Fertility and Prostate Cancer

Prostate cancer affects a key gland in your body’s sexual and reproductive function. Worrying about how your fertility is affected by prostate cancer and its treatments is a common concern. If you wish to keep the option for having kids in the future open — rest assured that the effect prostate cancer and its treatments have on fertility has been studied in depth in recent years.

Before assigning you to treatments, your doctor should be able to advise you on the risks of each treatment, as well as what precautions you may need to take with regards to your sex life before and after treatment.

Currently, fertility preservation is emphasized as an important touchpoint upon any cancer diagnosis. The simplest method available would be to rely on a sperm bank, and have your sperm collected and frozen in storage to be kept safe in case you plan to conceive a child in the future.

Your prostate cancer may disrupt your hormone systems which regulate your reproductive health, and eventually threaten your fertility. Inflammation and immunity can also affect your sperm production, while the stress known to accompany a cancer diagnosis and treatment, may also influence your fertility.

When it comes to treatments, many chemotherapies are toxic to sperm at high levels and damage sperm-forming stem cells, especially as they tend to divide fast. Radiotherapy aimed at the pelvic area can also kill sperm cells. Generally, your fertility will only be affected permanently if sperm-forming stem cells are damaged, and can no longer produce mature sperm cells.

A less detrimental treatment you could consider would be low dose-rate brachytherapy, which limits the levels of radiation delivered to your prostate, by delivering much smaller doses over time. This would allow a higher chance of fertility recovery after your treatment.

A common strategy to treat prostate cancer is androgen deprivation therapy. If you undertake the surgical method — the removal of both testicles to stop testosterone production (otherwise known as bilateral orchiectomy), you will no longer be able to father children. Drug-mediated androgen deprivation therapy may also reduce sperm counts as well as lead to a lower sex drive or issues with maintaining erections. However, there is a chance of recovery after completion of the treatment.

In the case of early prostate cancer, radical prostatectomy is commonly recommended. This surgery will stop your semen production, and while you will still be able to enjoy the sensation of orgasm, you will not be able to ejaculate sperm after surgery. As such, even though your testicles may still be able to produce sperm, you will not be able to conceive a child naturally.

If protecting your fertility is a big concern for you, a referral to a reproductive specialist may best help you understand the current options available to you. Your doctors will then be able to advise you on potential solutions and treatment options, before treating your cancer.