Ask Amy … to Get a Woman’s Point of View

Sometimes even men can benefit from a female point of view on what appear, at first sight, to be exclusively male health issues.

ask-amy-sm.jpgAmy 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.

215 Responses

  1. 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.


  2. 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?


  3. 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?

  4. 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!

  5. 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?




    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?



  6. My lover and I met again after 50 years and we are very much in love. It has been so cruel to learn that he has prostate cancer, and is having hormone treatment and then radiotherapy. I love him so much and want a life with him, but he seems to be so quiet with me since the diagnosis and never talks of love now, although he says he still loves me very much. How can I help him.



    Amy relied:

    Dear Pat:

    Your friend is struggling with the implications of his mortality … as well as with the practical necessities of treatment for his prostate cancer. You can best help him by giving him distractions that take his mind off the cancer and are just “old-fashioned fun.” Forget the “love” thing for a while. That is going to remind him that standard sex is going to be a problem. What you can do is make sure you go do “ordinary” things together regularly. Go to the movies; go dancing; go for walks in the evening; ask him to do simple things for you like digging over the flowerbed so that you can plant things. What your friend needs more than anything at the moment is a sense of normalcy so that he can realize how to — and have the time to — adapt to the change in his situation. Help him to achieve that sense of normalcy.


  7. Dear Amy

    Thank you for the above answer. My wife walked out when my prostate cancer was diagnosed just under 2 years ago. I’m now 54. I previously had a healthy, active, regular love life

    Now, after a CyberKnife process 19 months ago followed by and an intense course of radiotherapy (14 doses), ED is total for me. Is it likely that this will recover in any degree?

    This is playing hugely on my mind, and not helped by other pressures — divorce, resolving the access and contact arrangements for our children and step-children, plus money and work and the horrible reduction in my general strength and ability to lift, carry etc.

    I am suffering from depression as well, due to circumstances, and having no-one to support me has made that so much harder to cope with.

    Recently I have (very unexpectedly) fallen for someone — but — I am at the beginning of our relationship; nothing has yet “happened,” beyond holding hands and kissing and cuddling. She senses “something” is not right and is being very loving and supportive — amazingly so for someone who I’ve just got to know. … I am struggling to get into my head the best way of explaining the effects of prostate cancer and ED.

    Can you offer any guidance please?


    Amy replied as follows:

    Dear Graham:

    First, let’s talk about the ED. I think we may need to accept that recovery of good, “normal” erectile and sexual function is highly unlikely if there have been few “signs of life” after 19 months. … And I am assuming you have tried using drugs like Viagra to see if they would be of any help. Yes? So this leads to the question of whether you have consulted a specialist in erectile dysfunction to have a serious conversation about what could be done to help with this … up to and including the possibility of things like a penile implant.

    Second, there’s the issue of the depression associated with all the other stuff. It sounds to me as though you are ready to “let go” of a lot of that. This will be helped if you can persuade yourself to give more attention to your general health and fitness. You aren’t going to be able to turn yourself back into an 18-year-old, but making really sure that you are eating well and exercising regularly will help you to feel better about yourself physically and know that you are doing what you can to maximize your level of vigor.

    And then there is the issue of the new person in your life. …

    It is going to be a difficult conversation, but you are going to need to start explaining the situation to her. If you want a real relationship with this woman, it has to be based on honesty and trust above all else. And in having that conversation you need to focus on what you are doing to “make the best” of the situation. It’s OK to tell her that some of this can “get you down” at times, but the important thing is going to be to focus on the positive and how you feel about her and why she needs to need to know the whole truth, so that she is under no illusions or mistaken expectations. I think you know what you are going to need to tell her. What you need to work out is how to tell her while making it more about her that about you. And give her lots of opportunities to ask questions rather than just doing a “data dump” on her. OK?

    I hope that helps.


  8. Thank you Amy. My new partner and I are talking things through.

    As she says, there are so many other ways to make love, as well as the “obvious”. She has put me on a diet, and has dragged me kicking and screaming (not) to early bed each night since reading this — to make me relax.

    And I don’t want to change him for another man, he’s lovely even with this issue x Nina

  9. Thank you Amy, I will try my hardest to do as you say. I must add, we love experiencing the lovely normal, everyday things together, and look back on our lives to realise that we have missed such a lot by not being together all these years, so really the normal things are very precious to us.

    Kind regards,


  10. Dear Amy,

    I am, sadly, about to end a 30-year marriage with my husband, who had prostate surgery 15 months ago. Like most prostate cancer survivors he has complete ED, as well as a significantly lower libido. He is also severely depressed, has completely let himself go physically, and drinks too much.

    I am so lonely, so distraught that I simply can’t go on. All communication (always a tough thing for us) has stopped, and I am no longer willing to be the one trying to fix this mess.

    Here are my concerns:

    (1) I am so angry. I’m angry with the medical establishment that they did this to us and then left us completely alone as we struggled to deal with it. I tried everything I could to get us help — even as soon as he was diagnosed — but it just felt like no one took our intimate life seriously. While he was focused on getting rid of the cancer, I was concerned about our relationship — but no one cared about me, I wasn’t their patient! So, they saved my husband, but wrecked his life.

    (2) I’m also angry that there is a lot of discussion in the news about diagnosing/treating prostate cancer, but so little about the quality of lives of the men and their partners after they are treated. It all feels like a big lie, or a cover up.

    (3) I don’t want him to be alone the rest of his life. I sincerely hope he can meet a woman who, perhaps, has different sexual and intimate needs than me. But how will he ever be able to communicate with someone new, when he can’t even communicate with me?

    Anyway, what a heartbreaking mess this is. Thank you for being on line to discuss this honestly, and to give a voice to the other victims of this awful disease.


    Amy replied as follows:

    Dear Clara:

    I am probably going to get a lot of negative comment from some people after this, but I feel obliged to say what I think is right.

    First … Far too many men (and sometimes far too many of their family members too) don’t do anything like enough homework when they hear the word “cancer.” In some cases, their doctors also fail (badly) to give them a full appreciation of the risks associated with treatment, but that is not always the case. What my experience has told me is that prostate cancer is over-treated for a host of reasons, but a great deal of that has to do with men simply not wanting to really look at what they are getting into and not listening closely to what they are being told … and sometimes other family members pushing them into treatment that may well be unnecessary.

    Second … While I understand that the sequelae, side effects, and complications of treatment of prostate cancer can come with all sorts of aggravating impact, I no longer have a lot of sympathy with the male depression that seems so common. People lose eyes, legs, arms, all mobility, their homes, their children’s lives, and are able to rebuild positive lives afterwards. The will to just deal with what happens in life has a lot to do with how other people see us … and a man who lets the complications of localized prostate cancer make him severely depressed and start drinking heavily is hardly going to be a person that most of us would want as a regular acquaintance, let alone a soul-mate. Sometimes we all need to be able to swallow hard and say, “Okay … so this is something I just need to deal with.”

    Third … I think you are right to have decided that you needed to “move on”. The ED is one thing. The loss of any will on the part of your husband to make himself helpful, amusing, entertaining, and even (God forbid) sexually desirable to you is quite another. It demonstrates a degree of self-centeredness that I don’t see as justifiable. The fact that you are still willing to worry about whether he can “pick himself up and start over” demonstates (at least to me) the clear difference between where you are coming from as opposed to where he is coming from. People who sit and feel sorry for themselves become very unattractive very rapidly. At least if we know someone is making an effort to cope, we are willing to cut them some slack, give them some time, and even help them to actually succeed.

    Fourth … You have every right to be angry. You are going through the same sequence of shock, denial, loss, anger, and acceptance as does an actual cancer patient. Anger is a very normal step along that path under the circumstances. But just as your husband needs to let go of his denial and loss, you will need to let go of the anger. After a while you will find that it is simply not constructive … and you will need to move beyond it. Could society be doing a better job of dealing with this disorder? Of course it could. And some members of the medical community and the news media and others are actually trying very hard to do that … but there is a long way to go.

    Last … By no means do I believe all men have this response to prostate cancer. For a strikingly reverse extreme, one can look at this web site someone told me about just the other day … built, apparently, by a couple who feel that his prostate cancer actually revolutionized their intimacy in a very positive way. (Whether everyone would be able to have that respnse is perhaps open to question, but clearly some people have this type of coping mechanism.) This may not be possible for your husband. We are all different. But we should all have the determination to make the best of our lives, regardless of the hand that we get dealt by providence (or even by a poor physician).

    I have no idea whether this will be of any help, and maybe it will seem “cold”, even to you. I hope not … but it is part of how I have come to see this little piece of our world over recent years.


  11. Thank you Amy, It does not seem “cold.”

    I guess it isn’t news that some people cope better with adversity than others. While bad things of all sorts can strain some marriages, others will overcome. Perhaps the tough thing about prostate cancer side effects is that they really can impact a couples’ intimacy – just when you need it the most. I know couples who have overcome horrible things – loss of children, bankruptcy, etc. – but they’ve overcome them together, I suspect at least in part, because they’ve been able to find solace in familiar arms and familiar closeness. Somehow prostate cancer robs too many of us that, leaving such a terrible hole.

  12. Dear Amy,

    I need someone to talk to and maybe just typing this will be helpful enough.

    I met a really nice man 3+ years ago, 20+ years my senior. I was 48 somewhat settled; he 68; we dated and he was the perfect gentlemen. As time went on I began to have some feeling for him, not love but feelings.

    As we continued to date, he had to go in the hospital to have surgery. He said it was nothing serious and I took his word on that. What I didn’t know was, he was having an implant inserted due to ED. I didn’t know he had had prostate cancer almost 15+ years ago. He has always been the shy type and I just thought it was his way. He always was the type to avoid the lights being on, covering up, and he would shake if I tried to touch him. Like I said, him being older I took him as shy and that really didn’t bother me because I understood. (I thought it was refreshing.)

    One day I asked him if there was anything that he needed to tell me because something wasn’t right and I couldn’t put my finger on it but something wasn’t right. With the surgery he has a leak and I didn’t know he had to wear a pad. I was getting a slight yeast infection because we stop using condoms. He went and poured himself a big drink and confessed his ED, cancer, and a few other things. He was surprised that I didn’t freak out. I stayed calm and asked why he didn’t tell me before we got involved. He said he was scared and he was afraid of losing me.

    It took a few months but we talked a lot and moved past that. A year later we got married and I don’t know what happened. He started acting like an typical man: full of himself. I have been a stay at home wife and now he tells me that I need to work, that we don’t have enough money and other couples work and I should get a job to pay my bills. I married him for security, and he knows that, and I have accepted everything about him and will not hold it against him in exchange for the life that I have now. I confess sex with him has been a challenge. How do I tell him without bringing up the subject of his past. He’s been experiencing a few medical problems and I can’t help but wonder if he thought I would be his nurse and not just a wife.


    Amy replied as follows:

    Dear Gator:

    So I have been looking at your implied “question” (“How am I meant to react to this change in behavior?”) for most of the morning.

    There is a well-understood set of male behavior patterns in which men who initially come across as charming and mild mannered later appear to change their behaviors and seek to become controlling of the behaviors of others (to a greater or a lesser degree). Such behavior change can often occur once the male in question believes that the (in his mind) “subordinate” partner has in some way become “his” to control. Why such behavioral change occurs, I do not know. I am not a psychiatrist. What I do know is that confrontation of such men can be difficult and sometimes even dangerous.

    The bottom line here is that you did not “sign up” for what is now being suggested and implied. Why it is being suggested and implied, I have no idea. It could be no more than fear in the mind of your husband that his health is failing and he needs help.

    Clearly you do need a way to confront your husband about these demands and get the cards on the table. However, you may want to be careful about how and when and where you do this since he may not react well to such confrontation.

    Please understand that I am not trying to suggest that there is necessarily any great risk of violence here. He may just do what he did last time: get himself a stiff drink and say, “I’m really sorry. I’ve been feeling really stressed because it doesn’t look as though I’ve got the savings and the pension income that I thought I was going to have. I haven’t behaved very well about it have I?” On the other hand, you might want to initiate this conversation somewhere where, if he does have a bad and explosive reaction to the implied criticism, there are going to be other people around.

    The other thing is that “his past” may all be very much a part of this, and bringing it up may be a necessary part of the necessary conversation. On the positive side, you have already been through one conversation like this together, and you were both able to get beyond it. If you aren’t able to tell him that you don’t understand what the heck he thinks is going on in his head, then there really is a problem. Every so often, most wives need to be able to look their husbands square in the eyes and say, “Jimmy … You’re a great guy and most of the time I love having you around … but sometime you start to behave like Clint Eastwood on steroids and it is significantly less than attractive! So … what’s going on?”

    I hope this is of some help.


  13. I think I know what the problem is. He went to church today and before he came home he had a drink or so and just snapped at me. Could this be playing a factor because Clint Eastwood comes out more when he drinks.


