Gay Men and Prostate Cancer

Gay men have a tougher time dealing with the aftermath of prostatectomy than heterosexual men do, says researchers at the American Urological Association. The physical as well as psychosocial quality of life of a gay man appears to suffer more from the side effects of the cancer treatment compared with the situation for straight men, said David Latini, PhD, Assistant Professor of Urology at Baylor College. “We find that men in our sample are significantly different in almost every domain of quality of life, and these differences are large enough to not just be statistically significant but are also clinically relevant,” Dr. Latini said at a news briefing.

Dr. Latini also noted that many gay men, especially the insertive partner, had severe sexual “quality-of-life disturbances,” mainly erectile dysfunction, because the aftermath of prostatectomy was not helped as much by phosphodiesterase-5 inhibitor medication that allows men with erectile dysfunction to function sexually.

“For gay men this is a particularly difficult area,” he explained. “The phosphodiesterase-5 inhibitors were created with an endpoint in the trials of vaginal penetration. We know that an erection has to be firmer to penetrate someone anally. So for sexual intercourse between two males, these medications are usually not sufficient.” I don’t agree but in my experience I know that men who undergo radical prostatectomy, the majority do not respond to phosphodiesterase-5-inhibitor unlike men who opt for radiation therapy. “Many of the guys in our sample are struggling with that, and are forced, if they want to remain the insertive partner to go to other more invasive treatments.”

The moderator of the news conference, Tomas Griebling, MD, MPH, Professor of Urology at the University of Kansas Medical Center, said, “From my perspective, one of the biggest things we learned from these results is that gay men and straight men experience prostate cancer and the effects of prostate cancer in different ways. For gay men the negative impact on their overall health-related quality of life is more severe. It’s more profound.”

Dr. Latini said that since gay men constitute about 3% to 5% of the total male population of the United States, that also means that about 3% to 5% of the 200,000 men diagnosed with prostate cancer are gay and that 3% to 5% of the men living with prostate cancer are gay men.

More data needs to be collected looking at gay men with prostate cancer and the aftermath of their treatment.

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