what are the odds that my sperm are still viable?

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F8
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Date Joined Feb 2010
Total Posts : 3834
   Posted 3/1/2011 12:14 PM (GMT -6)   
after the treatment that i've been through (lupron, BT & IGRT) what are the chances that my sperm are still viable?  my doctors never really gave me a straight answer but he did say that we should be practicing birth control when sexual activity resumes.  anyhow my wife doesn't want me to get a vasectomy after all the trauma to the region and she's scheduled to have her tubes tied later this month.
 
thanx,
 
ed
age: 55
PSA on 12/09: 6.8
gleason 3+4 = 7
HT, BT and IGRT
received 3rd and last lupron shot 9/14/10
2/8/11 PSA <.1, T= 6 ng/dl

Tony Crispino
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Date Joined Dec 2006
Total Posts : 8128
   Posted 3/1/2011 12:30 PM (GMT -6)   
Hi Ed,
I've been doing this for over 4 years and I have no clue what is the appropriate answer. But it may be in the doctors response to use birth control. I have heard it takes time for the full effects of radiation and I did have IMRT myself but that was after the prostate was dissected. So no need to worry about it for me. But radiation and sperm does not sound like a good thing if a pregnancy were to happen.

I will say that I have not heard of such a case, but it certainly sounds logically possible. I will be watching this thread for actual occurrences...

Tony
Advanced Prostate Cancer at age 44 (I am 48 now)
pT3b,N0,Mx (original PSA was 19.8) EPE, PM, SVI. Gleason 4+3=7

Treatments:
Da Vinci Surgery ~ 2/16/2007
Adjuvant Radiation Therapy ~ IMRT Completed 8/07
Adjuvant Hormone Therapy ~ 28 months on Casodex and Lupron.
Undetectable PSA.

Blog: www.caringbridge.org/visit/tonycrispino

Post Edited (TC-LasVegas) : 3/1/2011 10:35:26 AM (GMT-7)


Fairwind
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Date Joined Jul 2010
Total Posts : 3781
   Posted 3/1/2011 12:31 PM (GMT -6)   
Tubes tied?? An IUD worked well for my wife for many years...

ED wise, have you recovered from the effects of the Lupron??
Age 68.
PSA age 55: 3.5, DRE normal.
age 58: 4.5
61: 5.2
64: 7.5, DRE "Abnormal"
65: 8.5, " normal", biopsy, 12 core, negative...
66 9.0 "normal", 2ed biopsy, negative, BPH, Proscar
67 4.5 DRE "normal"
68 7.0 3rd biopsy positive, 4 out of 12, G-6,7, 9
RALP Sept 3 2010, pos margin, one pos vesicle nodes neg. Post Op PSA 0.9 SRT, HT. 2-15-'11 PSA 0.0

F8
Veteran Member


Date Joined Feb 2010
Total Posts : 3834
   Posted 3/1/2011 12:45 PM (GMT -6)   
Fairwind -- tubes tied is my wife's idea.  her friend who's also never gave birth before was not able to  have an IUD inserted so my wife wants to just get it done.  i don't feel great about it but i'm not in a bargaining posture on this one .
 
as far as side effects hot flashes are more intense than ever.  when i stand up i feel like an old man but it's like i got old in a year.  mentally i feel less mushy tho.  it's defintely a process and you do get your money's worth with lupron cool .
 
ed
age: 55
PSA on 12/09: 6.8
gleason 3+4 = 7
HT, BT and IGRT
received 3rd and last lupron shot 9/14/10
2/8/11 PSA <.1, T= 6 ng/dl

Casey59
Veteran Member


Date Joined Sep 2009
Total Posts : 3172
   Posted 3/1/2011 1:27 PM (GMT -6)   
Ed,

Sorry, I have no idea how to answer your question, but I thought I would contibute a vaguely similar anecdote of my own...

When we were dating in college (where we met), my (eventual) wife started on the pill after I used a condom several times. Several years after our 2nd child was born, I had a vasectomy. In the year before our 25th anniversary, I had my prostatectomy (and therefore, no more ejaculate coming out). My wife is now on chemo, and at her first treatment a chemo nurse gave her the whole run-down on what to do/not to do, etc. One instruction was for me to use a condom during intercourse to avoid possible transmission/absorption of the chemo during intimate contact down below. She said it hadn't been studied, but they want to err on the safe side. So, even though I'm "shooting blanks", I'm now using condoms again.

