Should a woman perform anal penetration on a man with prostate cancer, given she receives no sexual stimulation and the cancerous prostate should not be massaged?

No Medical Recommendation for This Activity

There is no medical indication or evidence-based recommendation for a female partner to perform anal penetration on a man with prostate cancer. This question appears to conflate sexual health counseling for prostate cancer survivors with a specific sexual practice that has no therapeutic benefit and raises legitimate safety concerns.

Key Clinical Considerations

Prostate Cancer and Sexual Activity

The available guidelines address sexual dysfunction and intimacy after prostate cancer treatment, but focus on:

• Erectile dysfunction management through PDE5 inhibitors, vacuum devices, penile prostheses, and psychosexual counseling 1, 2
• Couples-based counseling to help partners adapt to changes in sexual function 1, 2
• Alternative forms of intimacy when penetrative sex is affected 1

Specific Concerns About Prostate Manipulation

Your concern about massaging a cancerous prostate is clinically valid. While the guidelines don't specifically address external prostate manipulation during sexual activity, the principle of avoiding unnecessary trauma to cancerous tissue is sound medical practice.

What Guidelines Actually Recommend

For men with prostate cancer experiencing sexual dysfunction:

• Medical interventions: Sildenafil, vardenafil, tadalafil for erectile dysfunction 1
• Mechanical aids: Vacuum erection devices, intraurethral prostaglandin, intracavernosal injections 1
• Psychosexual counseling: Individual or couples-based therapy to address intimacy changes 2
• Alternative sexual practices: Focus on mutual pleasure through non-penetrative activities that both partners find satisfying 1, 2

For Men Who Have Sex With Men

The guidelines specifically acknowledge that men with same-sex partners may have unique concerns, particularly regarding receptive anal intercourse after prostate cancer treatment 1, 3. Research shows that 23% of gay and bisexual men who attempt receptive anal intercourse after prostate cancer treatment experience anodyspareunia (painful receptive anal sex) 3.

Bottom Line

Sexual activity after prostate cancer should focus on mutually pleasurable activities that both partners desire and find satisfying. The overwhelming evidence supports that sexual satisfaction can be maintained through various forms of intimacy that don't require specific anatomical stimulation 4. Any sexual practice should be consensual, mutually desired, and not undertaken solely for perceived medical benefit when none exists.

If sexual dysfunction is affecting quality of life, referral to a urologist or sexual health specialist is appropriate 1.