    Amy replied:

    Dear Gator:

    Alcohol rarely helps people to deal well with fundamental issues of emotion and communication. On the other hand, in and of itself, alcohol is also probably not the basic problem, which is likely to be much more deeply seated. People who drink and then snap at others usually need to work out how to deal with something that the alcohol is helping them to avoid dealing with.


  14. What happens if a man doesn’t have sex after prostate cancer? Will he need more surgery?


    Amy replied below:

    Dear Robin:

    You’ll need to excuse my naivety, but I am a little puzzled by your question.

    Are you asking about what happens if a man is unable to have sexual intercourse after being treated for prostate cancer or are you asking what happens if he is simply unwilling to have or uninterested in having intercourse after prostate cancer?

    The treatment of sexual dysfunction after a diagnosis of and treatment for prostate cancer depends on many related factors. There is no “simple” surgical solution to this problem, although surgery would certainly be involved under some circumstances.

    If you can give me some more information I can try to give you a better answer to your question.


  15. Dear Amy:

    I am an 83-year-old man first diagnosed with prostate cancer in 1996. I’ve survived all these years under the excellent care of Memorial Sloan-Kettering and a variety of medications (Lupron, Casodex, etc., etc.), all of which ultimately stopped working. For the past year, I have been doing excellently well with Zytiga (PSA currently at 0.35) which was provided for 1 year by J&J’s Patient Assistance Program. Now they have denied (but are re-considering) my application for another year of the drug under patient assistance.

    My concern with this situation is not only for myself but for the thousands of middle-class prostate cancer patients out there who are neither wealthy enough to pay the retail price of $7,500 per month nor poor enough for the company’s stringent and somewhat Byzantine procedures in order to qualify for patient assistance. So, in effect this makes the drug available to the wealthy and to the indigent, leaving a vast number of middle-class patients in a very precarious situation of having to dismantle retirement savings and/or otherwise imperil the remaining financial stability, well-being, and dignity of healthy spouses and families, all of whom can expect many more years of life.

    While it is understood that developing these “miracle drugs” is a very costly business, it would seem to make far more sense for these drugs to be marketed to a much wider (middle-class) market at affordable prices than to restrict sales to the segment of the very few very wealthy and the continually growing segment of the very poor.

    My question to you is: Why? And do you see any end to this huge inequality? And how can we organize to pressure change in this?


    Amy replied as follows:

    Dear Rod:

    The entire financial structure of the American health-care system is Victorian in both concept and execution, and it is rife with “special interest” groups of 1,001 types who all either want it to change to give them greater benefits or not to change so that they don’t lose the benefits they have. The whole thing is a walking nightmare, and while I certainly don’t agree with everything in the Affordable Care Act, I also see that act as simply a beginning toward a rational, modern health-care system in which patients know exactly what things really cost and health professionals (including the pharmaceutical industry) are all required to explain why things cost what they do so that people can make real decisions about “value”.

    The way drugs are priced today is driven by what the law allows drug companies to do and what the law allows physicians, hospitals, and payers to do. Since the relevant laws were all written with massive input from the lobbyists for all the different interest groups, we have the inevitable dogs’ breakfast in which the priorities of the middle class came last because they are the least well-organized with the least lobbying power.

    I have absolutely no meaningful idea how to change the current status quo to something more sensible and equitable. And as far as I know, at this point in time, neither does anyone else. On the other hand, almost everyone understands that the current system is crazy and unsustainable. But for everyone who wants to make changes in director X or direction Y, there are always five other people who will immediately say, “You can’t do that because ….”

    This precise question came up earlier today during a phone conversation Amy was having with a friend in the pharmaceutical industry. Amy’s friend knows that the way the system works now is nuts, but he has no more idea about how it could be changed than Amy does, because investors in the pharmaceutical industry take large, long-term risks with their investments and so they expect a very high level of profit when profits are forthcoming.

    The only people who have the power to actually make any sense of all of this would be Congress … but in case you hadn’t noticed, our elected representatives are all more interested in arguing about philosophy than they are in actually doing things in the interests of the American people ….

    I wish I had answers to your questions …. I just don’t! But I am glad that drugs that have been developed over the the last 30 years have been able to help you for as long as they have. And I hope that J&J will renew your patient assistance for at least another year.


  16. Thanks for your response, Amy.

    I’m sure you can understand how amused some of are to watch the currently most popular series on televison. Of course, I mean: “Breaking Bad” about a mild-mannered high school chemistry teacher who learns he has inoperable lung cancer. He has no money and many debts — a condition he does not want to leave saddling his wife. So, he turns (in broad parody, played straight) to producing crystal meth in an improvised lab — and an ever-spiraling life of crime. Very funny — but also dead on with all of us with advanced cancers and facing humongous charges for those Big Pharma “medical drugs” that have the promise of extending our lives.

    Needless to say, not a path any of us intend to follow in real life, but a stark picture of the conundrum we face.

  17. Dear Amy,

    I’ve been looking for a “site” like this since my husband was diagnosed with prostate cancer at the age of 54, almost 10 years ago.

    We went through various stages of handling the trauma and changes; he was sure he would be “cured” because the doctors and hospital claimed a “high success rate”. Well, that did not happen.

    I learned to pretend I was having a great time with 30 seconds of foreplay and 45 minutes of waiting while he was working with the machinery he was told to purchase until he came back to bed. It was all very difficult and awful; he had terrible side effects, and continues to do so, and for a man who did not like to talk about any of it, it was incredibly stressful. I was supposed to pretend that everything was “just fine”, and of course I was glad the cancer was gone. But it was at a high cost, and he was unprepared.

    The stress, for me, has been intense. He has stopped touching me, kissing me, hugging me. I broke down and told him there was a wall in every aspect of our life, because I was not allowed to touch him, or initiate affection, and our bed had an invisible wall. Sex stopped 4 or 5 years ago; he moved to a separate bedroom, and we are housemates. I finally bought my own sex toy — last woman of my generation, probably — and have been on various antidepressants. Not him. I feel we are living a lie to our grown children and friends and I hate it. I care about him deeply, but this is not how I want us to spend the rest of our lives.

    We only attended the local “support group” twice, at the very beginning, but he did not find the other men’s discussion helpful — he had made his choice (surgery), and found the life afterward to be a whole new world. No one wanted to talk about that. I was the youngest woman in the woman’s group and felt our marriage was too stressed to act perky and hopeful when some women were facing critical health situations with their spouses.

    He has found, in the past year, diversion and happiness in exercise. It relieves his stress, gives him something to do, and the instructor is a young woman. He goes every day of the week. It is convenient to his work and at the crack of dawn; it is completely inconvenient for me, and I have health issues.

    I feel the medical establishment in this, as in many other situations, felt it “did its job” by diagnosing his cancer and then giving him choices in how to deal with it (cut it out). No one talked much about what would happen afterward, and for how long (side effects). No one provided a counselor for me, or rather, I did not know how to find one. He refused to attend or seek sex counseling, so perhaps a lot of this is his “fault”.

    I know many men and woman lose a limb, or become seriously disabled from illness or accidents, and have had chronic pain issues myself. But it has been a rotten 10 years, it was a rotten 3 years, and it is difficult to imagine a future “retirement”.

    He just does not want to acknowledge the situation.


    Amy replied as follows:

    Dear Anna:

    I have read through your message above four times now. I would like to have something truly brilliant to suggest. Sadly, I just don’t!

    Obviously this is by no means the first time the inability of the patient to “acknowledge the situation” has come up. It is one thing to be patient and caring and give one’s husband or partner time to adapt to a new reality. It is quite another when that adaptation fails to occur. At some point, that new reality has to be recognized, acknowledged, and acted on. Ten years seems like more than enough time to me.

    Your situation reminds me of watching politicians “come clean” about their serial misdeeds while their “loving wives” stand passively behind them being “supportive.” At some point one inevitably has to ask, “Who is kidding whom?”

    I have no idea whatsoever what you can do at this stage to recover from what has clearly been a complete breakdown in communication between you. Is someone to “blame”? Probably not. You were both faced with a whole new and complex situation, and he just seems to have been unable to adapt. It happens. However, you can hardly be expected to just lie there like a doormat and accept his approach to what has occurred.

    The question now is, “If he can’t accept reality, are you going to accept that he can’t accept the new reality and (potentially) never will? And if so, when, and by doing what?”

    I have a difficult time thinking that this can “help” in any meaningful way … but I just can’t think what else to say.


  18. Hi, Amy,

    As a prostate cancer survivor and intimacy coach I’ve been deeply moved by the poignant questions of prostate cancer patients and their partners and by your responses to them.

    Next month I will be a panelist at an event in Dallas sponsored by Cure magazine. May I have your permission to cite your thoughts re: two cases involving some patients’ and partners’ disappointment with the medical establishment leaving them high and dry? Also, may I distribute both postings in their entirety to the 75 participants at the conference, with full attribution to you? I refer to one in June and the other this month (October)?

    Continued success in bringing profound awareness and comfort to your many viewers.

    Rabbi Ed Weinsberg, EdD (


    Amy responded:

    Dear Rabbi Ed:

    First, thank you for your very kind comments. I just do what I can, and I certainly don’t consider myself to be any sort of expert on anything. I just try to help people who need to talk to someone.

    Second, thank you for asking permission to use and distribute the information you refer to. Many people today wouldn’t even ask, but I am rather old-fashioned about that sort of thing, so I appreciate it.

    Third, if you really think it would be helpful, please feel free to use these questions and my responses as you see fit. And if you think there are better or alternative answers to these types of problems, please do let me know … because I always feel I know so little when they come up.

    Enjoy your meeting in Dallas.


  19. To Amy, and Rabbi Ed,

    First, Amy, thank you for your thoughtful and honest reply.

    If my October posting is one you are interested in sharing, Rabbi Ed, please, please do. I just searched for CURE magazine [“Combining science with humanity, CURE makes cancer understandable” — maybe it wasn’t around when my husband was operated on, maybe he sees it at his doctor’s … I doubt it … but I never heard of it til now], but do oncologists, especially prostate cancer specialists and urologists read this? Patients need the straight scoop … to understand the impact on their lives, and their abilities. The surgeons or physicians making the cut, or writing the scripts, rarely have a clue. They see so many people/they are allowed so little time, etc. Some, we know, have seen too much mortality in the course of their practice and have lost some empathy.

    Do I regret my husband being alive the past 10 years, instead of, possibly, gone because of raging prostate cancer? Of course not. He has been here, with his growing/now grown family; he has achieved much in his chosen work, and he has found fulfillment in many things … without sex, without me (because he withdrew from me). He helps me with things, we visit the children, everyone thinks he is the World’s Greatest Guy (and he still is, just not in all the ways they think he is), but there is an invisible wall throughout the house … do not pass, do not touch.

    What we have here is a huge failure to communicate (sorry, taken from a movie), and … few physicians want to do it.

    When my husband was diagnosed, he knew nothing about prostate cancer. I knew immediately: impotence is the main side effect. We read about various prostate cancer treatments available when he was diagnosed. Books and pamphlets and three or four consultations and so much pressure because of his particular situation … we were told: Make your decision now. As if in another 5 minutes the cancer would metastasize and it would be our fault for dawdling, and then … the point of no return. This, all implied, was certain death.

    Shock … He could not have handled it, maybe, if someone had said:

    “This medicine/treatment/protocol/surgery is good for what we know ails you now, but the immediate side effects and those possible over the long term are practically unforgivable. But you won’t be seeing me by then, so I hope you don’t have problems with any of the side effects I am cleverly minimizing.
    And, of course, I sure am glad it has not happened to me because I would probably go crazy, and this is my field.”

    Thank you for giving me a space to vent.

  20. Dear Amy, Anna, and Rabbi Ed,

    Such a sad conversation. Rabbi Ed, feel free to use my comments, but this is not my real name.. Anna, how I wish I knew you! Your life sounds just like mine. I might add that there is another women’s forum (, but it is so depressing I can’t even go there anymore.

    I was in a traffic jam a couple of months ago, and there, next to me, in his very fancy Porsche, was my husband’s surgeon. First I wanted to ram my car into his. Then I wanted to roll down my window and yell, “You broke my husband you &$=+/! and you wrecked our lives.” Irrational? I suppose, but there’s the daily anger.

    I’m even angry at a doctor that was doing a fellowship with our surgeon. He was Muslim, and was literally incapable of looking at me, answering my questions, or addressing my concerns. I remember like it was yesterday him grinning while telling my husband, “You may never have a spontaneous erection again, but, don’t worry, there are lots of things we can do to help you.” If I ever run into that doctor I cannot be responsible for my actions.

    The last time I went to an appointment with my husband, in the waiting room was a young (50s) couple, him with his catheter bag, her looking worried … and it made me so sad I started to cry and I had to leave. I just wanted to yell at them, “They won’t tell you this, but you’ll never have sex again.”

