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From the Townsend Letter
August/September 2015

Let's Talk About Sex: the Effects of Prostate Cancer on Sex, Men, and Their Relationships
by Daniel Lander, ND, FABNO
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1.      Bober SL and Varela VS. Sexuality in adult cancer survivors: challenges and intervention. J Clin Oncol. 2012;30(30):3712–3719.
2.      Soloway CT et al. Sexual, psychological and dyadic qualities of the prostate cancer "couple." BJU Int. 2005;95(6):780–785.
3.      Montorsi F, McCullough A.J. Efficacy of sildenafil citrate in men with erectile dysfunction following radical prostatectomy: a systematic review of clinical data. Sex Med. 2005;2(5):658–667.
4.      Thomas RJ et al. Lifestyle factors correlate with the risk of late pelvic symptoms after prostatic radiotherapy. Clin Oncol (R Coll Radiol). 2013;25(4):246–251.
5.      Cormie P et al. Exercise maintains sexual activity in men undergoing androgen suppression for prostate cancer: a randomized controlled trial. Prostate Cancer Prostatic Dis. 2013;16(2):170–175.
6.      Tsai MY et al. Overview of the relevant literature on the possible role of acupuncture in treating male sexual dysfunction. Acupunct Med. 2014;32(5):406–410.
7.      Chen J et al. Effect of oral administration of high-dose nitric oxide donor L-arginine in men with organic erectile dysfunction: results of a double-blind, randomized, placebo-controlled study. BJU Int. 1999;83(3):269–273.
8.      Cormio L et al. Oral L-citrulline supplementation improves erection hardness in men with mild erectile dysfunction. Urology. 2011 Jan;77(1):119–122.
9.      Aoki H et al. Clinical assessment of a supplement of Pycnogenol® and L-arginine in Japanese patients with mild to moderate erectile dysfunction. Phytother Res. 2012;26(2):204–207.
10.    Ledda A et al. Investigation of a complex plant extract for mild to moderate erectile dysfunction in a randomized, double-blind, placebo-controlled, parallel-arm study. BJU Int. 2010;106(7):1030–1033.
11.    Stanislavov R et al. Improvement of erectile function with Prelox: a randomized, double-blind, placebo-controlled, crossover trial. Int J Impot Res. 2008;20(2):173–180.
12.    Stanislavov R, Nikolova V. Treatment of erectile dysfunction with pycnogenol and L-arginine. J Sex Marital Ther. 2003;29(3):207–213.
13.    Neuzillet Y et al.A randomized, double-blind, crossover, placebo-controlled comparative clinical trial of arginine aspartate plus adenosine monophosphate for the intermittent treatment of male erectile dysfunction. Andrology. 2013;1(2):223–228.
14.    Medeiros JL Jr et al. Protective effects of nutritional supplementation with arginine and glutamine on the penis of rats submitted to pelvic radiation. Andrology. 2014;2(6):943–950.
15.    Cavallini G et al. Acetyl-L-carnitine plus propionyl-L-carnitine improve efficacy of sildenafil in treatment of erectile dysfunction after bilateral nerve-sparing radical retropubic prostatectomy. Urology. 2005;66(5):1080–1085.
16.    Jang DJ et al. Red ginseng for treating erectile dysfunction: a systematic review. Br J Clin Pharmacol. 2008;66(4):444–450.
17.    Ernst E, Pittler MH. Yohimbine for erectile dysfunction: a systematic review and meta-analysis of randomized clinical trials. J Urol. 1998;159(2):433–436.
18.    Shin BC et al. Maca (L. meyenii) for improving sexual function: a systematic review. BMC Complement Altern Med. 2010;10:44.
19.    Gonzales GF et al. Effect of Lepidium meyenii (MACA) on sexual desire and its absent relationship with serum testosterone levels in adult healthy men. Andrologia. 2002;34(6):367–372.
20.    Safarinejad MR et al. An open label, randomized, fixed-dose, crossover study comparing efficacy and safety of sildenafil citrate and saffron (Crocus sativus Linn.) for treating erectile dysfunction in men naïve to treatment. Int J Impot Res. 2010;22(4):240–250.
21.    Modabbernia A et al. Effect of saffron on fluoxetine-induced sexual impairment in men: randomized double-blind placebo-controlled trial. Psychopharmacology (Berl). 2012;223(4):381–388.
22.    Santos CA Jr et al. Tribulus terrestris versus placebo in the treatment of erectile dysfunction: A prospective, randomized, double blind study. Actas Urol Esp. 2014;38(4):244–248.
23.    Sansalone S et al. Alga Ecklonia bicyclis, Tribulus terrestris, and glucosamine oligosaccharide improve erectile function, sexual quality of life, and ejaculation function in patients with moderate mild-moderate erectile dysfunction: a prospective, randomized, placebo-controlled, single-blinded study. Biomed Res Int. 2014;2014:121396.
24.    Iacono F et al. Sexual asthenia: Tradamixina versus Tadalafil 5 mg daily. BMC Surg. 2012;12 Suppl 1:S23.
25.    Kang BJ et al. A placebo-controlled, double-blind trial of Ginkgo biloba for antidepressant-induced sexual dysfunction. Hum Psychopharmacol. 2002;17(6):279–284.
26.    Wheatley D. Triple-blind, placebo-controlled trial of Ginkgo biloba in sexual dysfunction due to antidepressant drugs. Hum Psychopharmacol. 2004;19(8):545–548.
27.    Lind DS. Arginine and cancer. J Nutr. 2004;134(10 Suppl):2837S–2841S; discussion 2853S.
28.    Roaiah MF et al. Pilot study on the effect of botanical medicine (tribulus terrestris) on serum testosterone level and erectile function in aging males with partial androgen deficiency (PADAM). J Sex Marital Ther. 2015;7:1–5.
29.    Gannon K et al. Re-constructing masculinity following radical prostatectomy for prostate cancer. Aging Male. 2010;13(4):258–264.
30.    Beck AM et al. Sexual values as the key to maintaining satisfying sex after prostate cancer treatment: the physical pleasure-relational intimacy model of sexual motivation. Arch Sex Behav. 2013;42(8):1637–1647.
31.    Ibid.

As a fellow of the American Board of Naturopathic Oncology (FABNO), Daniel Lander is a naturopathic doctor board certified in naturopathic oncology. His clinical training included a residency at the Cancer Treatment Centers of America. He is currently an associate professor at the Canadian College of Naturopathic Medicine teaching oncology and clinical nutrition, as well as supervising 4th-year interns in the Adjunctive Cancer Care Shift at the Robert Schad Naturopathic Clinic. He also maintains a small private practice in Toronto, where he focuses in integrative oncology, supporting patients with cancer during and after their conventional care.

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