Partners in Care Managing Erectile Dysfunction in Prostate Cancer

At the OneOncology APP Symposium, the conversation surrounding prostate cancer care extended beyond oncologic outcomes to emphasize the preservation of quality of life. Dan Silver, PA-C, a physician assistant with Arizona Urology Specialists, shared his clinical perspective on the essential role of advanced practice providers (APPs) in managing treatment-related erectile dysfunction (ED).

Partners in care

Silver, who treats patients in Arizona, advocates for a high-touch, partnership-based model of care. He emphasized that APPs must be deeply integrated into the patient’s surgical or oncologic journey, often serving as the primary point of contact for survivorship concerns.

"I am their partner," Silver stated during the interview. "I tell them I am with you through this and we're going to get you through it."

This approach is designed to provide patients with a sense of security during a vulnerable time, ensuring they do not feel abandoned after their primary treatment concludes.

Timing and clinical Intervention

A critical component of Silver’s strategy is the timing of the intervention. He suggested that patients should ideally be seen in a dedicated men’s health clinic either immediately before or shortly after surgery. By establishing this relationship early, the APP can work with the surgeon to create a tailored penile rehabilitation plan.

Silver noted that the goal of his clinic is focused: "The APP needs to work with them and find out — do you want to preserve erections?" For patients who prioritize sexual health, Silver employs an aggressive management style, positioning himself as "the erection guy" who will find a solution regardless of the challenges presented by the cancer treatment.

Beyond the patient: Addressing intimacy

Silver also highlighted the psychological and relational impact of ED, noting that it is rarely an individual issue. "It's not only to them, but it's intimacy for their spouse, too," he explained. Because of this shared impact, Silver encourages spouses to attend appointments, fostering an environment where intimacy can be discussed openly as part of the healing process.

This holistic view ensures that the focus remains on the patient’s overall well-being and the maintenance of their primary relationships.

Clinical expertise and background

Silver’s focus on men’s health, including ED, Peyronie’s disease, and hypogonadism, is informed by a broad medical background. Before joining Arizona Urology Specialists in 2016, he gained experience in family practice, intensive care, and cardiology.

For oncology nurses and APPs, Silver’s insights serve as a reminder that compassionate care requires both clinical expertise and a visible, supportive presence. By proactively addressing sexual health "upfront," providers can significantly improve the long-term satisfaction and recovery of prostate cancer survivors.