Vasectomy and Prostate Cancer

enjamin Franklin once said: “He that is good for making excuses is seldom good for anything else”.

I guess it is fair to direct such criticism for men who have an attitude of “intentional avoidance” in life.

Most of us make conscious decisions such as avoiding smoking and a fatty diet that may have a cumulative impact on our health.

Today, we open the debate linking vasectomy to prostate cancer.

In light of the certainty (or uncertainty), is it still fair to criticise men for not accepting vasectomy as a form of contraception, with the fear of getting prostate cancer in the future?

Dear Dr G,

My wife and I are in our late 30s and we have three children.

She recently got pregnant and had a miscarriage. We are both worried that such “accident” will happen again.

I am not a big fan of condoms as I find it reduces intimacy. Besides, I am also allergic to latex.

My wife is taking oral contraceptive pills. I am just a bit worried about its effectiveness since she got pregnant even when using the pills.

My wife suggested that I go for a vasectomy after reading your column.

I have also read your views about the ease of vasectomy and how men should take the lead in family planning and contraception.

I must say I take a completely different stance when it comes to this subject.

Firstly, I think the use of contraception has been well-researched and safe. Why change this tradition mode of contraception for women?

Secondly, for women to make a decision to undergo sterilisation is in a way to empower their body in family planning. Surely this is good for them.

Lastly and most importantly, I found out recently there was a link between vasectomy and prostate cancer.

Surely, this procedure is too new for us to understand the long-term impact of such “brutal” intervention.

Hope you agree with my argument.

Non-supporter

Vasectomy is a surgical procedure for male contraception/sterilisation.

This is an intervention which essentially severs the continuity of the vas deferens, in order to prevent sperms from entering the seminal fluid prior to ejaculation.

Vasectomy is technically a simple operation.

The intervention is usually done in the clinic with minimal incision under the utilisation of local anesthesia.

In addition, such mode of sterilisation is comparatively safer and more cost effective, compared to fallopian ligation in women, usually conducted under general anesthesia with higher risks of complications.

Many men are also pleasantly surprised after the vasectomy as their libido, erectile rigidity and quality of ejaculation remain unaltered after the snip.

On one hand, the prevalence of vasectomy in many countries has gain momentum amongst men actively participating in contraception.

Ten per cent and 18% of men in the United States and New Zealand respectively have had vasectomy as a form of sterilisation.

Many men, however, are resisting the intervention due to fear of potential complications.

When most men think of complications after vasectomy, the thoughts of bleeding, pain and infections often comes across their minds.

In recent years, the issues of the causative effect of vasectomy resulting in prostate cancer have compounded further uncertainties in men contemplating the snip.

The first large-scale study in 2014 linking vasectomy to prostate cancer was highlighted in 2014.

Although the exact etiology and mechanism is unknown, the study demonstrated a 10% increase in the risk of prostate cancer amongst men who had a vasectomy.

As the study had generated some concerns, most health care professionals considered the evidence “weak” as it did not take into account of more obvious cancer risks such as smoking and sedentary lifestyle.

A recent study published in the Journal of Clinical Oncology had demonstrated no link between vasectomy and cancer.

In a much larger study with longer interval of follow up, researchers at the American Cancer Society analysed more than 363,000 men since 1982.

This includes 42,000 known to have had vasectomies.

In this study, about 7,400 participants died of prostate cancer over the 30 years, and there is no difference in the cancer development between those who did and did not have the snip.

In reality, men who worry about prostate cancer should focus on reducing the exposure to cigarettes and high-fat diet, as the links are robustly established.

In light of the latest research with large number of participants and more than 30 years of follow-up, there are really no more excuses not to have the snip!