After prostate cancer, oral may be better than anal for several weeks

Simon Blish

Men treated for prostate cancer should put off anal sex for a number of weeks depending on what treatment or testing they’ve had, new guidance says.

While sex is encouraged after prostate cancer to maintain erectile function, anal sex at the wrong time can lead to complications for you and your partner.

‘This important and much-needed research has addressed an important gap in our ability to support gay and bisexual men,’ says Catherine Winsor, from Prostate Cancer UK.

‘We’ve used this to update our written patient information for this group to include these more specific timeframes on when they should abstain.

‘We hope that health professionals will use these findings to provide more consistent, evidence-based guidance.’

‘Men are normally advised to resume [oral and vaginal] sexual activity soon after prostate cancer treatments in order to help preserve their erectile function,’ says Sean Ralph from Clatterbridge Cancer Centre. But he adds that the discussion around anal sex is often ‘glossed over’.

‘This guidance will be invaluable to clinicians and people receiving treatment for prostate cancer,’ says vice president of oncology Dr John Burton, from Edinburgh Cancer Centre.

‘It is long overdue, and addresses an inequality in the level of information available to patients.’

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26 specialists developed the guidance in response to frequent questions asked of specialist nurses and clinicians – although experts think that, despite this being a common question, not enough men are comfortable asking for advice. The guidance was launched at the UK Imaging and Oncology congress in Liverpool to combat that need.

How long should men abstain from receiving anal sex?

  • Before a PSA blood test, you should wait at least one week, to avoid an inaccurate result
  • Following a transrectal biopsy (TRUS), you should wait at least two weeks to avoid bleeding, pain or increased risk of infection
  • Following a transperineal biopsy, you should wait one week to allow bruising to settle, and reduce painful intercourse
  • Following a radical prostatectomy, the wait is at least six weeks to avoid bleeding, pain, or increasing the risk of urinary incontinence
  • After external beam radiotherapy, you need to wait two months. Anal sex within this time frame could make acute side effects worse, be painful, or result in long-term complications such as rectal bleeding
  • After permanent seed brachytherapy, where radioactive seeds are inserted into the prostate to kill cancer, anal sex needs to be delayed for six months – to minimise radiation exposure to your partner.

Read the guidance in full online.

For general advice on prostate cancer, visit Prostate Cancer UK.

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