Sometimes even men can benefit from a female point of view on what appear, at first sight, to be exclusively male health issues.
Amy is the wife of a long-time prostate cancer patient who has agreed to offer her experience in whatever way she may be able to help. In particular, we believe she will be able to give suggestions and guidance to the wives, partners, mother, sisters, daughters, nieces, and female friends of prostate cancer patients as those patients go through the difficult processes of diagnosis and treatment for a disease that is emotionally unsettling for most men.
Please understand that Amy is not a physician. She is ”just” a well educated laywoman with very personal experience of prostate cancer and its problems. She cannot provide you with medical advice. You should always talk to your doctor about your clinical condition and how it should be managed.
You may post your question for Amy using the comments / reply box below. Questions and answers are retained on this page for approximately 60-90 days from the time they are originally posted.
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Amy:
I am a 62-year-old man recently diagnosed with T3b, high-risk prostate cancer with Gleason scores of 9 and 7 who just started external beam radiation targeted to the prostate and the general pelvic region (in case it has escaped the prostate capsule). I am also on bicalutamide with hormone injections to start next week. I am in great care here in London, Ontario at the London Regional Cancer Clinic and know that the treatment is aimed at cure and not management.
My question is more for my wife and I and our intimate life together. My wife is 8 years younger than me, also robust, and we have enjoyed a fabulous physical and emotional intimacy throughout our 10-year relationship (7 years married). What successful strategies are you aware of to help us bridge the 3 years of impotence that we are expecting? I know this is a very delicate subject and we are not adverse to oral pleasure and know about toys. What can I look forward to in terms of my wife’s needs, and best ways to solve them?
Amy responded as follows:
Dear Ric:
What your wife needs from you more than anything else is probably to know that you love her and that you will always talk to her about what you are feeling and what she is feeling. Then you can make good decisions together about what you both want to do about any specific issue. However, you and she need to discuss what she needs, together. You don’t need my help to do this!
In my relatively limited and personal experience, most of the problems related to physical and emotional intimacy associated with prostate cancer (and many other sexually related medical conditions) are the consequence of (a) a failure to communicate and (b) the fact that so many men define their relationships with their partners in terms of their supposed sexual prowess (as opposed to their frequently limited ability to understand that intimacy is first emotional and only secondarily physical).
So my advice is simple. Talk to each other. Think of this period as starting dating all over again. Go dancing. Take her out for romantic dinners. Make her feel loved. The physical bit will take care of itself if you are both delighting in each other’s company. Every day is a new opportunity to surprise her with something … however small.
Amy
I feel confused. I am dating a prostate survivor whose divorce is pending. His wife didn’t want physical relations and asked for a divorce. My confusion arises because he seems to enjoy me, communicates daily. Yet when we’re together he never initiates touching.
We have been going out several months with just a chaste kiss and hug. Us this a common situation for a man who is a prostate cancer survivor? What should my role be? He a prince of a guy. But I need to feel desired. What to do?
Amy responded as follows:
Dear Julie:
So there is dating and friendship and a fond relationship and then there is love, passion, desire, and …
There is a series of very fundamental questions that — sooner or later — you and your survivor need to face up to, which include “Can he?” “Does he want to, but is nervous about his performance?” and “So, are we going to?” In a “normal” relationship, these questions never have to be put into words. However, …
Some prostate cancer survivors are unable to get an erection at all. Some of those who can’t get an erection at all have found ways to deal with that (e.g., through the use of penile implants or other methods). Some can get an erection but it is not exactly what they used to be able to manage (and they can be very depressed about that). Some can get a decent erection if they use drugs like Viagra or Cialis. And some prostate cancer survivors are completely functional.
I know that in most cases it is customary for the man to do the desiring and the woman to be the desiree (so to speak), but I came to the conclusion some time ago that in the situation you describe … if nothing is happening after everyone has reached the point in which one might reasonably expect something to be happening … there is a responsibility that falls to the woman to find a way to reach her hand across the table at dinner and say, “So I think maybe there’s something we really need to talk about now that we’ve been out on date 32.” And then one does need to talk about it.
The resulting outcome depends on all sorts of factors, but the defining criteria for moving beyond where you are is that everyone is going to need to put their cards on the table (again, so to speak). Until you understand the limits of the possible, and he understands whether you can deal with the limits of the possible, your relationship may be stuck exactly where it is, because he probably doesn’t know how to take the next step.
Does that help?
Amy
Hi Amy.
I am currently seeing a man who is going to have his prostate removed. The relationship is still new (less than 6 months) and he has been very shy and refuses to talk about the situation at all. I want to know how I should deal with this and what might change in the relationship after the surgery.
*****
Amy responded as follows:
Dear Robin:
I’m going to be straightforward, so please excuse some of the language below, but it’s important!
While, as the saying goes, “Men … You can’t live with’em and you can’t live without’em,” you are facing a situation in which the apparent inability of the man in question to deal with reality brings this into close focus!
I am quite sure that the man in question is having a real problem knowing how to talk about all this to you or to anyone else. This is (regrettably) normal. Why? Because the potential side effects of having surgery for prostate cancer are emotionally devastating for most men, who tend to measure their “maleness” in terms of their perception of their sexual prowess (regardless of how accurate or inaccurate that perception may be).
