At a cancer follow-up, it can feel awkward to bring up erections or sex. It belongs on the list. If you only manage one sentence, try “Intimacy has changed since treatment. Who can help me work through it?”
Say what has changed
“I’m interested, but erections are harder to get or keep” gives your team a different starting point from “I rarely feel interested these days.” If orgasm feels different, or worries about urine leakage make you hesitant, those details matter too. The NHS lists erection, orgasm and urinary changes among possible effects of prostate surgery. NHS prostate cancer treatment guide
Before the appointment, jot down when the change started, which treatment you received and what you most want help with. You can hand over the note if it feels easier than saying everything aloud.
What the long follow-up tells us
In the UK ProtecT trial, 1,643 men with localised prostate cancer were randomly assigned to active monitoring, surgery or radiotherapy with hormone treatment. At seven years, 18% of the group assigned to surgery reported erections sufficient for intercourse, compared with 30% assigned to monitoring and 27% assigned to radiotherapy. By year 12, all three groups reported low rates on that measure. These are group results from specific treatment approaches. Some men changed management over time, and the measure captures one aspect of sexual function. Your own treatment and priorities belong in the conversation. Donovan et al., NEJM Evidence, 2023
Ask for a next step
Ask your specialist nurse or cancer team what support is available and whether a referral to an erectile function clinic or sexual wellbeing service fits your situation. If you want your partner involved, ask if they can come along. St George’s NHS guidance on erection difficulties after cancer treatment
At home, you can start smaller. “I’d like to be close. Can we keep it easy tonight?” leaves room for both people to say what feels comfortable. The appointment and the evening can each go at their own pace.
Research notes
The ProtecT follow-up was funded by the UK NIHR Health Technology Assessment Programme. The radiotherapy and surgery studied reflect the regimens used in that trial. The study record was fetched through Consensus. Individual author disclosures were not independently verified.
General information for adults. Prepared with AI assistance and checked against the linked sources. For advice about your care, speak with your healthcare team.