    I asked his doctor about the book, Saving Your Sex Life … (which I was reading, but my husband wouldn’t) and he blew me off by suggesting the author was in the pockets of the pharmaceutical industry. His treatment included virtually no penile rehab, and my husband was 100% on board with everything that doctor said. I often wonder if he regrets that now. (Of course we don’t discuss it, we don’t discuss any of it. …)

    My husband was my best friend, a wonderful father, loyal, honest, hardworking. We always had mismatched libidos, but I’d be able fix things with us if the dry spell lasted too long. This I simply can’t fix. I have too much resentment, too much anger, and frankly, I just don’t know how. My husband shows zero interest in me. Anna — you speak of the “wall” — oh, how well I know it! I moved into a separate room about a year ago. (He had surgery 19 months ago.) I saw a lawyer in February, and proceedings are under way, although I am still at home. Thirty years is a long time to love someone, and the guilt I can’t even describe, but I truly feel that I need to save myself because I can’t save us. I’m fit, attractive, very active, and I am just so lonely it’s unbearable. Maybe I’ll never find someone else … I know that statistics aren’t on my side … but I can’t live like this. We planned such a nice retirement, travel, maybe a new patio home, grandkids, … all seem hopeless now. The divorce will be financially terrifying (especially for me).

    My husband just seems happy that the cancer is gone (so far anyway). I’m even angry that he isn’t angry about what it’s done to us, as a couple. I’m angry that he doesn’t seem to miss me, and that he has consistently not listened to my concerns (especially early on when I was giving them voice). Now that I am leaving him he is angry — very angry — and upset, but not upset enough to come to me and hold me, or anything.

    Sorry for the rambling, everyone. Anna, my heart breaks for you. Thank you Amy for this forum, and thank you Rabbi for caring about the lives of those involved with this awful cancer.


    Amy wanted to just add a few words …


    Please repeat after me … “This is not my fault. This is not my fault. This is not my ….” and do this regularly and often!

  21. Hi Amy,

    Thanks for your remarkable comments and insights. … It’s an enormous relief to know that I’m not alone out there.

    I’ve got a question that’s kind of, well, intimate. I’ve tried looking it up, and only get poor “porn” responses.

    I’ve fallen (quite unexpectedly) in love with a dear friend of more than 20 years, who had his prostate removed 3 years ago. So far, so good. We’re a great couple, and sex is honest and lovely. Although rarely penetrative. That’s okay with us.

    However, now his PSA levels are up, and he’s opting for radiation therapy. That’s okay, too — we’ve talked about side effects, and we’ll deal with what comes.

    My big question is … although he can’t ejaculate, he says he still has a form of orgasm. I’m struggling with exactly what that means, and what I can do for him to keep that. If he can’t maintain an erection, how can I keep stimulating him? What the hell is this “dry orgasm”?! He’s terrified of losing even that, and I’m scared too. I’ve read the comments from the women above, and I feel such empathy for everyone — I don’t want to lose the man I’ve spent 40 years figuring out that I adore. I’m worried that it was sexual attraction that got us to where we are, and that if he loses his libido completely, he’ll lose interest in me, too.

    When we first struck up a very close relationship (some months back), he was quite resolute about not going through with more treatment, given the side effects. He seemed fatalistic. He’s only 50, and couldn’t seem to face the possible impotence and incontinence. Then, as these things do, we became intimate and more — and it’s given him the spark to continue with treatment, and side effects be damned!

    I’m just frightened, I suppose. … What happens from here? What is radiation treatment going to do to him? How can I continue to be sexually intimate with the man I love, and is that even possible?

    Well, thanks for listening. Any advice is welcomed.



    Amy replied:

    Dear G.:

    So first let’s deal with the “dry orgasm” issue. Here’s a link that may help you to understand what’s going on.

    Second, even if your friend becomes unable to have a physical erection (they all do in the end you know … men, I mean), this does not necessarily stop him from experiencing orgasm. So you can stop worrying about that one!

    Which brings me to the key point. None of this is about “sex”. It is about the actual intimacy and the ways you find to give each other pleasure. As you have clearly discovered, what appeared to many of us to be the key issues when were were 18-20 years old should have long been bypassed by an understanding that intimacies come in 1,000 different forms. Of course you are frightened by the idea that what seems to have been working for you both might vanish overnight … but I don’t think it will, and even if it does, I will bet that you both have the imagination to come up with new forms of intimacy.

    Intimacy, like life, is a journey. It comes with exciting surprises and unexpected shocks and periods of routine sameness that need to be overcome! So I would suggest that rather than worry about what might go wrong (which is, of course, a very natural thing to worry about), you focus on how to expand the current levels of your intimacy, with a specific focus on things that will still be fun regardless of what happens after the radiation.

    Oh … and there is one thing that is not allowed. Neither of you is allowed to retreat into gloom and self-pity. The occasional bout of feeling sorry for oneself and sulking on the sofa is one thing. Making that a habit is where the line gets drawn. That habit is unacceptable for all concerned! Recommended treatments include severe tickling with the nearest feather duster and other things I shall leave to your imagination!


  22. Hi Amy.

    I have read through all of the questions and answers posted. Not only am I now terrified, I am sooo sad.

    My 44-year-old husband was just diagnosed with early stage prostate cancer. The urologist said we could consider radiation seeds or prostatectomy and, being a surgeon, he would recommend prostatectomy. My husband has struggled with ED the last several years. He takes SSRIs and when we got tests back his testosterone level was 200; that and his prostate is enlarged to 36 grams. We were hoping the urologist visit would help us to fix the intimacy issues but now it looks like things are about to get much worse.

    If we elect the prostatectomy, are we pretty much guaranteed no sex life? Do we run the same risks with radiation seeds? I know some women are fine with “other things” but I have been living with half erections and sex maybe five times a year. We were looking for a cure for ED and now I feel lost and honestly angry at the prospect of not having sex again or for a year or more. I feel so selfish but we are still so young I am not ready to give this up and no, “other things” won’t cut it for me. Would you say more people that have had this procedure would say no don’t do it try something else like the radiation seeds? Am I overreacting and is the likelihood of him being fine a good percentage? If he has the prostatectomy, wouldn’t the removal of the enlarged prostate holding him back from erections now be gone? If he has that, really, how long till we could have good sex again? I know this is a lot but I am stressing out just a little.


    Amy replied:

    Dear Stephanie:

    Of course you are feeling lost and angry and “stressing out just a little”. Let’s see if we can clarify some of the issues.

    First, you are dealing with two quite different problems here: the ED and the prostate cancer. The most likely reason for the ED (a low testosterone level) may well not actually be connected to the reason for the prostate cancer. However, giving testosterone therapy to a man who has been diagnosed with prostate cancer is a very controversial subject (and there are arguments for and against this in specific types of patient but giving testosterone therapy to you husband at the moment is not something anyone would be likely to recommend).

    Second, responses to the various forms of treatment for prostate cancer are very individual for a whole variety of reasons. For example, younger men are much more likely to recover good sexual function after any type of treatment than older men, but — without some other form of treatment that is specific to your husband’s ED — treatment for the prostate cancer is almost certainly not going to improve his ED or his sexual function.

    So the two key factors here are going to be: (a) how to deal with your husband’s prostate cancer (which also depends on how aggressive his cancer is, and you haven’t mentioned any of that) and (b) what could be done after his prostate cancer treatment to optimize his ED/sexual function?

    I can’t lie to you about this. It is a really complex problem and there are no easy answers. What you both need more than anything else is some really good advice from an expert in male sexual function who also understands the implications of your husband’s diagnosis of prostate cancer. There are a rather small number of these specialists, and so a lot depends on where you live and whether you are able to identify someone who can help you. There are certainly, for example, such individuals in major centers on the East Coast like Boston and New York and Baltimore.

    The other thing that may be relevant here is the size (volume) of your husband’s prostate. If it weighs 36 g then it is about three times heavier than the average “normal” prostate, but when it comes to treating prostate cancer with radioactive seed implantation (brachytherapy), it is usual to make sure that the prostate has a volume of 45 cc or less, which seems unlikely in your husband’s case, and this has implications about whether brachytherapy is even a real possibility for your husband unless he was to have androgen deprivation therapy (ADT, also known as “hormone” therapy) beforehand to shrink his prostate … and that comes with another series of potential issues.

    I know you are feeling selfish in asking all the questions you are asking, but what you are actually being is realistic. By being able to ask these types of question, you are accepting and facing up to the truth about what is going on, and of course that isn’t an easy or comfortable thing to do … but it is not selfish. I can’t answer all your questions for you because, as I said at the beginning, responses to treatments for prostate cancer are so individual and your husband is relatively young. However, there is one thing that I can tell you: I do know of couples in whom the man had a penile implant after treatment for prostate cancer for whom this was extremely satisfying for all concerned. This is a radical solutioon to the problem … and I am not suggesting it is the only one by any means, but …

  23. I started my treatment on February 2013. My doctor put me on a shot every 4 months and a pill which I take every day called bicalutamide 50 mg. So far I have no side effects. In October 2013 I had my PSA taken and it was undetectable so my doctor told me that if the next time he sees me, in February 2014, the results are the same he will take me off the treatment.

    I am confused because I have heard that when you start hormone therapy you should be always on it (better results for the future) and on the other hand you should take breaks when your PSA is very, very low. As I stated above, my doctor wants to take me off the treatment if my PSA is undetectable. I told him my thoughts and he said, “I will take you off the the shot ” and then I told him how about the pills and he said “If you wish you can continue taking them … it is your decision”.

    So my question is, will I gain better results if i continue taking only the pill even though my PSA is undectable? So is “start and stop” hormone therapy as effective as continuous therapy?

    Thank you


    Dear Jimmy:

    I see that you have already asked the same question on the InfoLink social network, and that the sitemaster had responded to your question.

    I am sorry but I really can’t provide any better guidance than what the sitemaster has already offered you. There really is no “right” or “wrong” here.


  24. My husband and I are in our late 50s and have been married for 8 months. He had prostate cancer surgery about 3 years ago. So, I never knew him as “normal”. There is an openness between us in companionship, and we connect spiritually, mentally, and are active socially. However, although, at first, he was attentive to me emotionally and physically, he is not so much now.

    We used to talk on the phone for hours and hours before we were married … we dated for about a year … and he communicates well when he wants to. When we got engaged, he said that we would work together on how best to make love once we were married … that he would go to the doctor and see what could be done. He has not pursued it.

    He’d told me that his erections are weak, which I found to be true, but he does have some response. He enjoys oral sex and is pleased with how I please him. But he tells me that he doesn’t necessarily have the desire and can go indefinitely without it. Although our frequency started off nominal, it has dwindled off even more. No matter what I do, he does not respond to me … and basically just sidesteps any talk of sex. If I bring it up lightheartedly to not pressure him, he still avoids it by just making a little joke about it. He has had some pain issues with his back and he blames the infrequency on that, although he is active in work projects that are physically demanding and will work even when he is in pain.

    I’m a giving, loving person and enjoy sex. He knows this but doesn’t seem concerned that I’ve got higher than normal desires even though he has almost none. It seemed at first that he was going to be attentive to me. Yet, it has been almost 2 months since he has even touched my body in a sexual area or way. He holds my hand and gives me kisses, but that’s all. It has caused tension because he will not talk about it. We had a “discussion” the other night that turned sour because I am so disillusioned about this wall I feel between us. Although we spend a lot of time together, he is constantly distracted with business e-mails or the dog or work around the house.

    I think, in his mind, we have “us” time, but to me, we do not. The lack of emotional intimacy and romance are harder to deal with than the lack of sex. I’m so confused because he tells me he loves me all the time. But I don’t see how we can build a marriage on such a limited scope. Before you suggest it, he would never consider counseling … He had tried it before and said that all he did was hear himself talk with no feedback from the counselor.


    Amy replied:

    Dear Debbie:

    You write that “There is an openness between us in companionship, and we connect spiritually, mentally, and are active socially.” However, it seems clear to me in the rest of your message that you and your husband are not, in fact, connecting mentally about something that is extremely important to you. He is either not hearing or not responding to your expressed need for greater intimacy.

    Without wishing to be disparaging, men tend not to experience the same level of need for intimacy as women, and so they tend not to recognize its importance to the women in their lives. They also tend to miss the distinctions between intimacy and sexual activity. (Not all forms of sexual activity are necessarily intimate, and not all forms of intimacy involve sexual activity at all.)

    What you seem to be missing (if I am hearing you correctly) is his simple attention. He made time to give this to you when you were courting, but now that he has “caught” you, he doesn’t recognize that he needs to maintain the process of constant re-courting in order to keep the sparks flying.

    There is, of course, no simple solution to the underlying difficulty unless the pair of you can find a way to get past this problem. It is a communication problem that is affecting your ability to “couple well” emotionally and also physically. He is sending a message that he “isn’t interested”. He may be receiving a message that you are “demanding.” And probably neither of you intend to send these messages to the other. It so easily becomes a vicious cycle.

