The first clinical guidance on having anal sex after prostate cancer has been released by UK Imaging and Oncology Congress (UKIO).

The guidance is particularly relevant to men who have sex with men, and found that most clinicians do not ask about sexual orientation when treating prostate cancer patients. It was put together by Sean Ralph, a therapeutic radiographer and co-founder of Out with Prostate Cancer, the UK’s first prostate cancer support group for gay and bisexual men.

Ralph said: “Men are normally advised to resume sexual activity soon after prostate cancer treatments in order to help preserve their erectile function.

“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.”

A panel of UK doctors and surgeons gave advice on safely receiving anal sex before, during and after prostate cancer tests and treatments.

The panel recommended that men refrain from receiving anal sex one week before a prostate-specific antigen (PSA) blood test, which is used to detect prostate cancer, as it may lead to an inaccurate result.

Biopsies are another way that doctors can diagnose prostate cancer, and recommendations were made on how long men should wait afterwards.

After having a transrectal biopsy (TRUS) men should wait two weeks as anal sex may cause bleeding, pain or increase the risk of infection, and after a transperineal biopsy they should wait one week to avoid painful intercourse and reduce bruising.

If diagnosed with prostate cancer, the prostate may have to be surgically removed, in which case men should wait six weeks before receiving anal sex to avoid bleeding, pain and increased risk of urinary incontinence.

Men should also avoid anal sex during external beam radiotherapy, and for two months afterwards, as it could make acute side effects worse, be painful, or result in long term complications such as rectal bleeding.

In some cases, giving anal sex to a man having treatment for prostate cancer could also put someone at risk.

After permanent seed brachytherapy, where radioactive seeds are inserted into the prostate to kill the cancer, it was agreed that men should abstain from receiving anal sex for six months, in order to minimise radiation exposure to sexual partners.

black-black-and-white-black-and-white-1149363.jpg?resize=430%2C248&ssl=1The panel found that most clinicians do not ask about sexual orientation when treating prostate cancer patients. (Pexels)

Ralph said: “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.” 

Only three out of the 26 panel members (12 percent) always ask prostate cancer patients about their sexual orientation, and only two of the 26 (8 percent) always ask about anal sex if they are aware that their patient is gay or bisexual.

Dr John Burton, UKIO vice president, said: “This guidance will be invaluable to clinicians and people receiving treatment for prostate cancer. It is long overdue, and addresses an inequality in the level of information available to patients.

“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.”


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