer should have the following time to have anal sex to prevent internal injury, incorrect test results or damage to their partner:
- A week for a prostate-specific antigen (PSA) blood test
- A week after a biopsy with the help of a needle through the perineum (between the scrotum and the anus)
- Two weeks after a biopsy with the help of a needle through the rectum
- Six weeks after surgery to remove the prostate gland (radical prostatectomy)
- Two months after external radiotherapy
- Six months after permanent seed brachytherapy
And men who have permanent seed brachytherapy, with chunks of radioactive material left in the body to destroy the cancer, have to wait six months or more.
Their sexual partners can be exposed to harmful radiation if they start having sex again too soon, the experts said.
And before a PSA test, a blood test that can help diagnose prostate cancer, sex can skew the results and should therefore be avoided a week earlier.
This is the first time health professionals have come together to develop clinical advice regarding anal sex and prostate cancer.
The panel admitted that they did not always ask prostate cancer patients about their sex lives.
Only three out of 26 (12 percent) said they always asked prostate cancer patients about their sexual orientation.
And only two out of 26 (eight percent) always ask about anal sex if they know their patient is gay or bisexual.
Dr. John Burton, of the Edinburgh Cancer Center, said: “This guideline is invaluable for doctors and people being treated for prostate cancer.
‘It’s already too late and solves an inequality in the level of information available to patients.
“This will not only benefit patient care in the UK, but as the first guideline of its kind in the world, it will inevitably have an impact on the cancer community worldwide.”
Mr. Ralph said that providing guidance was difficult because there is a lack of concrete clinical evidence on this subject. The figures are based on the most common answers from top doctors.
Prostate cancer UK has already incorporated these findings in its patient advice.
Catherine Winsor, spokeswoman for the charity, said that her specialized nurses are often asked about the problem of patients and professionals.
She said: “This important and much needed research has solved an important gap in our ability to support gay and bisexual men.
“We hope health professionals will use these findings to provide more consistent, fact-based guidance to men who have anal sex.”
Prostate cancer is the most common cancer in men and affects one in eight men in the UK.
In the United Kingdom, approximately 47,000 men are diagnosed with prostate cancer each year and 174,650 men in the US.
The guidelines are presented at the UK Imaging and Oncology congress in Liverpool.
WHAT IS PROSTATE CANCER?
How many people does it kill?
Prostate cancer became a greater killer than breast cancer for the first time, official statistics revealed last year.
More than 11,800 men a year – or one every 45 minutes – are now killed by the disease in Britain, compared to around 11,400 women who die of breast cancer.
It means that prostate cancer is behind lung and intestinal tracts in terms of the number of people it kills in Britain. In the US, the disease kills 26,000 each year.
Nevertheless, it receives less than half of the research funding for breast cancer – while treatments for the disease are at least a decade behind.
How fast is it developing?
Prostate cancer usually develops slowly, so there can be no signs that someone has it for years, according to the NHS.
If the cancer is at an early stage and causes no symptoms, a policy of “watchful waiting” or “active surveillance” can be adopted.
Some patients can be cured if the disease is treated at an early stage.
But if it is diagnosed at a later stage, when it has spread, it becomes terminal and the treatment revolves around relieving symptoms.
Thousands of men are delayed to diagnose because of the known side effects of the treatment, including erectile dysfunction.
Tests and treatment
Tests for prostate cancer are haphazard, with accurate tools that are just starting to show up.
There is no national prostate screening program because the tests have been too inaccurate for years.
Doctors have difficulty distinguishing between aggressive and less severe tumors, making it difficult to choose a treatment.
Men over 50 are eligible for a “PSA” blood test that gives doctors a rough idea of whether a patient is at risk.
But it is unreliable. Patients with a positive result usually receive a biopsy that is also not watertight.
Scientists don’t know for sure what causes prostate cancer, but age, obesity, and lack of exercise are known risks.
Anyone with concerns can contact the Prostate Cancer UK specialist nurses on 0800 074 8383 or come to visit prostatecanceruk.org