One of life's ironies...

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 3/1/2011 2:38 PM (GMT -6)   
Ed, I am not familiar with the source, so not vouching for it, but looks like it answers your question:

http://www.malecare.com/new_page_8.htm
Age: 58, 56 dx, PSA: 7/07 5.8, 10/08 16.3
3rd Biopsy: 9/08 7 of 7 Positive, 40-90%, Gleason 4+3
open RP: 11/08, on catheters for 101 days
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos marg
Incont & ED: None
Post Surgery PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, 8/6 .06 11/10 Not taking it
Latest: 6 Corr Surgeries to Bladder Neck, SP Catheter since 10/1/9, SRT 39 Sess/72 gy ended 11/09, 21 Catheters, Ileal Conduit Surgery 9/23/10

Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 3/1/2011 2:43 PM (GMT -6)   
David,
Malecare is a great resource. They are a great advocacy group as well.

However,
Sperm Banking is not relevant to F8's question. He is asking if he is still potent even after seeds and EBRT and there is that possibility. I am fairly certain he is not trying to add a(nother) little F8 but just wondering if he still needs to use prophylactics.

And that is a good question...

Tony
Advanced Prostate Cancer at age 44 (I am 48 now)
pT3b,N0,Mx (original PSA was 19.8) EPE, PM, SVI. Gleason 4+3=7

Treatments:
Da Vinci Surgery ~ 2/16/2007
Adjuvant Radiation Therapy ~ IMRT Completed 8/07
Adjuvant Hormone Therapy ~ 28 months on Casodex and Lupron.
Undetectable PSA.

Blog: www.caringbridge.org/visit/tonycrispino

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 3/1/2011 2:47 PM (GMT -6)   
Tony, the article talks about the infertility issues in general with radiation, aside from the topic of sperm banking. I knew that part of it didnt relate to him about the sperm banking.
 

How cancer treatment affects sperm production

Radical Prostatectomy, External Radiation, Brachytherapy and Cryosurgery all will destroy some or all of the prostate. It will be virtually impossible for a prostate cancer patient to ejaculate sperm after any of these treatments.

For testicular and male breast cancer patients, chemotherapy may be a more critical problem. The testicles are the organs in a man's body that produce both testosterone (the male hormone) and sperm. Chemotherapy may not affect the production of testosterone, but studies have shown that chemotherapy can damage sperm production. There is a high probability that a man will experience at least some period of infertility following chemotherapy treatment; for this reason alone, men are encouraged to consider sperm banking before any treatment for cancer is started.

Some types of cancer treatments can harm a man's fertility, either temporarily or permanently. Many chemotherapy drugs will damage a man's ability to produce sperm. Chemotherapy typically kills all sperm forming cells resulting in a condition known as azoospermia - meaning no sperm are present in the ejaculate. There are different estimates as to if or when a man's sperm count will return to near normal levels following chemotherapy. In some situations, sperm production never returns. In other cases, sperm formation will begin again within about 1 to 4 years following treatment. However, there are situations where sperm counts will remain low as long as five years after treatment has stopped. Depending on the types of anti-cancer drugs given, the dose received and the individual's own unique recovery, fertility potential may return, or the man may produce only a few sperm which may not be enough to get a partner pregnant without medical assistance.

Permanent sterility is especially common in men who are given high doses of chemotherapy before a bone-marrow or stem-cell transplant. When radiation therapy is aimed at or near a man's testicles, it may also damage sperm production. Concern also exists about the potential for birth defects in the children of men receiving radiation treatment. Whole-body irradiation, used before transplants, can also cause infertility. After radiation therapy, a man may recover his fertility, depending on the dose of radiation received by his testicles. Radiation therapy can potentially damage sperm production and it may be necessary to wait 6 to 12 months or more before attempting to conceive. With some cancer surgeries, some men may have parts of their reproductive system, such as the prostate or a testicle removed, or experience damage to the nerves important for normal ejaculation. The potential complication of some surgeries, such as retroperitoneal lymph node dissection for testis cancer, is ejaculatory problems whereby the semen no longer comes out of the penis during ejaculation; instead it goes backward into the bladder, and is eliminated through urination or does not come out at all

Post Edited (Purgatory) : 3/1/2011 12:52:28 PM (GMT-7)


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 3/1/2011 2:57 PM (GMT -6)   
Thanks for posting the article. That isn't what came up when I went to the link.

