DEAR DR. ROACH: After blood analysis revealed elevated PSA levels, a urologist felt a lump on my prostate and arranged a biopsy. Of 12 samples taken, three were cancerous. The doctor recommends removal instead of radiation or any other therapy. I asked which type of cancer it is, and he replied that it is just cancer and wont spread in a month or two but I should not wait too long to have the surgery.
I am concerned about negative physical consequences, but realize whatever they are it wont be as bad as the cancer growing and spreading. At 61 I am not wanting to give up the prospect of being a father. I understand that there will be no ejaculate and freezing sperm is expensive. Is it possible to extract sperm from the testicle, and will my sex drive be diminished? R.T.
ANSWER: If you are going to get surgery (and I have no information to recommend against it), I agree you shouldnt wait too long. But let me answer your question about fertility.
Although the testes, which make sperm, are not usually removed in prostate cancer surgery, the loss of the prostate gland and the nearby seminal vesicles (which make most of the volume of semen) prevents sperm from being ejaculated during sexual intercourse, so fertility is usually impaired. Therefore, banking sperm prior to treatment is probably the best option. Sperm can be extracted from the testes, but the success rate is less than 50 percent. This is also a very expensive procedure, so your odds for fertility are better and you will probably have lower costs if you choose to have a child with the frozen storage method.
The LIVESTRONG Foundation has a discount program for freezing sperm, oocytes and embryos for people with cancer. You can find out more at www.livestrong.org/what-we-do/program/fertility or call 855-844-7777.
