DR. ELLIE CANNON: Viagra didn’t work after several prostate surgeries. What CAN I try?

I have slowly progressing prostate cancer and had to undergo several procedures to remove parts of it. I have also suffered from erectile dysfunction for several years. I tried every pill available, including Viagra, but to no avail. Are there any other options? It pains me to think that my sex life is over at 67 years old.

More than two-thirds of men treated for prostate cancer suffer from erectile dysfunction – a problem that can significantly affect self-esteem, relationships and quality of life.

But according to the charity Prostate Cancer UK, less than half receive effective treatment.

There are options. Medications such as Viagra can be tried “as often as needed”, but we also prescribe a low daily dose of a similar medication, Tadalafil, to men with prostate cancer. Some prostate surgeons recommend “as needed” dosing, but it’s important to consult a doctor before starting anything like this.

Vacuum pumps – which cause an erection – can be off-putting to men, but they are an accepted treatment and worth investigating. About 70 percent of men who use it find it effective. For someone with prostate cancer, they are often available free of charge in NHS-funded clinics.

Injections sound scary, but in reality, many find that they don’t hurt. A very thin needle is used and men can learn to do it themselves. They often work best on men with active libidos.

There are many advertisements for creams and pills to treat erectile dysfunction. Unfortunately, few work and some can even be risky – online products may not be subject to the same strict regulations as prescription drugs.

Quitting smoking and drinking less alcohol has been shown to reduce the problem. Men can also contact their primary care physician for a referral to a local erection clinic, psychosexual clinic or caregiver.

It’s also important to know that even if none of the above works, your sex life doesn’t have to be over. This may mean that you have to redefine what sex means to you.

I recently had surgery to treat stage 2 breast cancer. I now need radiotherapy and will have to take tamoxifen for the next five years, but I have heard the side effects can be similar to menopause. At 66, I’ve experienced this before and have no desire to do it again. My doctor said the benefit of these two additional treatments was small, so I decided not to take them. Is this the right decision?

We do not take a one-size-fits-all approach to cancer treatment. Instead, we outline the risks and benefits of various aspects of care, let patients weigh them and make a decision.

Tamoxifen is a hormone medication used to suppress the effects of estrogen – which can cause some tumors – in breast cancer. The side effects can be similar to those of menopause, such as hot flashes, nausea and fatigue.

However, many women use tamoxifen and tolerate it very well, especially if they are already menopausal. So I can recommend trying it out before dismissing it.

Radiation therapy can be debilitating. So before offering it, the benefits must be worth it. I can understand why patients would choose not to, but in my experience, the vast majority would choose not to.

One reason for this is that you can comfortably live with your choice in the future.

Cancer treatment decisions are typically about quality of life. Therefore, it makes no sense to forgo treatment because of the side effects and then spend months or even years wondering if it was the wrong decision.

I am completely deaf in my left ear. A few months ago I paid £50 for ear cleaning – the suction method as an alternative to spraying – and it worked quite well. I asked my GP if he could do the same procedure and was told: “The NHS won’t do anything about ear wax.” Do I have to pay £50 every time my ears need attention?

There is a huge debate about ear washing in the NHS these days.

Until recently, many primary care physicians offered removal using a syringe or lavage. This has changed due to funding shifts and also concerns that the process could damage the ear. As a result, many people suffer from excessive earwaxing and treatment is not possible.

This can cause a range of serious symptoms such as numbness, pain, tinnitus and dizziness.

If deafness is a person’s main symptom, I would always recommend an examination by a doctor to make sure that ear washing is indeed the cause.

Often, especially in old age, there are other causes of deafness and a hearing test can be helpful.

For most people, earwax falls out naturally through normal jaw movements. We can help this process by using olive or almond oil drops to soften the wax. It may take a few days to work, but it can be incredibly effective.

A pharmacist can advise you on treatments, including sodium bicarbonate ear drops, which dissolve and help move earwax.

If earwax build-up causes frequent deafness or other serious symptoms and does not respond to home remedies, a GP can arrange a referral to the hospital’s microsuction unit for more intensive treatment.

Something to sneeze on…

Is there such a thing as autumn sneezing syndrome?

I was asked this by a colleague who sneezes constantly – as often as during hay fever season. My answer was no, it must be a cold – but he had no other symptoms. And he was not the only one who suffered like this.

Other possible causes include allergies: Mold spores can grow outdoors in moist areas, such as piles of leaves. Even when the central heating is on and clothes are dried indoors, mold thrives and thrives in the house, causing respiratory irritation and … sneezing!

Dust mite allergies also get worse when it gets colder and we spend more time indoors with the windows closed.

Over-the-counter antihistamines are an easy way to test if this is the answer. Otherwise, I would like to know if you suffer from autumn sneezing and do not think it is due to a cold.

Email me at the address on the right and let me know.

Are you on a never-ending waiting list for critical surgery?

A staggering 11 million people are currently on NHS waiting lists hoping for operations and treatment, according to reports. I see the difficulties with my own eyes.

And I’m sorry to say it, but a GP can hardly help. After Covid the problems increased. The misuse of all resources to combat the virus was something that I and many other GPs made very clear in their efforts to warn the government. Now it’s time to go home to sleep.

I have elderly patients who have been waiting over a year for cataract surgery – some of whom are at risk of falling daily due to poor vision. Falls can be catastrophic in this age group.

Hernia surgery also proves difficult to perform. I just had to lay off a young man after ten months of waiting.

Are you on a waiting list? Write and let me know.

A depressing 11 million people are currently languishing on NHS waiting lists hoping for surgery and treatment, according to reports