Of course reading the article leaves open the possibility that it IS possible that a man can ejaculate sperm after therapy.

Interesting article.

Tony
Advanced Prostate Cancer at age 44 (I am 48 now)
pT3b,N0,Mx (original PSA was 19.8) EPE, PM, SVI. Gleason 4+3=7

Treatments:
Da Vinci Surgery ~ 2/16/2007
Adjuvant Radiation Therapy ~ IMRT Completed 8/07
Adjuvant Hormone Therapy ~ 28 months on Casodex and Lupron.
Undetectable PSA.

Blog: www.caringbridge.org/visit/tonycrispino

Trepidation
Regular Member


Date Joined Feb 2011
Total Posts : 173
   Posted 3/1/2011 5:35 PM (GMT -6)   
Can a man with PC transfer any form of cancer to his wife through his sperm? I have read that PC and breast cancer are similar. Thanks

JNF
Veteran Member


Date Joined Dec 2010
Total Posts : 3794
   Posted 3/2/2011 3:58 PM (GMT -6)   
I just read several repoprts that human cancer is not contagious and that PCa can not be spread to a partner. Men can get (rarely) breast cancer as they do have breasts, However, women can not get PCa as they do not have a prostate. A women's hormonal make up would be a poor environment for PCa as it needs testosterone. If any PCa cells were in the ejaculate, they could not live in the woman or another man for that matter due to the DNA differences. The immune system would recognize the foreign DNA and attack it.

Trepidation
Regular Member


Date Joined Feb 2011
Total Posts : 173
   Posted 3/2/2011 5:39 PM (GMT -6)   
Thanks. Again, I read that PC and BC are very similar.

Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 3/2/2011 8:57 PM (GMT -6)   
Trepidation,
PC and BC can be glandular in nature (adenocarcinoma). And for that reason they react similarly to the same therapies. There has even been a genetic tie to the BRCA2 gene's. But the similarities stop there. Many breast cancers can also be Squamish cell sarcoma's which do not react at all like prostate cancers do.

Tony
Advanced Prostate Cancer at age 44 (I am 48 now)
pT3b,N0,Mx (original PSA was 19.8) EPE, PM, SVI. Gleason 4+3=7

Treatments:
Da Vinci Surgery ~ 2/16/2007
Adjuvant Radiation Therapy ~ IMRT Completed 8/07
Adjuvant Hormone Therapy ~ 28 months on Casodex and Lupron.
Undetectable PSA.

Blog: www.caringbridge.org/visit/tonycrispino

NEIrish
Regular Member


Date Joined Aug 2010
Total Posts : 245
   Posted 3/3/2011 12:32 AM (GMT -6)   
If you definitely do not want another child, and you can ejaculate one healthy little swimmer after your treatments, and your wife is young enough to conceive, then the answer is obvious.  If you kinda like the idea of another child and want to take the chance, the question - well, it's not really a question anymore.  Hope you get what you want...

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 3/3/2011 1:28 AM (GMT -6)   
I went to high school with a girl, who's father died of breast cancer when he was 42 years old. In all the years since, I have never known of another case like that. I can only assume its very rare in males.

David
Age: 58, 56 dx, PSA: 7/07 5.8, 10/08 16.3
3rd Biopsy: 9/08 7 of 7 Positive, 40-90%, Gleason 4+3
open RP: 11/08, on catheters for 101 days
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos marg
Incont & ED: None
Post Surgery PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, 8/6 .06 11/10 Not taking it
Latest: 6 Corr Surgeries to Bladder Neck, SP Catheter since 10/1/9, SRT 39 Sess/72 gy ended 11/09, 21 Catheters, Ileal Conduit Surgery 9/23/10

F8
Veteran Member


Date Joined Feb 2010
Total Posts : 3834
   Posted 3/3/2011 1:37 AM (GMT -6)   
>>>If you definitely do not want another child, and you can ejaculate one healthy little swimmer after your treatments, and your wife is young enough to conceive, then the answer is obvious.  If you kinda like the idea of another child and want to take the chance, the question - well, it's not really a question anymore.  Hope you get what you want...<<<
 
we don't have any children and we don't want any.  the question is really academic because my wife is already scheduled for tubal ligation in three weeks.  one reason i've asked the question is because no one really seems to know the odds of still having viable sperm after two different radiation treatments.  we want permanent birth control and vasectomy has been ruled out by my wife.
 