    So what to do?

    You both need to to start “dating” again. With each other. You need date nights. You need to go dancing or to go to the movies or do together whatever it is you like to do in common. You need to be able to flirt with each other. He needs to walk away from his work projects every so often and give you his undivided attention. You need to find ways to make him want to do that — and those ways very likely don’t necessarily involve sex — although ideally they will lead to a recognition on his part that sexual gratification is important for you.

    Is any of this helping?


  25. Dear Amy,

    My father recently let us know that he has prostate cancer. It is Stage 1 and his prognosis is very good according to his doctor. He has decided to have his prostate removed, which, according to my mom, is the best option for him.

    Can you please give me advise on things I can do for my dad to keep his spirits up and remain positive? I don’t know what to expect and I am trying to stay positive myself. Of course my initial reaction when he told me was of shock and high emotion. Now that I have processed the news I want to give him the best possible support. Unfortunately, I live in another state than he does but I want to send him care packages. Also, do you know how long after his treatment will he be able to resume his normal activity?

    Thank you,



    Amy replied:

    Dear C:

    Thank you for the excuse to stop cooking for 10 minutes! It never seems to stop at this time of year!

    So it is very hard for anyone to tell you things like “how long after his treatment will he be able to resume his normal activity.” Why? Because this will depend on a whole bunch of details, including, for example, the precise nature of his cancer; his own personal anatomical details (big prostate or small prostate; narrow hips or wide hips; etc.); his age and general physical health; the skill and experience of his surgeon; and more. However, what I can tell you is that most men do just fine; that they recover relatively quickly from the surgery today; and that complications are generally a lot less serious and a lot less common than they were 20 years ago.

    With regard to dealing with your Dad and the care packages, etc., my suggestion to you is that you let him “call the shots”. He and your Mom appear to feel that they have this under control, and your Dad (like most males) is probably going to want to just “get it done and move on”, so you need to be cautious about over-communicating about all this. You might do better to see if you can “set him a goal” without making it too obvious. For example, if he knew that you and any grandkids might be coming to see him in about 3 months time after the surgery, then he would (presumably) be highly motivated to make sure he was well recovered by then, and in the meantime you could simply ask your Mom if there was anything she needed help with and ask your Dad how he was doing, without making too much of a big deal about it.

    If your Dad has Stage I disease, he is generally in good health, and he has a good surgeon, he should do fine, especially if he has a positive attitude to life. The best help you can probably give him is your complete confidence that everything will be fine, and that you expect him to be back to doing all the things he normally does within a few weeks after his surgery.


  26. My husband had prostate surgery in 2008. The urologist told us that he had spared the nerves, and after about 2 months we did have intercourse, although my husband was very aware of the length his penis having been shortened.

    Since that point in time, he is very self-conscious of urine leakage during any sexual activity. I think he is frustrated, and no matter what I say or do he is private about this and we are now celibate and have been for about 4 years.

    We have been married since I was 18 and he was 21, we are both in our 60s. I love my husband, he is my best friend and I wanted him alive, first and foremost. I expected sex wouldn’t matter as long as I have him and, truthfully, if that is how it has to be, I can live with that. But, I am so lonely, he has just emotionally abandoned me. He sleeps in a different room cause his back hurts, he watches TV half the night till he falls asleep. I work all week, so I am gone all day; he is on disability for his back and other issues, but he is never still. He builds, cleans, cooks, etc. He has dinner for me every night, whether I want it or not.

    I know he is trying to make up for what he thinks are his shortcomings, and I get that, but I would just love to have him hold me in his arms and cuddle or kiss. There are other sexual things to be done, but he has just totally turned his back on any of it. I think he feels that a man without a functioning penis is useless to the world.

    I feel bad for him, but I can’t seem to make him understand that that isn’t all there is. He just shuts me down, and I truly feel lost without him. I want my husband back emotionally. I would never cheat on my husband; I know he had a big fear of that when this first surfaced, but that isn’t my style. However, I need someone to hold and hug and kiss me, not just go about life as if we are roommates. Does anyone have any suggestions? One time he mentioned the pump, but if he isn’t going to have any sensation from it, I don’t want him to undergo any more surgery. He tried the vacuun but said that was too painful. The pills don’t do a lot. I think the “use it or lose it” factor may have been true, but I guess he is past the “lose it” option.


    Amy replied:

    Dear Debbie:

    I so often hear of stories like yours, in which the man seems to associate everything about his masculinity with the ability to have sex as though he is still 20 years old, and he utterly ignores and negates the importance of forms of intimacy that have far more to do with empathy, touch, conversation, and shared activities other than sex.

    At the end of the day, this is all about honesty in communication between the partners and about mutual understanding for each others’ needs and “happiness factors” and a determination to meet those needs. Obviously, no one else is going to be able to make that “happen” for you and your husband, but maybe I can tell you some things that may be important.

    First, I suspect that your husband may be suppressing enormous anger about all of this … and for all I know, you may be too! When I was younger, and I was angry, I used to have those old, cheap, orange pottery flowerpots everyone used to use, and I would take half a dozen out and throw them really hard against a brick wall so that they broke in an enormously satisfying manner! And I would tell anyone who saw or heard me doing it exactly what I was angry about. I haven’t had to do this much recently … but I still have some of those flowerpots out in the garage, just in case! Maybe you and your husband need to do something like that together! Many of us aren’t too good at sharing our anger with others and so we suppress it to the point and which it becomes truly destructive,

    Second, you are obviously both trying really hard to please each other by substituting “doing things” for honesty. I am no psychiatrist or psychologist, but I know enough to know that this is only a “temporary fix”, and you clearly recognize this too, but maybe your husband can’t see that yet. I’m not sure what to do about that … but “something” does need to be done.

    Third, I think you and your husband need to start “dating” again. You need to go on “date nights”. You need to find something you’d both like to try doing and go do it. You need to “break the routine” so that you can find new things to share and enjoy together and laugh about together, so that the intimacy can come back into your marriage without having to be associated only with sex.

    Finally, maybe you need to just go into your husband’s room one night and ask him to turn down the TV a little so that you can sleep, but tell him that you just don’t like sleeping alone ‘cos you like to be near to him. It may take a little adaptation on the part of all concerned, but it may also be worth the effort.


  27. Dear Amy,

    I hear myself in so many of these comments. I am also full of anger. If I had known about prostate cancer, I would never have married any man. I wouldn’t have allowed myself to love one because what I have left hurts too much.

    My husband was 42 when he was diagnosed with Stage II prostate cancer; his PSA was 4.2. The doctors immediately sold him on a robot-assisted laparoscopic prostatectomy. They made it sound like he would be back to his old self in a few short weeks. A cakewalk they said. Don’t believe them. They lie.

    I did months of research prior to surgery and even talked with the doctor about watchful waiting but his mind was made up. When he told me the surgery date I began to shake. Never had I felt such out of control rage. I wanted to kill that surgeon. (Still do.) I knew surgery was wrong. KNEW IT!

    My research was to no avail. My husband had really made up his mind within minutes of hearing the doctor’s sales pitch. I pulled myself together and tried to support him. I was wrong. I should have fought, but in the end it’s his decision to make; we are just along for the ride.

    The day of the surgery was the last time I ever saw the man I once thought I knew so well. That was 19 months ago

    BTW … None of the drugs worked; the pump was painful. (They only gave him about a 50% erection.) The shots worked but freaked him out. He did it once and did achieve a 100% erection that lasted about an hour. (Which can be adjusted.) That was a couple months ago. At the time I was just happy the shot worked and I thought we would work through his needle phobia. That hasn’t happened.

    I asked if he still has desire and sensation. He says yes, but he does nothing about it. At least, not with me.

    He also goes to the gym and has tons of hobbies. I tried to fill the loneliness with hobbies but it didn’t work. I have tons of half-finished projects that just remind me of the quality of life lost. I can’t say “we” because he seems OK with what is left.

    When we go to bed he puts on earphones and watches videos about whatever the hobby of the day is on Youtube. I pretend to watch TV. Every time he opens his tablet I want to cry. … I have cried. He never noticed.

    He went from someone that was always touching me, hugging me, holding my hand, etc., to a stranger that avoids me. I haven’t complained. I’ve told him we will work it out. In retrospect I should be screaming.

    We married young and both our children are now away at college. I was a stay at home Mom. My life was my family. Now, I have no one. I’m alone always. Even if he’s here. I feel invisible.

    Men are so stupid. STUPID! It’s not about the sex. How many times do we have to say it?

    I don’t even care about the sex as much as the hugs and hand-holding and him just talking to me.

    I think I was sentenced to solitary confinement for life.

    Newly diagnosed … Beware doctors; they have money to make and fancy toys to finance.

    Yes, I’m bitter.


    Amy replied:

    Dear Caty:

    Of course you are angry, and of course you are bitter. … I am so sorry. … I hear every word you are saying. … I wish, … how I wish … that I had something — anything — really intelligent to say in response.


  28. Caty,

    You just broke my heart. So many of us partners of prostate cancer victims either are living that, or were living that but left.

    I have no helpful advice. It sucks. Eventually you will decide to either sacrifice yourself or give up everything you’ve known. The worst part is that all the burden of that decision will fall on you, no one will be able to relieve any of it.

    A million hugs to you honey.

  29. Caty,

    I’m a wife of a 45-year-old who was diagnosed with prostate cancer a year ago. I’m dealing with the same heart-break as you.

    My husband underwent the same surgery and after the 6-month waiting period he started taking shots for an erection. They worked very well; too well! He would have an erection for 4 hours at times, no matter how he adjusted the shots. As a result, he got scar tissue on his shaft. The doctor insisted on an implant and said that at the same time he would clean out the tartar. After another long waiting period, we tried having intercourse. It was a total failure and has formed an invisible wall between us. This has taken a toll on our emotions. We love each other deeply and are best friends, but I’m like you. Wives are the forgotten factor in the problem of prostate cancer. We need a support group.


    Amy replied:

    Dear Becky (and Caty and others):

    There is an organization specifically for wives, partners, daughters of prostate cancer patients called “Women Against Prostate Cancer“. And it does have local chapters in some states.

  30. I noticed that my husband’s penis has shrank. I kept telling him whenever we made love but he kept ignoring me. … I noticed he spend much time in the living room and come to bed late when I am fast asleep likewise before when we both go to bed together. Then 2 months later he told me he has prostate problem. I said to him jokingly, “Did you have an affair?” because he said when he urinates is very painful. He is currently talking some antibiotics; he had a scan.

    So does it mean we no longer can have sex? Or our marriage is over?


    Amy replied as follows:

    Dear Ma:

    I suspect that your husband is upset and very worried. It is not entirely clear what his problem is from what you have told me. He might have an infection of some type (and that does not necessarily mean that it is a sexually transmitted one). Or he might simply have an enlarged prostate, which is giving him problems with urination. If he is over 50, the second possibility is very common.

    I also think you and your husband need to talk about this problem so that you both understand what is going on. Why? Because the problem is already affecting both of your sex lives and you need to have a shared appreciation of exactly what the problem is, what can be done about it, and how serious it is.

    Is your sex life over? I can’t answer that question. It depends on all sorts of things, including exactly what the problem is and whether it is curable. What I can tell you, however, is that failure to be able to communicate honestly with each other about a problem like this can have very real effects on marital relationships, … and men have a very hard time talking about health issues that affect their sexual capabilities. Your husband probably needs your help.


  31. Dear Amy:

    I have been dating a man for about 15 months. He proposed after 9 months. I accepted. This month he was having severe back pain and needed to go see a doctor. I suggested a spine specialist as I do not believe in messing around and to get to a specialist. He went after a lot of convincing. They took an MRI and yes he has prostate cancer. It is level 4 (PSA of 266) and is attached to his pelvis, lumbar region, spine, both femurs, shoulder, and there is a mass on his kidney. This has all been confirmed with a CT scan, a PET scan, and a biopsy of the prostate. He admitted to me and the doctor that he suspected there was something wrong for the past 10 years! Yes, 10 years! I feel deceived. I feel that if he “suspected” something was wrong he should have got it checked out before dating someone, let alone proposing marriage. Am I crazy for feeling this way? I do not think I can trust him, and I have called the wedding off.


    Amy replied:

    Dear Judi:

    Are you crazy for feeling the way you do? No. Your reaction may be a little extreme, but it isn’t crazy. You were deceived, although I very much doubt that it was deliberate. Men just tend to ignore health issues until something really serious happens. They are male after all!

    I suppose the only other important question here is how you are going to feel after you have had the chance to get over the initial reaction. Are you just going to be able to walk away, or do you still love him in spite of the stupidity of not having addressed a health problem that was more serious than had ever occurred to him? You don’t have to marry him. And since he is probably already on some form of androgen deprivation therapy, you can forget about a normal sex life. But seriously, can you just walk away?

