Breaking the silence on life after prostate cancer

According to the National Cancer Registry, 2023, prostate cancer is the most common cancer affecting South African men. It has a lifetime risk of 1 in 16 and accounts for more than 25% of all male cancers reported. Yet, despite the success of modern treatment, many survivors face challenges such as erectile dysfunction, loss of libido, and changes in orgasm or ejaculation.

“These changes can have a profound effect on confidence, relationships, and overall quality of life,” says Lorraine Govender, Cansa’s national manager: Health Programmes. “It’s vital that men understand these side effects are common, manageable and nothing to be ashamed of. Talking about them is the first step to recovery.”

Historically, men have been less likely to seek help for emotional or sexual challenges after treatment. Cultural and social pressures often discourage open discussion, leaving many feeling isolated or embarrassed. Cansa encourages breaking the silence and normalising the conversation, not only among survivors, but also within relationships, communities and with medical practitioners.

“The stigma around sexual health is one of the biggest barriers to recovery,” adds Govender. “When men hear that others share their experiences, they find a supportive space for healing. Our goal is to make sure that prostate cancer survivors know that these side effects are not a sign of weakness, but a normal part of treatment and recovery.”

Common side effects of treatment may include:

• Difficulty achieving or maintaining an erection
  
• Reduced sexual desire due to hormone changes
  
• Changes in orgasm or ejaculation
  
• Urine leakage during orgasm (known as climacturia)
  
• Emotional or relationship strain caused by anxiety, fatigue or body-image concerns
  
• Support and rehabilitation can make a real difference. Pre- and post-treatment counselling and peer support groups can help survivors regain confidence and improve intimacy.

Why these side effects occur:

• Nerve and tissue damage: surgery or radiation can impact nerves or blood flow essential for erections.
  
• Hormone changes: ADT lowers testosterone which affects libido and energy.
  
• Psychological factors: anxiety, fear of recurrence, and body image concerns can affect sexual desire.
  
• Overall health and fatigue: cancer treatment, comorbidities and lifestyle can lower sexual function.

Cansa encourages men to talk to their doctors early, before treatment begins, to understand what to expect and to discuss options for sexual rehabilitation and fertility preservation.

“Sexual wellness is an important part of life after cancer,” states Govender. “Recovery isn’t only about surviving cancer, but about living fully again, physically, emotionally and intimately. We want men and their partners to know that help exists and that these changes do not define who they are.”

Cansa provides a counselling service dedicated to providing advice to cancer survivors. Make an appointment on the online booking form for Tele or Virtual Counselling or email az.gro.asnac@ofni. Men can also join the Champions of Hope Facebook group for cancer survivors and chat to peers who are facing similar challenges.

“We also recognise the importance of support groups for cancer survivors, caregivers and loved ones, and offer them the opportunity to join a caring community, when they join a Cansa support group,” concludes Govender

Partners play a vital role in the journey toward recovery. Open communication, patience, and shared learning can ease emotional strain and restore closeness. Cansa encourages couples to seek information together and to join support groups where both can benefit from shared experiences.

Through this awareness campaign, Cansa hopes to normalise conversations about sexual health after prostate cancer and encourage men to seek guidance early. The message is clear: you are not alone, and support is within reach.

For information and support, visit www.cansa.org.za or call Cansa’s Help Desk on 0800 22 66 22.