On the other hand, if he wants to build a long-term relationship with you, he’d better find a way to come out of his shell and talk about it. If he can’t, then it seems to me that the whole relationship is probably doomed because it is a signal that the relationship is built on sand (or something else that won’t last forever). It is extraordinarily hard to build any good long-term relationship on a foundation that lacks honesty of communication.
You have presumably tried being gentle and kind and using the “I just want to know how I am going to be able to help” approach. So a lot depends on the details of the nature of the current level of the relationship (i.e., what, exactly does “I am currently seeing a man” imply?).
If “I am currently seeing a man” implies regular horizontal and mutual entertainment, then it seems to me that the next time this starts you need to take advantage of the situation after you are both in bed and he is well “primed” and say (with a big smile), “Stop. I wanna ask you something? Are you sure we’re still gonna be able to do this 6 months after your surgery? …”
I mean, he simply can’t promise you that. It’s just not a promisable eventuality. He may want to be sure but he can’t be — and neither can his surgeon. So then you have the opportunity to pull the rug out from under him fears by saying (if it is true), “… because I can think of all sorts of other ways that we will still be able to have fun if you can’t!”
The pair of you are at a key moment in the evolution of your relationship. If this is something you can laugh about together and agree that there are ways to get beyond it, that will be great. If he just won’t talk about it at all, under any circumstances, I think you need to think hard about how much further you want to take all this.
If the relationship hasn’t reached the level implied above, then you have an even bigger challenge because you are basically faced by someone who won’t talk to you about one of the most important things that is ever going to happen to him. And you don’t have the same level of leverage to address the situation. What does that imply about all the other things he may never feel able to talk to you about?
Amy:
My question: Why am I so angry at my husband for having prostate cancer and not being able to be intimate with me?
He was diagnosed 7 years ago, at a time when our marriage was very fragile. He had just confessed to me he was having an affair with a younger woman. I reacted as any healthcare worker would and insisted he get tested for STD. Within 15 days, we were in a whirlwind of his diagnosis and surgery and treatment. His cancer was advanced and out of the capsule. We have never had sex since. We have tried many times to be intimate, but anger creeps in. I can’t help but feel like my husband is gone. I know the man is here, but my prince is gone. I loved him so much and all of this was a terrible shock. I miss our intimacy. I just can’t get over all of it.
I have been to counseling … and it works for a while and then I begin to mourn the loss of our life as it was. He has on a rare occasion wanted to “please me” as he says, but it turns out a disaster. I always think of how “she took the last of my man.” He has changed in so many ways. He is very clingy to me, never wanting me away from him overnight. He is afraid that I am going to cheat on him. I have never and would never inflict that pain on anyone, as I know how it is. Will I ever be able to accept our intimacy as it has to be now or should we just hang it up and get over it. I am just turning 59 and I feel like the last 7 years has aged me immensely.
Amy responded as follows:
Dear Nita:
Clearly the entire experience has been very distressing for you — and probably for him to. It is hardly surprising. The underpinnings of your relationship were severely damaged not just once but twice — within weeks. He has become scared and “clingly”. Why, because he loves you but he feels he has lost the ability to “be a man” in your eyes. You still feel both betrayed and (physically) rejected … to the point at which you can’t even accept his attempts to be intimate. And you (apparently) can’t completely forgive him for the original stupidity … which he must have been feeling bad about if he confessed it and you hadn’t seen that coming.
I am not a professional counselor, and I really don’t know what to tell you about how you can deal with such circumstances. What is clear to me, however, is that nothing good will happen unless and until you can both put the past 7 years behind you. He has to learn to let you have a life of your own. You need to stop thinking about what you have lost and start accepting and thinking about what you really want (which is certainly not just sex). You seem to need new goals to strive for together and individually, because it sounds as though you are both just “going through the motions” of being a couple without actually acting as one.
There is a way to deal with the sex problem, and that is for him to go and get a pemile implant — if you can afford this. Many men who have done this feel as though it has “re-masculinized” them. However, this procedure isn’t cheap.
So to deal with your actual question, I really don’t know why you are so angry with him. I can think of a thousand possible reasons — and many of them are really good ones! But the problem that needs to be addressed is what you both need to be able to do — together and separately — to make that anger go away. It’s gonna take two!
Hi Amy,
My boyfriend had a spinal cord injury years ago. He cannot have an erection and a few months ago he said that he was thinking about having an implant done. I told him that please do not do this on my account, that I love him the way he is and that we get very intimate, and I’m happy the way things are between us. He feels that he’s not equally sharing with me. That couldn’t be farther from the truth. To add to this he found out that he has prostate cancer. He is undergoing radiation treatment for a total of 9 weeks.
He doesn’t want us to see each other until after the treatments. For one thing he says he can’t feel he can keep his hands off me. Well, I feel the same. But I understand his concerns. He just started after the completion of 2 weeks into radiation therapy to feel the side effects of fatigue, frequent urination. He’s a trouper. I feel helpless during this time. Is there anything I can do besides offer him encouragement and let him know that I am just a phone call away? I really love him, he’s a great man. Any suggestions?
Thanks
Moonstruck
*****
Amy replied as follows:
Dear Moonstruck:
So if I was in your position I would be sending him silly gifts and postcards a couple of times a week. (I’ll let you get creative about thinking what sort of silly gifts and postcards!) Just because he’s being a dumb, isolationist male doesn’t mean that you can’t be the one who optimizes the creative interconnections! And why does he have to “keep his hands off you” during his treatment anyway?
:O)
Amy