  32. Hi Amy.

    I agree with your assessment of Judi’s fiance, who was on a self-denial kick until push came to pain. However I can’t help but wonder why you stated that “since he is probably already on some form of androgen deprivation therapy, you can forget about a normal sex life.”

    I sincerely doubt that any of us prostate patients or survivors who have been through androgen therapy should “forget about a normal sex life.” Speaking as a prostate cancer survivor, and as an AASECT-Certified Sexuality Counselor and Intimacy Coach, I need to remind fellow survivors and their spouses that it’s up to us to develop a “new normal”. I’m convinced we can do so by redefining what we mean by “a normal sex life” and what we mean by “sex” itself.

    I have some specific ideas, including those in my Kindle book, Reigniting Intimacy and Sexuality after You’re Ill. This, includes the notion that sexuality need not goal-oriented with undue emphasis stress on male and female orgasm.

    Thanks in response to you.


    Amy responded:

    Dear Rabbi Ed:

    In no way did I intend to deny the possibility of a “new normal” when it comes to one’s sex life for those who have been able to accept and adapted to the realities of ADT. However, in Judi’s case, based on what she is clearly experiencing, what I had carefully stated was that the she could forget the idea of a normal sex life — something that a recently engaged couple, shortly to be married, might have expected during a honeymoon period and for a significant period of time thereafter. Before anything else is going to happen, Judi and her fiance will need to find a way to get through the acceptance and adaptation phases (if that is going to be possible for them).


  33. No, I am not walking away; I will still be here for him. We have not had sex by the way; we were waiting for marriage before that occurred. So I suspect there just will be no sex, period.


    Amy replied:

    Dear Judi:

    I think the important thing is going to be for you both to take one day at a time for a while. You have both been given serious shocks to the system: him medically; you emotionally. It is going to take a while for you both to decide where you want to be as you work your ways through this.


  34. Dear Amy,

    My husband had prostate surgery 2 years ago. He was left incontinent and impotent. With support from his doctor he was able to use injections to help his impotence some and we were able to have sex, but it was not easy. In March he was told that his PSA was rising (to 0.4 ng/ml) as he now has a recurrence.

    Due to all his side effects, he has made the decision to do nothing more for treatment. Although this has been difficult for me, I understand it is his body and his choice. Since then he has distanced himself. He just revealed to me that he has been unhappy in our marriage, that he has been living my life, and things are going to be different. He said I may not like it and I may want to divorce him but he doesn’t want to divorce me yet. We had established plans for our future. He retired in August and moved to Florida in October to find a place for us to live during the winter. I needed to finish another year of work so I have been up north, retiring as of June, and I have sold my home and planned to join him in Florida this October. We have a summer place here and planned to spend summers here. He had said we will have no sex and now claims our sex was never good. He never communicated this before and up until March he expressed his love and affection to me at all times. I visited him twice over the year in Florida and he was here several times. There were no signs of his discontent in our marriage. The carpet has been yanked from under me. He still acts like my friend, but unless I reach out to him there is no communication. On one occasion he told me he loved me. He is returning north in 2 weeks because he wants to come help me move from this home and to go to my retirement dinner and a wedding we have. Is this a protective mechanism he is using? Is this a form of depression? I feel so helpless because I don’t really know if I can live with this rejection. I plan to fight through this as long as I can. I was wondering if you had any advice or knew of anyone who has lived through a similar situation.




    Amy’s response:

    Dear Dotty:

    Men can be very odd, and I am not sure that I have anything very intelligent to offer in response to this set of events.

    The sense that I am getting from what you have told us above is that your husband seems to feel he has failed to achieve what he has always seen as certain goals in his life. … Whether these goals were ever reasonable or achievable or not is a whole other question.

    When one feels like that (rightly or wrongly) one has a tendency to ascribe a certain amount of the responsibility for the consequences to others. For example, your husband’s statement that “sex was never good” between you seems to ignore the fact that he may be the responsible party for that problem. (I’m not saying that either of you actually is the responsible party, but if it never came up before, how was anyone meant to know? And for all I know, you may think he wasn’t that good at sex anyway, but you are too much of a lady to say so!)

    It does seem very likely to me that the combination of his retirement, the prostate cancer, and the recurrence has driven him to think that if he does want to meet some of those other goals in his life, then he has to go and just do whatever it is he wants to do. And he doesn’t want you to get in the way. Why he needs to make you feel guilty about it too, I am not sure. He may think that he needs to “explain” in some way. However, sometimes the explanations are more like justifications … and not very good ones at that.

    It also seems very clear to me that your husband is very torn about what he is doing. On the one hand he is telling you that he wants to make significant changes in his life; and he clearly appreciates that this will have significant impact on your life. On the other hand, he seems to want your approval and your blessing in an odd sort of way.

    Frankly, I think you are entitled to be furious with him and find a good lawyer to make sure you get every penny you can out of a divorce settlement. If he hasn’t been living the life he wants to live now, and hasn’t had the guts in the past to talk to you about the fact that, from his perspective, he had been “living your life”, that’s not your fault. That’s his. Why on Earth he should think that you would be happy to accommodate this, I cannot imagine.

    I don’t think you need to necessarily become bitter and “bitchy” to him about all this. However, my concern would be that unless you start to deal with this problem now, what will happen is that you will cede to him a lot of your joint property, leaving yourself with no husband and nothing like the resources you were hoping to retire on, while he continues to see you as some sort of “friend”. (You won’t feel that about him if this happens!)

    I know that at the moment you feel misled and betrayed and all the other things that happen to women when men suddenly pull this sort of stunt. However, the bottom line here is that he isn’t being completely honest with you. If he was being completely honest with you, he would have told you that he just needed to do something completely different with the rest of his life, and to do that he needed to make sure first that you were going to have what you needed to live the rest of your life in the way that you had reasonably expected.

    However good looking, charming, friendly, and everything else he may have been for the past 30+ years, it is clear to me that he is walking out on you (at least mentally). You are going to need to accept that and move on with the rest of your life. But you need to make very sure that you will have the resources to do that in the manner to which you have very reasonably become accustomed. I don’t see this as a “rescueable” situation, and if it isn’t rescueable, then one needs to cut through the Gordian knot as fast as possible and find ways to make very sure that you can enjoy the rest of your life by doing what you want to do with it. So … Ask yourself this: If you don’t have to spend the next 20 years watching your current husband do a whole bunch of the things that already annoy you about him, as well as some new ones you don’t know about yet, then what are some of the things that you would really like to do instead? Do you really even want to move to Florida at all?

    Not very helpfully


  35. My husband has prostate cancer and is sulking as he has ED. It doesn’t bother me as I have had the menopause, but he keeps on about having sex — which is a waste of time and effort as he can’t keep a erection for long enough.

    I really don’t care. We have been married for 35 years. I just want him to fight the cancer and all he cares about is sex. He is 61 and I am 59. He is going to have radiation treatment. Which one is the worst as regards ED and for taking all the cancer away? He is a big man of 18 stone (250 lb), and he smokes, drinks, and eats too much. It’s like he doesn’t care and I’m so fed up right now.

    Sorry to vent … He doesn’t even think about me; won’t even talk. I live in the other room. He has no hobbies or work — although he did work from age 15 to 60.



    Amy replied:

    Dear Sylvie:

    I feel for you. Your husband is living in a self-deluded world — one in which he is still phenomenally handsome and attractive to all women and his sexual prowess is unreproachable! Alas, neither of these appears to be entirely true, and he isn’t even trying to do much to foster the illusion very effectively!

    What does one do in these circumstances? Well, ideally one just laughs at him and tells him that he hasn’t been coming across as Casanova in quite a while now, and that his sexual prowess leaves a lot (everything?) to be desired. Of course when one is dealing with a male who has no capacity to laugh at himself, this can be a risky strategy … particularly if there is any history of abusive behavior.

    The best way to treat his cancer depends on how aggressive it is. If it is really aggressive then surgery is usually wisest (and then he really would have a high likelihood of lifelong ED). On the other hand, if it is less aggressive, radiation therapy is perfectly reasonable, and it will increase his ED over time, but not immediately.

    The real problem here, however, is not the ED or the cancer. It is that your husband has stopped working and has no external motivation to do anything to make himself interesting and helpful to others. What did he think he was going to do when he retired, sit around the house while you waited on him hand and foot for the next 20 years? Can’t he apply the skills he acquired over the past 45 years to help others? He doesn’t have to do that 40 hours a week, but it would help him to get his butt off the sofa and outta the house! The hardest thing for many men to do once they retire is actually to discover what to do with all that time they now have on their hands: it’s time he could use to help others less fortunate than he is.

  36. Greetings Amy;

    How do you learn to live without sex and very little touch?

    My husband is 68 and I am 55; he is a wonderful man whom I love very much and we want to continue living our lives together. We have been together for 12 years, which began with us both having similar sexual needs. About 6 years ago he started losing the ability to stay erect as long and sex went down to once a week to once a month in a 2-year span; the following 3 years it went to once a year. During this time I was trying to be supportive and to let him know I still love him, but I wished he would go to the doctor to see what was creating the issue, with him always saying “Sometime soon.”

    At this point, one morning, I was getting ready to go to town he stated his loving statement he said each time I went to town” “Hey Chick, you’re getting all sexed up. You’re not taking your love to town are you?”

    This time my response was different, I just sat down and started crying and told him that no I wasn’t, but I think about it because I miss sex so much and that I was so angry at him for thinking I was not worth enough to him to find out what was wrong. I still have the image of his face when I said that to him. When I got home he had made a doctor’s appointment and 2 months after that he was having robotic surgery to remove his prostate.

    It has now been 18 months and he takes Viagra every day without any difference. He also has a pump that he has never gotten out to try with me. He has tried it when I am not home and he said he doesn’t like it. I asked him if he would consider getting an implant and he told me that as long as he is having urine leakage he doesn’t want sex of any kind. I told him if doesn’t want sex I understand, but that I need sexual touch still — even if he just one gave me one orgasm any way he wanted maybe once a week. His response is he understands, he will work on it, and his famous last word I have begun to hate — “Sometime soon”.

    Since the surgery it is not just sex that is non-existent. He was never a much of a touch person, but now we have no touch and none of our fun sexually commits. I feel like a piece of me is dying. I do okay for a while and then I get so sad. I give myself an orgasm all the time in the tub and I used to invite only my husband to my vision images. Now I never invite him into my tub (in my head) I envision other people. It is taking every piece of my strength have not to have a sexual affair.

    If it wasn’t for the fact that I am a Christian, I almost did last week. I feel so incredibility wretched, I couldn’t even take communion last Sunday. It was not because I haven’t been praying to God for help and to keep me strong; it was because I couldn’t totally give it to God because what if the answer meant I may never have sex again in my whole life.

    We have a good life together. We like the same things; we have a business together; we have horses that we both enjoy; and even though we are both in a second marriage our children have blended well and have given us grandchildren that we love so much. So, back to my question: How do you learn to live without sex and very little touch?

    Thank you,



    Amy replied:

    Dear Jan:

    This is going to be really horrible to have to say, but the answer to your question (at least from my point of view) is, “You don’t. You only learn how to endure it. And it’s very, very hard.”

    If your husband was losing his erectile and sexual capabilities before his radical prostatectomy, there was never really going to be much chance that he would be able to recover them after the surgery. However, that is no excuse for the lack of closeness and sexual touch and understanding of your needs. I have no idea why this is so hard for so many men to understand, but apparently it is.

    We are all, of course, very different in our sexual needs. Some couples are able to talk about all of this and work out ways to keep everyone happy. Other couples seem to be unable to talk about any of this, and you only have to read back through some of the other questions and comments I have received in the past to see the consequences. You and your husband seem to be stuck somewhere in the middle: you can talk about it when it gets stressful enough, but he doesn’t seem to be willing or able to actually do anything about it.

    I can understand that the Viagra may not work for him. I can understand his dislike of the pump. I can understand that he is less than enthusiastic about a penile implant. I can’t understand why he doesn’t know how to whisper sweet nothings into your ear while helping you to have gratification. That shouldn’t be so hard. Especially since you have clearly told him you’d appreciate that.

    Maybe the next time he pulls the “Sometime soon” stunt, you need to be more assertive and simply say, “No. Not sometime soon. Sometime now!” And then take him upstairs to the shower or the bath or the bedroom or wherever and grin broadly and say, “Come on big boy. Give me an orgasm. And make it a good one, Please!” He does seem to be able to “get the message” when you are blunt enough about it.

    And then there is the other half of the equation. Do you know if he is still able to have an orgasm — even if he can’t get a good erection any more? Maybe you need to ask him … and then help him to have one. After all — fair’s fair!

  37. Dear Amy;

    I have tried the “Sometime now”. It doesn’t work so well; then I feel completely rejected. I even tried “Don’t do anything at all, just watch” (which use to be his big turn-on) and he just closed his eyes and fell asleep, which left me going to my tub where anything I think or do feels safe. The only thing that has worked on that note is I jumped on top of him when wasn’t expecting it and let him know I was borrowing his leg for a while. He started to stop me and I let him know he couldn’t have his leg back until I was finished. That ended on a good note ….