ed
 
 
age: 55
PSA on 12/09: 6.8
gleason 3+4 = 7
HT, BT and IGRT
received 3rd and last lupron shot 9/14/10
2/8/11 PSA <.1, T= 6 ng/dl

F8
Veteran Member


Date Joined Feb 2010
Total Posts : 3834
   Posted 3/3/2011 1:41 AM (GMT -6)   
David -- richard roundtree (shaft) had breast cancer.  i have a male friend who may have breast cancer.  he's already been on tamoxifen and had two precancerous lumps removed from his breat and now has three more lumps.
 
ed
 
 
age: 55
PSA on 12/09: 6.8
gleason 3+4 = 7
HT, BT and IGRT
received 3rd and last lupron shot 9/14/10
2/8/11 PSA <.1, T= 6 ng/dl

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 3/3/2011 1:55 AM (GMT -6)   
ed, yeah, i remember the man from the original shaft movie, didn't know that.

unless its too personal to ask, if you don't have children and you don't want children (and that's cool), why would you wife
be against a vasectomy?

david
Age: 58, 56 dx, PSA: 7/07 5.8, 10/08 16.3
3rd Biopsy: 9/08 7 of 7 Positive, 40-90%, Gleason 4+3
open RP: 11/08, on catheters for 101 days
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos marg
Incont & ED: None
Post Surgery PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, 8/6 .06 11/10 Not taking it
Latest: 6 Corr Surgeries to Bladder Neck, SP Catheter since 10/1/9, SRT 39 Sess/72 gy ended 11/09, 21 Catheters, Ileal Conduit Surgery 9/23/10

F8
Veteran Member


Date Joined Feb 2010
Total Posts : 3834
   Posted 3/3/2011 2:24 AM (GMT -6)   
David -- first off my wife is a biologist.  she doesn't think it wise that they cut into my irradiated scrotum.  hey she's looking out for her man cool .
 
ed
 
 
age: 55
PSA on 12/09: 6.8
gleason 3+4 = 7
HT, BT and IGRT
received 3rd and last lupron shot 9/14/10
2/8/11 PSA <.1, T= 6 ng/dl

English Alf
Veteran Member


Date Joined Oct 2009
Total Posts : 2216
   Posted 3/3/2011 2:33 AM (GMT -6)   
ed,
If you can ejaculate then you can produce viable sperm.
As for radiaiton. Radiation affects sperm and eggs in different ways.
A woman is born with all her eggs, thus if her ovaries are subject to any radiation all her eggs will be affected.
New sperm however get made all the time, so only those sperm that were made during RT will have suffered any sort of damage.

The main factor here is clearly the damage RT causes to the prostate itself. RT will damage most of the prostate and affect it's ability to produce semen, ie the liquid part of the ejaculate. Damage may also result in the semen being ejaculated in the wrong direction at orgasm (ie into the bladder).
However, there is clearly still a strong likelihood that there will be some viable sperm all over the place in assorted pipes etc and thus still able to find its way out of the end of the penis, and it only takes one little fellow to end up with an egg to bring about conception, so I think contraception for those not wanting children is a must.
What form of contraception you choose is up to you. If you and your wife want to opt for tube tying rather than a vasectomy, then that is fine.

Also note that all those of us who have had surgery to completely remove the prostate are still making sperm, we are not however still fertile as the sperm simply can't get anywhere as the pipes have been severed or removed. (So they just get reabsorbed by the body) There are however special surical techniques to harvest sperm from a testicle so that pregnancy can be brought about using IVF.


Alf
Born Jun ‘60
Apr 09 PSA 8.6
DRE neg
Biop 2 of 12 pos
Gleason 3+3
29 Jul 09 DaVinci AVL-NKI Amsterdam
6 Aug 09 Cath out
PostOp Gleason 3+4 Bladder neck & Left SVI -T3b
No perin’l No vasc invasion Clear margins
Dry at night
21 Sep 09 No pads daytime
17 Nov 09 PSA 0.1
17 Mar 10 PSA 0.4 sent to RT
13 Apr CT
66Gy 28 Apr to 11 Jun 10
Tired + weird BMs
14 Sep 10 PSA <0.1
12 Jan 11 PSA <0.1
Erection OK

