What types of sexual side effects do you discuss with men undergoing radiation therapy for rectal and/or anal cancer?

This is an excellent question as the literature is pretty clear sexual side effects of non-gynecologic or prostate cancer therapy are often omitted from discussion before therapy or in follow-up. Consequently, there is limited data on sexual dysfunction for rectal or anal cancer survivors.

The studies that have been published are small, but fit with clinical experience which is that sexual dysfunction is very high (one study stated ED was present in 80% after rectal surgery). ED is not the only ...

It is true that it is difficult to have an evidence based discussion about the risk of impotence with an anal cancer patient who is receiving low doses of radiation. Is a multifactorial problem and comorbidities are probably the dominant factors in most cases. Testosterone levels can drop with age but can also be affected by radiation doses in the 20Gy range. This problem probably goes underappreciated and undertreated. Erectile dysfunction (ED) can also be affected by testosterone levels, but, ...