    I would give him all the time in the world to take care of any of his wants or needs and he knows that; he doesn’t want me to touch him anymore. He used to love for me to give him a body massage and doesn’t even want me to do that now.

    He says he cannot get any erection at all unless he uses the pump. He was able to have an orgasm; however, urine came out and he can’t get past that. He has bladder control to a point, but he has a non-stop, constant drip which depresses him. He still gets up 4 or 5 times a night to use the bathroom, so he is never fully rested.



    Amy replied:

    Dear Jan:

    It sounds to me as though the basic problem here is two things: (a) the failure to recover good continence after surgery (which he ought to be able to accomplish with the help of a good physiotherapist who specializes in continence problems, and (b) depression, which is a consequence of tiredness as a result of his poor sleep.

    He has clearly lost his sense of humor … but then depression and lack of sleep (combined with a sense of sexual inadequacy) is likely to do that to anyone.

    If you could find a way to persuade him and help him to do something about the continence problem, then he might be able to get over the related tiredness and depression. I’m not suggesting that he’s ever going to become Lothario again, but if you could help him to get a sense of humor back, he might at least be able to laugh with you again (at himself and with you).


  38. Hi Amy,

    I feel a glimmer of hope in finding this site and your answers page here.

    I’ll try to be brief.

    My husband was 46 when he was diagnosed with prostate cancer. This was 25 years ago. He had a radical prostatectomy in 1989. We were married 2.5 months later. I was 24 years old.

    I really didn’t know what I was getting into. I had no clue what the consequences of the surgery would be, but one side effect was clear: impotence. He was really worried about this, naturally, and I was concerned.

    About 2 years after the surgery, his PSA was going up again and they recommended radiation treatment. We agonized over the decision because it was made clear that the radiation would likely negatively affect his ability to get an erection. He went ahead with the radiation.

    Ever since, it has been a battle. We have had hours-long sessions where we carve out time for each other and he struggles to get an erection hard enough for sex. When Viagra came out, I thought it was the end to our issues. We tried it numerous times, but he said he didn’t like to take something systemically. It was stuffing up his nose as well. ;)

    I went through a bout of depression (still have issues there) that I’m sure were from dealing with all of this alone — can’t really talk to your friends about this! I saw a therapist who told me about Muse. Well, we used that satisfactorily numerous times, but he didn’t like having to insert it. It’s expensive too … so that one got checked off the list.

    About 8 years ago, his urologist (who he does not see regularly) told him about a pump. We had tried them way back when they were not as good. He practiced with it a lot but then was irritated that the rings you have to buy are so expensive.

    I feel like I have been the one trying to find a solution and I hear him coming up with excuses or objections to every solution.

    At the same time, I’ve realized that he is sarcastic often and some of his behavior I see as controlling. He says he’s always been sarcastic. I say that a lot of the things he says are meant to hurt me and that he has a lot of anger over the situation.

    I realize that I have shut down my sexual feelings. I also feel hurt a lot by things he says or the way he says things. Five years ago, after he made an advance and I wasn’t in the mood, he made a comment to me that I was going to have to let him go see a prostitute if I wouldn’t have sex with him because he needed it. Ouch — to say the least! It wasn’t just a flippant, one-time comment. He kept talking about it. He even made me an appointment with the nurse practitioner at his urologist’s office. I went, but I’m not sure why. I was really at a low point then, dealing with his comment. I guess maybe there was supposed to be something wrong with me, but I told her there wasn’t — not physically.

    I have really shut down emotionally since then. I felt like our marriage was over. We agreed to go to marriage counseling, but I don’t feel it addressed the real issues. The therapist just instructed us on how to set aside time for each other, to let the positive feelings have time to develop, with no pressure to have sex. I think it’s a good idea. We had a little success with it.

    Not much has changed since. I have been dealing with feeling down, trying to deal with his biting remarks and his instructing me frequently on the “right way” to do things, say things. I’m getting older so I’m pretty weary of these types of things. I started seeing the same therapist a few months ago and he has gone with me once. But what happens is he has a logical explanation for all his behavior. It always seems like I’m the one with the problem or who needs to think differently and not be so negative. I’m not sure the therapist is seeing the big picture. It doesn’t help that I’ve worked from home for years. My isolation and not having a larger support group, not getting out of the house (he’s been retired for years) does not help, I’m finally realizing.

    All of this has been so difficult. I’m not sure if our sex life can ever be normal. I realize there are a lot of different factors that have affected our relationship. It has been hard. I’m getting older and getting tired. …

    I’m not sure if I have a specific question for you. It has been good just for me to type all of this out. :) I think there is unaddressed anger in our marriage. We can resolve things for a while and be sexual, but then the pattern starts again with his comments, and my shutting down/getting angry, etc. The issue is bigger than just the fact that I don’t feel like having sex any more. If you have any comments or suggestions I would genuinely appreciate them.

    I wanted this to be shorter. :)

    Best to you!



    Amy responded:

    Dear Lilly:

    You are right. There is clearly and “unaddressed anger” factor in your marriage. Whether it is really addressable is a whole different matter.

    As happens in the vast majority of long-term relationships, certain types of behavior become systematic under certain types of circumstance. When those behaviors are used to “cope” (however poorly) with unsatisfactory aspects of the relationship, then the behaviors themselves become part of the problem. I’m no psychologist, but that sounds like what has happened to you and your husband.

    I also have to say that I suspect it is extraordinarily difficult for even the very best counselors to be able to help couples get over this type of situation unless you are both prepared to really let go and “cry together” about what you never really had and have therefore lost. It’s the only way I know that you might be able to regain a mutual empathy for each others’ distress.

    Yes, your husband’s demeanor and language are obviously selfish, aggravating, and distressing, and he could be doing a better job of seeing this from your perspective. But clearly you are also pretty much “at the end of your rope” as well, which is why you have “shut down” to a large extent.

    I have no magic solution to this problem. The one thing that I would say is that you and your husband seem to have worked really had at this together over a very long period of time — even though you haven’t found a satisfactory solution. You wouldn’t have done this if you hadn’t had some deep underlying feelings and respect for each other.

    Do you know if he has ever talked to a doctor about getting a penile implant? Some men of my acquaintance (and their wives/partners) have had great success with modern forms of such implant. The problem is that usually such surgery isn’t covered by insurance. However, it is a relatively small cost to save a marriage.


  39. Even after my long post, I forgot to mention the other problem: incontinence. It has gotten progressively worse as he ages. He could not function without men’s guards. I know that has been extremely difficult for him. Me as well, I guess, because I have to deal with his losing his temper over it and sometimes it’s not very conducive to feeling romantic I guess.

    Amy responded:

    Well, that certainly can’t be helping … and it is just one more place where your mutual reactions to the situation are at complete odds to your feelings for each other. He’s just frustrated because it all makes him feel helpless. You’re frustrated because he gets angry and, as you say, it is hardly conducive to a romantic atmosphere!

    The fundamental question here, as far as I can tell, is being framed in the context of “What is he (or she from his perspective) going to do about his (or her) beahavior?” However, I suspect that the real question is “What can we both do together to make each other laugh more?” If you were able to laugh together about some of this, then maybe the anger would die back and your could find a whole series of other ways to make each other happier. And if you could combine that with a penile implant (which, by its very nature, does come with a humorous side to it), who knows what might be achieved!

  40. Thanks for your quick reply Amy.

    No, he has never talked to doctor about getting a penile implant. I doubt that he would even consider it. I think the last thing he would consider, at this point in life, is more surgery.

    There are anger issues. He doesn’t admit he’s angry, but it comes out in his comments. Also, someone who isn’t angry doesn’t suddenly yell in frustration or get irritated so easily by small things like he does.

    My anger comes from the fact that I feel I am the one who has done all the work. I’m the one who has seen a individual therapist to work through feelings. I’m the one who suggested a marriage therapist years ago, and this current time as well. But when we get there, he has an explanation for everything. Instead of working out the anger and issues, he thinks going to therapy is some sort of magic thing to fix me so we’ll have sex again. Since it didn’t have that desired effect last time we went, he says I tricked him.

    You see, I’m dealing with some very hurtful words. I’m trying to maintain myself, my self-esteem, but it is difficult. So much of it gets framed as if I have problems or they are my issues. I maintain it takes two. His condescending words, his parental or lecturing type way of talking to me sometimes just doesn’t help.

    I, like you, think it is going to be extremely difficult for a therapist to really help with this. It has been going on for some time. It isn’t as easy as the therapist makes it seem. I realize now that we should have had counseling a long, long time ago. We have had to deal with this ourselves. He never reached out much to a urologist or any support groups. I don’t think men tend to do that much anyway.

    I like your comment about asking what we can do to laugh more. We do have some fun times, and I have made it a goal to get out more and do more social things with other people. That helps.

    I am more than happy to just put all the sex stuff aside, so it doesn’t feel like the elephant in the room all the time, and just put focus elsewhere. However…and this is a big however…he will frequently then make snide, sexual innuendo type comments or puns. Sometimes they’re in normal voice, sometimes not. But they hurt too. They’re like little digs and reminders to me that things aren’t right.

    I’ve been good to him. I feel I’ve been patient with all of this…yet this is the thanks I get?! It just hurts.

    The ambivalence I feel is difficult. On one hand, I know he’s a good person. I feel sorry for him. On the other…how long do you have to deal with this. I feel like I’m tired, I’m out of energy. I just want to be happy.

    I need to take all of this into the therapist I guess. I truly do feel that I’m at the end of my rope because no matter how I address these things, it doesn’t work. I have seriously considered leaving numerous times, although he doesn’t know that. He does know that I’m not happy but he tries to tell me that I’m just not as happy a person as he is or that I tend toward depression. I’m realizing that isn’t the case. I have had a lot to deal with, being presented with this situation from a relatively young age. It’s a problem that you don’t talk to anyone about and that makes it all the more difficult. I have hardly ever even reached out to people on online forums, etc., over the years myself because, even from behind a computer screen, I’m afraid someone will know who I am. I’m embarrassed.

    Thanks for listening Amy! Just typing this all out is helpful to me. I hope some of any of what I have posted will help someone else somehow.


    Amy replied:


    Let me make a couple of things extremely clear.

    (1) You have nothing, that’s NOTHING, to be embarrassed about. While some people may find the situation to be embarrassing (just as they find breast feeding in public to be embarrassing), that doesn’t mean that you need to be embarrassed. You are trying to deal with a complex, difficult, and emotional painful problem. We all have to do that from time to time. However, most of us don’t have to deal with one for 25 years … and your husband is clearly not helping.

    (2) It is possible (I am not encouraging you; just stating a fact) that you may need to cut the ties and just move on. How and whether to do that obviously depends on all sorts of factors that I don’t know about. What I do know is that there is no way I could personally stay in a relationship like your current one for another 25 years unless there was radical change for the better. You have better things to do with your life. And, if you were to move on, you might find you “allowed” yourself to talk about why it had happened without that sense of embarrassment. After all, you must have enough friends and acquaintances who would ask.


  41. Hi Amy,

    I do appreciate your comments and insight.

    I understand what you’re saying about embarrassment. It’s not so much that I’m embarrassed, per se, but that it’s not a topic that you can discuss with a friend. I can’t take the chance that someone wouldn’t spill my secret … or that it would embarrass my husband. It wasn’t until years ago that I ever talked to anyone about this and that was the therapist I started going to. What’s amazing is that her husband had prostate cancer as well and so she’s been through the same things.

    I really don’t hold out much hope for things improving to the degree that I have a fantasy that they would. I don’t think the therapist has been much help and not sure how much they can be. It’s something that has been going on for a long time. I’m trying to find ways that I can cope and not blame myself, that I can let his comments roll off my back. I realize that I have neglected to follow some of my interests and I’m working on doing that — getting out of the house, taking up some hobbies, etc.

    One frustrating part is that my husband doesn’t seem to think things are all that bad and he thinks we have talked about things, while I don’t think we really have. Maybe it’s the difference between men and women. I think we women really can access our feelings better and don’t have as much problem discussing things whereas men seem to have more problems with it or just simply don’t do it.

    After our last therapy appointment, things were rough. You’re supposed to “leave it all” at the therapist’s office, but that’s ridiculous. We finally talked some more and I felt a little better. I did tell my husband that I think the prostate surgery really devastated our relationship and that we should have had some help and counseling a long time ago to help us deal with things.

