World’s first guidelines on anal sex after prostate cancer

UK doctors and surgeons have formulated what’s thought to be the world’s first clinical guidance on anal sex before, during, and after diagnosis and treatment for prostate cancer.

The recommendations, which are aimed at clinicians as well as gay and bisexual men with prostate cancer, recommend that they should abstain from receiving anal sex for a period of time before, during, and after certain tests and cancer treatments.

The guidelines were deemed necessary because doctors rarely ask their patients about their sexuality or sex life, thereby ignoring the unique needs and risks faced by gay and bisexual men.

“Men are normally advised to resume sexual activity soon after prostate cancer treatments in order to help preserve their erectile function,” said Guideline coordinator Sean Ralph of the Clatterbridge Cancer Centre, Wirral.

“However, the increased likelihood of participating in anal sex means that some groups of patients—gay and bisexual men in particular—have different risks, such as the possibility of anal sex causing physical damage after a prostate operation or radiotherapy.”

Ralph continued: “We found that most oncologists and surgeons don’t ask patients about their sexual orientation or sexual practices, which means some men won’t get the appropriate advice and support they need to continue having a safe and fulfilling sex life.”

The recommendations also warn of possible risks to sexual partners from exposure to radiation.

According to the guidelines, men being tested or treated for prostate cancer should leave the following time gaps from receiving anal sex to avoid internal injuries, incorrect test results or damage to their partner:

  • One week before a prostate-specific antigen (PSA) blood test
  • One week after a biopsy using a needle through the perineum (between the scrotum and anus)
  • Two weeks after a biopsy using a needle through the rectum
  • Six weeks after surgery to remove the prostate (radical prostatectomy)
  • Two months after external beam radiotherapy
  • Six months after permanent seed brachytherapy

The guidance is based on the consensus opinion of 15 clinical oncologists and 11 urological surgeons, recruited with help from The Royal College of Radiologists, The British Association of Urological Surgeons, the British Uro-oncology Group, Prostate Cancer UK and the Gay and Lesbian Association of Doctors and Dentists.

“This will not just benefit patient care in the UK, but as the first guidance of its kind in the world, it will inevitably have an impact across the cancer community globally,” commented UKIO Vice-President Dr John Burton of the Edinburgh Cancer Centre. “More generally, this work is about not making assumptions but instead listening to the patient and providing them with advice appropriate to their situation; this is something we need to remember with every patient.”

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