F8
Veteran Member


Date Joined Feb 2010
Total Posts : 3834
   Posted 3/3/2011 2:43 AM (GMT -6)   
Alf -- i haven't had an orgasm in more than a year so i don't know what to expect.  actually i'd be pretty amazed that a prostrate gland that has been carpet bombed by BT and IGRT could still produce semen. 
 
ed
 
 
age: 55
PSA on 12/09: 6.8
gleason 3+4 = 7
HT, BT and IGRT
received 3rd and last lupron shot 9/14/10
2/8/11 PSA <.1, T= 6 ng/dl

English Alf
Veteran Member


Date Joined Oct 2009
Total Posts : 2216
   Posted 3/3/2011 7:04 AM (GMT -6)   
I understand that when seeds were first used they were often "loose" and not joined together in chains and some patients were told to use condoms in case one of the seeds worked itself free and passed through the system during an ejaculation.

A quick google found this article:
www.oncolink.org/experts/article.cfm?c=3&s=26&ss=74&id=2264
from which I'll quote this:

"With regards to "seeds" used for prostate cancer, the guidelines are slightly different at every institution, but here are the basics. The implanted seeds are radioactive, giving off low energy x-rays. They are designed so that the amount of radiation is just enough to treat the prostate tissue. The patient is not radioactive, and nothing he touches will become radioactive. Also his urine, stool, and semen are not radioactive. It is recommend that these men wear a condom when having sex for at least the first 2 weeks because of the potential risk of a seed being expelled (this risk is very low)."

It also suggests that they expect people to ejaculate after seeds, but I know that adding IGRT into the equation can do more damage.

Alf

An38
Veteran Member


Date Joined Mar 2010
Total Posts : 1149
   Posted 3/3/2011 7:53 AM (GMT -6)   
Purgatory said...
I went to high school with a girl, who's father died of breast cancer when he was 42 years old. In all the years since, I have never known of another case like that. I can only assume its very rare in males.

A male friend of mine had breast cancer at age 37, three years ago. He had surgery, chemo and now has a six month old baby. His nipple started loooking strange and leaking and that's what alerted him to go to the doctor.

It does happen.

An

Sancarlos
Regular Member


Date Joined Feb 2010
Total Posts : 242
   Posted 3/3/2011 11:30 AM (GMT -6)   
F8 said...
Alf -- i haven't had an orgasm in more than a year so i don't know what to expect. actually i'd be pretty amazed that a prostrate gland that has been carpet bombed by BT and IGRT could still produce semen.


ed


If your entire prostate gland was radiated I believe it would be something of a miracle if you could have an ejaculation and produce viable sperm after BT and IGRT. I asked my oncologist what a prostate looked like after BT and IMRT and he replied, like a dried up prune.

So frankly I think the last thing you and your wife need to worry about is birth control.

Sancarlos
Age 66, PC diagnosed 7/2009 at age 65
Stage: T2c, Gleason: 9 (4 + 5), 6 of 6 cores positive
Bone, CAT and MIR scans negative

Treatment: brachytherapy (103 palladium), 100 gy, 11/2009 + IMRT on Novalis, 45 gy, 3/2010 + ADT3 (Lupron + Casodex+Avodart)

PSA: 7/2009, At time of diagnosis -- 11.9
10/2009 -- 5.0 ; 12/2009 -- 0.56 ; 5/2010 -- 0.15
8/9/2010 -- 0.06 ; 11/2010 -- 0.013; 3/25/2011-- 0.005

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 3/3/2011 11:37 AM (GMT -6)   
sancarolos - i dont think i could ever eat a prune again after that, lol, the dr said that was probaby what my radiation destroyed bladder would like like now that it has been bypassed for 5 months

ed - biologist, that's cool too. makes sense. as a nurse, my wife oversees all my tests and procedures too.
Age: 58, 56 dx, PSA: 7/07 5.8, 10/08 16.3
3rd Biopsy: 9/08 7 of 7 Positive, 40-90%, Gleason 4+3
open RP: 11/08, on catheters for 101 days
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos marg
Incont & ED: None
Post Surgery PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, 8/6 .06 11/10 Not taking it
Latest: 6 Corr Surgeries to Bladder Neck, SP Catheter since 10/1/9, SRT 39 Sess/72 gy ended 11/09, 21 Catheters, Ileal Conduit Surgery 9/23/10
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