    I’m trying to prepare myself for another therapy appointment (coming up in a few days). This time, I want to be my strong self, not be emotional, and just be able to clearly state the things that I cannot handle in the relationship. I just feel like there’s so much sometimes, but I need to slow my mind down and just tap into that stronger part of me I know I have. :)

    Honestly, I think I have felt like most of the issues have been tossed in my lap. If I don’t respond to his advances, then I’m not sexy enough so I’m a failure there. I have gotten to the point where trying just feels like too much work and I have shut down my relaxed, sexy part. The guilt and the feelings of responsibility I have are sometimes overwhelming. There is always this elephant in the room — ALWAYS. It’s like we’re supposed to be having sex all the time. Years ago, I expressed interest in playing a card game and asked him if he would like to do that and he said that if he was going to spend time playing a game that his time would be better spent with us having sex.

    The thing is, I could relax a little more if I didn’t get some of his comments sprinkled here and there that make me doubt myself, wonder how he really feels, etc., and if when I did relax and cuddle a bit, he didn’t try to make it advance further. It always feels like when we do have talks and clear the air that he immediately tries to turn it into sex. It’s weird.

    A few nights ago, I scooted up to him in bed, which I haven’t done in awhile, and he started touching my nipple. I was happy to just relax in his arms. After a bit, I gently moved his hand because his touch wasn’t doing much for me except tickling me, but being close to him was nice. When I said “it tickles” in a kind way, he chuckled and said “that’s seriously the stupidest thing I have ever heard in my life.”


    So I go back and forth between this emerging relaxation where I think I can just get back into the sexual part and then some comment will come out of his mouth that just makes me feel defeated and down. I feel like he doesn’t respect me, like he thinks he is superior to me. And I’m the one with all the problems. That point really comes out. The therapist I/we are seeing now is the one we saw years ago and when I went back to her this spring to try once again to figure things out, my husband was very happy that I was getting “help with my problem.” He thinks it’s all just depression, on my part. But it’s not clinical depression, it’s that the situation and comments get me down.

    I’m really glad that I found this site. It’s nice to have your comments, Amy, because I realize I am not alone and that my thoughts and feelings aren’t out of line! This is so important to me! For so long, I have felt like I’m in this all alone, like he’s my only mirror and I’ve lost myself. I think finding a good forum, especially one focused on women affected by prostate cancer, would be a fantastic resource for me. I see lots of women comment here and share their pain and frustration. It’s like women are not really considered to be affected by the prostate cancer issues but we are of course! Several times my husband has said how he has been dealing with this for X number of years and I’ll say “I have too. You haven’t been doing it alone. I’ve had to deal with it too.”

    Well, I’ve typed way too much! :)



    Amy replied:

    Hello Lilly.

    It has seemed to me (for many years now) that disorders like prostate cancer that affect male sexual function have a strong tendency to then accentuate many of the minor problems that normally exist between couples.

    Usually, sex is a way for couples to be able to have fun and “private time” together and to “forget about” the minor irritations that they may cause each other (as in “Why can you never be ready to leave when I tell you we need to go?” and “Why do you never offer to do the dishes after dinner?”). The problems that men face when they get treated for prostate cancer often take away that “kiss and make up” aspect of sex. It becomes yet another of the irritations (and by no means a minor one) instead of one of the releases.

    I do know that two of the most important things in dealing with all of this are that: (a) You need to be able to be clear (at least in your own head, and preferably in your husband’s too) that most of what is going on here has nothing to do with the sex and everything to do with the communication problems. (b) Your husband appears to be unable to realize that intimacy does not always involve sex. The therapist ought to be able to help the pair of you address this. It won’t solve all of the problems, but while your husband keeps harping on the idea that you aren’t a 24/7 sex fiend and that everything you are feeling is therefore in some way your “fault”, what is really going on is that neither of you is really capable of responding to the other’s needs for intimacy (of whatever type) in a satisfactory manner. Equally, while you let him go on harping on this problem, he is continuously undermining any chance of progress beyond it.

    Men are from Mars and women are from Venus (at least metaphorically speaking), but while we are all living here on Earth, some compromises are important!



  42. I forgot to say that yes, Amy, you are correct that it may be time for me to consider leaving the relationship. I have thought about it many times over the years. I never come up with enough courage to even take a break, like a separation, to clear my head. I feel many times like I have lost the fun, nice part of me. It’s too easy for me to get down, worry, feel like I’m to blame or not doing enough … on and on. That’s mighty hard to live with.

    There is enough good here that I don’t want to make a mistake. But at the same time, some of the things I have to deal with … I want them to stop. However, I’m slowly accepting that I can’t change someone else. With that in mind, I’m trying to figure out how I can deal better with his comments. Can I deal with them better? Will they eventually make me want to leave? Maybe. I guess I’m just not strong enough to make that decision. Too ambivalent. But I am trying to just expand my activities and create a support network of friends, etc., so I don’t have to depend on him to be my “mirror” and the only source of feedback on “how I am.”

    The things I’ve shared here make my husband sound horrible and quite frankly he is on lots of occasions. But just like anything, it’s not 100%. That’s what makes things difficult. When things are bad, I want out, but if we talk a bit, things are better. It’s just a cycle though, that I can clearly see. It happens over and over again, just not always at the same intervals.

    I think my husband’s expectations of our sex life are unreasonable and I’m not sure he fully appreciates just how much prostate cancer has affected us.

    Like I’ve said before, if we could just put the sex stuff aside and have some fun, without there always being this elephant and this “sexual expectation” there, looming like a cloud … maybe things could be a lot more fun! :)


    Amy replied:


    So that’s going to require you to be less acceptant of the criticism and very much clearer with him about what you need to have happen. It’s gonna take two to make this into fun … and maybe even a party! Make sure you take the “strong” you to the therapy session. The “emotional” you may be reinforcing his beliefs that this is all in your head in some way.

  43. I am happy to say that I was successful in bringing my stronger, rational self into the therapy session. I finally feel like I got a lot of things said that I’ve wanted to say and therefore, it really felt like this was one of the most productive sessions I’ve had. I did feel much clearer on things, much more confident and I was not willing to shy away from things.

    We will see where things go. I have renewed confidence in the therapist.

    One thing I really noticed is that for everything I bring up, my husband has a logical explanation. Well, explanations aren’t very helpful sometimes and they don’t always make things better. He seems defensive, like when I describe how I feel, he usually responds with his feelings as a counter, like my feelings are secondary.

    I was able to say that as I see it, the prostate cancer surgery and the results from it are our main issue and the thing that has really caused our problems. You know, it’s hard to explain, but it’s something I’ve realized for years, decades really, but at the same time, have been working to make some of the symptoms better. I’ve been in the middle of things and not really stepped back and said that all the things that I’ve been dealing with are the result of the surgery and radiation and it’s effects.

    We do have a communication problem and it’s a long-standing one, peppered with hurt and guilt — mainly the guilt he feels for the results of the prostate cancer surgery. But I think that guilt, and resulting anger, gets turned on me.

    Amy, your comments about how the surgery takes away the ability for sex to smooth away the minor irritations of life and instead becomes one more irritation — that’s right on the money. For me, sex became work and yet one more problem I was supposed to solve. I’ve worked hard to make things right, but at some point, I just got tired of trying and turned off the sexual part of me. Something that should be natural and come from relaxing with one another is now a negative. Add in his smart ass comments or sexual innuendos and other jabs and you’ve got someone who just isn’t interested.

    Thanks Amy!

    Amy responded:

    Dear Lilly:

    I am pleased to hear that things seem to have gone better at your most recent therapy session. It may take time, but it sounds as though some real progress may be possible.

    Your husband’s tendency to be defensive and seek a “rational” explanation for everything is probably a key part of his own pain in dealing with all of this. It may take him a while to come to terms with it.


  44. I understand that his defensiveness and “rational” explanations may be his way of dealing with the pain. But they are also part of his overall personality, I think. I feel like he’s so smart and I’m the dummy that needs to be educated. :)

    I am really hoping that we will make some significant progress with the therapist this time. Honestly, I feel so down sometimes that getting out of bed each day is an effort, but I do it. I know I need to focus on the positive and not be so hard on myself. At this point, though, I know I don’t always feel so positive about myself. I feel like things are mostly my fault for not being sexier or something.

    If it’s okay with you, I’ll keep you updated. :) If nothing else, it’s good for me to write about this. I think keeping a private journal about all this would be very helpful for me … but it’s also hard to go back and read. Somehow, writing about it makes it real, and a part of me wishes it wasn’t and that my life was different.



    Amy replied:


    First … Feel free to write as often as you like.

    Second … There are three sorts of “smart” — intellectual smart, emotional smart, and “street smart”. Your husband may well excel at the first, but he appears to be less than brilliant at the second, and not being brilliant at the second may limit his ability to excel at the third.


  45. Thanks Amy!

    I know what you’re saying. There are different kinds of smart. My husband is intellectually smart — retired professor. ;)

    I do not understand how he cannot figure out that his comments put a damper on things. I just do not get it! It’s so frustrating. I have told him over and over these past many years that it’s not what he says, sometimes, but how he says it. I just can’t seem to get through to him. He has an excuse for every remark. You just cannot imagine how frustrating it is.

    I am having so many insights lately, though, that are really helping me I think. I was reading over on . I found this site awhile back and I must say, it is so helpful. I share the link but feel free to delete these last two sentences if you don’t want it here of course.

    I realized that I don’t have to react to things my husband says. I don’t have to take things to heart and have them make me feel hurt, sad, and in despair. When that happens, I become scared and immobile: I’m afraid to function, feel like less of a person, and the future seems bleak.

    Rather, I can hear the comments and let them float by, like clouds, much the way that dealing with your constant thoughts during meditation has been so eloquently described to me.

    I don’t have to take his words as the truth, the absolute pronouncement about anything, including me. I just don’t.

    This realization made me feel as if a weight had been lifted from my shoulders.

    I also realized just today that I found years ago. I think it must have been 2006. I met another woman and we exchanged e-mails but I cannot find that info now. I was so grateful to find support for my situation then. I just don’t know why I didn’t think about there being support groups online. I suffered for so many years alone. I’m sorry that I drifted away from this site. Life just gets in the way I guess.

    I’m going to continue with therapy and take my strong self :) I’m realizing more and more that I’m not happy and things have to change for me to want to stay in this relationship for, say, another 5 years.

    Therapy is frustrating because there is so much to discuss and work out. I think I have been feeling like I have to take examples and evidence with me, to make my case, to show the therapist the things he says and does, the difficulties that we both have had to deal with as a couple as a result of the cancer. It make me feel anxious because I just am so desperate for someone to validate my feelings, to say, “Yes, that is really a crappy way for your husband to talk to you.”

    I now see that I don’t have to take every shred of evidence with me. My feelings, my experiences as a person in this relationship are valid! I’m not crazy! I’m a good person, trying to make the best of a crappy situation. And I’m not sure most women would have put up with as much as I have, quite frankly.


    Amy replied:

    Social norms taught all too many women to defer to their husband’s “intellect” when it came to dealing with all sorts of things — from whether they should have a job to what they should wear and how they should dress to almost everything about sex. It doesn’t work for anyone who has the capacity to think for themselves! And it doesn’t matter how intellectually smart the man is if he is getting a failing grade on the emotional smart scale and the empathy scale. He may not even be “hearing” your therapist (well or at all) when the therapist says something like, “I can see why his response is upsetting to you.” Next time the therapist says something like that, maybe you need to look at your husband and say, “Can you see why that response is upsetting to me?”

  46. I wish the therapist would say, “I can see why his response is upsetting to you.” She hasn’t, but I think she gets it. Maybe I’ll just flat out ask her this next time.

    My husband just thinks I’m accusing him of things. He has used that word: “accusing.”

    He interprets my being relaxed enough to cuddle up to him in bed, then a week or so later, after enduring some of his comments or bickering, not wanting to be close to him, as “playing games.” Since the therapy years ago, which he apparently thought was just about getting my libido back so we would have sex, hasn’t really changed our sex life, he says I “tricked him.” I told him the therapist wasn’t just a sex therapist and the therapy was to improve our communication and our marriage.

    The difficulty I face with his intellect and comments is that it’s hard for me to trust my feelings and emotions. He makes comments that make me feel like I just don’t think right.

    I do think that perhaps I should not think about things that happened in the past. I would admit that I likely tend to ruminate. But these things have hurt me.

    I was thinking today about the fight or flight response and, you know, I think the reason that I have felt so bad, depressed, hopeless (whichever word you choose …) is because I have wanted to leave. I have known that I’m not happy if I am completely honest with myself. But instead of doing, leaving (flight) I stay. I stay because I feel like I would be a horrible person to leave. I stay even though I fantasize about getting my crazy, fun, laughing self back — back more than just for a few weeks at a time. I stay because I feel it would be wrong. I stay because I would feel guilty. I stay because he would make me feel, by the things he says now and would say then, like I was irrational for leaving.

    It’s like I need his approval and acceptance of how I feel.

    I am working on resurrecting my strong self and keeping her in place instead of the sad self that feels despair and doesn’t know how this is all going to resolve itself. Trying to be strong and not scared. :)


    Amy replied:

    Hi Lilly.

    So do your think your husband has any clue that you have actually thought about walking out the door?

    Maybe you need to get up the nerve to look him right in the eye during one of the therapy sessions and say very bluntly something like, “Do you have a clue how miserable you manage to make me feel sometimes? You obviously haven’t got any idea how hard I have tried to work at this marriage. And you have never thanked me for all my efforts. Maybe I really should just pack my bags and go. Maybe we’d both be happier. I’m pretty sure I would!”

    I always remember watching some couples having absolute screaming matches with each other and then making up as though nothing had happened at all. Have you seen the commercial for Haagen Dazs Gelato on youtube? It always makes me grin. Maybe you need to find a way to restructure your communication system with your husband to be more like that!

    OK … Maybe that’s a stretch … but you do need to get beyond feeling you need his approval all the time. He clearly doesn’t feel that he needs to seek yours!


  47. Dear Amy;

    Since my first letter to you I am still very depressed and having a really hard time with that I am living with basically no touch and my husband doesn’t comprehend my insides are literally dying because it is a core part of who I am. He has never been a touch person, but we both enjoyed regular sex which helped with the touch neediness. I think the only reason I can continued to work on this is I am married to such a good person and we get along well in most areas.

    I have been following Lilly’s correspondence and from her first letter I wanted to share my first marriage story. I just wasn’t sure if we were allowed to in this format.

    When I was 18 I married a 20-year-old for the main reason we were having sex since I was 16. (Once again this needy sex person, ha-ha.) We stayed married for 20 years because we didn’t believe in divorce. He had decided after 2 months of marriage he didn’t want to be married to me and probably made every day after that some sort of punishment for me. (I wasn’t even able to see the severity of this until after I left and started healing.) He especially liked to use areas I perceived as my weaknesses to bring me down, such as I am dyslexic. When I first married him I was totally was ashamed and embarrassed about my capabilities to communicate in writing and would go lengths not to. By the time I allowed him to finish with me not only did I believe I couldn’t write; I now believed I couldn’t speak, fit in with others, not intelligent, etc. The truth is I can’t write the same as most; now I take on the attitude: oh well, too bad … You don’t like it, don’t read it … It is who Janis is and I now love her enough to know to accept that in me. This wasn’t just the way I wasn’t respected, but I don’t want to write a book right now, maybe in my next life when I can write better.

    One of the ways this was confusing for me was we also had some good areas in our marriage and we had a regular sex and touch relationship. He was so good at making me believe all the issues we had were my fault. I did everything I could to make him love me … if I was thin enough … if the house was cleaner … if I did all the yard work … the prefect mother … the prefect Christian, etc.

    It took me 2 years to work through a process in my bath tub every night to get the courage to leave. This is what I did:

    I broke women down into four categories which I gave my own meanings to and could relate to and then decided which woman I wanted to be:

    1. Cinderella: She serves everyone to a fault, those around her have learned to use and take advantage of her to a point they feel they don’t need to give anything back in return. Cinderellas lose self-worth. When you read the story of Cinderella you see clearly that Prince Charming did not rescue her; she finally had the courage to rescue herself. When she finally was able to do so, she became worthy of the love of the prince … Don’t you love it!!! I was a true Cinderella.
    2. Princess: She is loved by most and fun to be around. She loves to receive from others more then she gives. The Princess is a well-enough balanced person, but she has to be careful for her strong desires to receive can turn her into a Queen.
    3. Queen: she likes to receive all she wants and will go to great lengths to achieve this. She does not give unless she thinks it is a way to get what she wants. People act like they like her and give her what she wants mainly because they are afraid of her. They know that if she doesn’t get what she wants she could have your bloody head on a platter!
    4. Goddess: Goddess doesn’t mean she wants to be worship; Goddess is a woman that believes she is a child of God. She believes God created her to be loved and respected and to give and respect others. She values herself enough not to let herself be abused by others and has learned that receiving helps her to give even more to others. She gives from the heart not to receive. Those around her see that and respect her even more.

    It took me 2 years to decide I was no longer going to be Cinderella, I was going to be a Goddess and the only one stopping me from that was me. It wasn’t easy and there were a lot of tears, which I decided to keep behind closed doors at night. Each morning I got up and walked out the door with a smile on my face, I made sure I walked with a straight confident back and would go places to be around people. The next thing I knew I had made Saturday morning coffee house friends of around 15 people; we would listen to the jazz band; talk about all sorts of things and laugh! The group of both men and women had teachers, lawyers, to bus drivers. After a couple of months I went over to my husband’s house and calmly told him, “You lied to me.”

    He said, “What?”

    I said. “You lied to me. I can communicate. People do like to talk to me. You lied.”

    I had a lot of set-backs and a lot of fun! Sometimes in fighting to be a Goddess I even was a Queen (I never took a head though!). I look back at my decision to leave my husband with no regrets except for the temporary pain it caused my children and family. I even know in my heart that God looks down on me with a smile that I chose Goddess.

    I guess when I read Lilly’s story, I can’t help wonder if the issues would be the same, just not centered on sex if her husband hadn’t had prostrate problems. I don’t know, just something to think about.

    P.S.: When my previous husband and I were separated for several months, I asked why I never could do things right. He said he had some affairs and if he stayed angry at me it justified his right to do so. The light bulb in my head went off that there was truly nothing I could have done to be good enough. I just smiled at him, because that was all this Goddess needed to do.

    I know this is way too long, but I guess what I am trying to say is that each of us can create a good portion of our story and learn how to work with challenges that come our way. My husband now is so different; for example, when I said I was going to get my Real Estate license, he said, “Get your Broker’s license.”

    I said, “I don’t know if I’m smart enough.”

    He she said, “Hey chick, you are.” I was the second one to finish the test the day I became a broker. I had to do the work, but I have a husband that believes in me.

    Thank you,


  48. Hi, Amy,

    I love your spirited reply to Lily. However, nowhere does she mention that her husband has/had prostate cancer. Can we assume that’s the case (else why did she write to you) and ask her if the therapist helped him and her grapple with that? If that’s not so, perhaps the two of them could be guided by a (new?) therapist to smooth out some of his ongoing (recent?) personality kinks and in turn, begin to give her more credit and positive acknowledgment.

    I agree with you that Lily needs to tell her husband that he’s mistreating her, and if it helps to do so in a therapy session. If she does not do so (and maybe even if she does?) one or both of these marriage partners will become so explosive that their marriage will completely fizzle. This will certainly occur without the communication and self-regard you’ve counseled,

    At this point I don’t think things between them will get better until they talk openly with each other. For sure, as Lilly wrote and you implied, there is no room in their life for sex therapy until their more basic communication issues get settled. I can assert this not only as a rabbi but as an intimacy coach and sexuality counselor in my current practice.

    Rabbi Dr. Ed Weinsberg, Sarasota, Florida


    Amy responded:

    Hi Rabbi Ed. How are you?

    If you scroll back up the page you will see that Lilly has been writing to me regularly for a while now. Her first message was on July 3 … and yes, her husband was diagnosed with prostate cancer when he was 46 years old.


  49. Hi Amy:

    Me again ;)

    To answer your question, no, I don’t think my husband really thinks that I have considered walking out the door. I do think he may suspect it though. He makes comments like, “Well, when you finally get rid of me you can do ______.” Two years ago, when we were in a bumpy period, he asked me if I wanted a divorce. I said no at the time, but honestly, I don’t know. Part of me does and part of me doesn’t. That’s my struggle right now.

    I think I do need to say something just like what you’ve suggested, in the safety of the therapy session. If I had to guess, he likely won’t hear me well and won’t take it completely seriously. I suspect he’ll counter it with his own similar statement about how hard he has worked and how hard the prostate cancer has been on him.

    Believe me, I know it has been hard on him. I think that’s what makes the decision of whether to stay or go so difficult. I’ve struggled with it for years.

    My husband isn’t a total jerk and things aren’t all bad. That’s what makes it difficult for me. He does thank me for every meal I make. He thanks me for lots of things. I can’t say I’ve ever really wanted for anything material in our marriage because of his salary. (I also realize that I’ve worked as well, just not as full-time or for other people most of our marriage. But I have contributed. I haven’t “just” been a housewife.) In therapy, he said that I don’t thank him enough. For instance, he says I’ve never thanked him for earning his salary. That is true. I think it’s because a lot of the times I’m angry at something he’s said. I wonder though … do other spouses thank the other for working? I’m not ungrateful at all, but it sounds a little weird.

    I think our relationship has many characteristics of a parent/child relationship rather than a marriage of equals. (Maybe that thanking him for earning his salary seems funny to me … because it is?) Some of this is caused by our age difference of 23 years, some by his being an intellectual/educator type, some by my letting it happen. The first couple of times he raised his voice or talked down to me or lectured me, etc., I should have said it was unacceptable. But I didn’t. I didn’t because our relationship was new. I had left a very short previous marriage with someone who couldn’t (or didn’t want to) hold a job, drank too much, smoked pot. Now, here was a mature man who was a professional, owned his own home, etc. He was a “good catch.”

    Also, there are things that I would lose if I left him, like where I live, trips we take, etc. I know … it sounds short-sighted and superficial to say that, but it is true. As bumpy a road as I feel we’ve had, we still have things and a history and have a life together. I’m afraid of upsetting that. What if I throw it all out and am miserable? At the same time, I frequently think of just where I would want to live, having my own place, and how comforting all of that makes me feel inside. I don’t think I would be lost.

    I’m scared to stay in the same situation but scared to move forward and yet I know I have to do something.

    I think my husband may not take me seriously because I said in our first joint therapy session this time around (about 2 months ago) that I wasn’t happy and that things needed to change now because I can’t go on like this and I don’t want it to affect my health. But … have I done anything since then? Not really. I have reacted just the same way to any crappy comments he makes, sometimes calling him on them and/or telling him to stop. But I haven’t really made a move. I’m still working things out in therapy. I don’t think that’s a bad thing I guess.

    He has gotten better. He hasn’t made hardly any snide, sarcastic remarks in several weeks. But how long will that last? Sadly, I don’t think for terribly long. I don’t think he can help it.

    Right now, the questions I need to find answers to are these: How do I know if I want to work on the marriage? Yes, we can improve our communication. I know there are issues we can improve. BUT … and this is a BIGGIE … the sex issues will still be there. I’m still sick of not having a more normal sex life and I’m tired of working on it. Is that even fair to say? There’s so much baggage there. How do you just forget and move forward? Do I just dwell too much on the past, which I get accused of? How do you know whether to leave or to stay? I don’t feel that warm fuzzy in the stomach feeling, or even really a fun feeling most of the time when I look at my husband. I feel like we’re more roommates than anything. Honestly, that is what it feels like.

    Also (and this is one I’m not sure I can say out loud in therapy at all), I’m not sure I’m physically attracted to my husband.

    Phew! That’s a lot of questions ;) LOL.

    I think to answer my questions, I need to be HONEST with MYSELF. I need to say these things in therapy, not just finally be brave enough to type them to you. I know that. I also recognize the things I need to do better or need to correct in my behavior that got me here and/or continues the pattern.

    Jan … THANK YOU! I can’t say it enough but please know your post meant a LOT to me.

    Jan, I think that many of the issues that exist would exist if my husband hadn’t had prostate cancer. In fact, I look back and remember a few instances, including on our first date to a restaurant, that were a bit telling. I think the age difference and my wanting to please were factors, Although I’ve always been mature for my age, I was still young.

    Okay … I have a therapy appointment this Friday. I’ll check in here afterward :)

    Amy … Thank you so much! I could type all of this to myself, but having feedback from other people, so I have perspective and know I’m not crazy … It means SO much to me!

    I typed a lot as usual. ;)


  50. Hi Amy,

    The therapy session with my husband was pretty intense.

    We had had a fight a few days before and I hit my limit and told him that I was done with the relationship. I know I probably shouldn’t have, but I didn’t say it lightly. I am just so sick of the bickering and his tone of voice, etc. So the first thing he brought up in therapy was that he didn’t know if I was leaving him or not and it was hard for him to plan anything. I didn’t directly answer it because I don’t know. I did say that if the communication issues don’t improve significantly that I didn’t see how I could stay because I was so tired of it.

    I’ve mentioned the prostate cancer as being a main contributor to the difficult issues in our marriage at least three times in therapy. I know the therapist hears me, but we’re working on listening and communication skills at the moment. I think from what I read and know that communication can make things a whole lot better … or a whole lot worse.

    What I noticed (and the therapist did too) is that he doesn’t really hear what I say. He takes things I say and spits out comments like, “She thinks I’m a bastard” and similar negatives when asked to repeat what he hears as my feelings or an issue I express.

    I think he feels ganged up on by two women, quite frankly. I heard him mumble about being a stupid man who doesn’t know anything when he was getting ready for bed.

    That said, things have been going pretty well these past few days. I think if we learn to communicate better and I start doing more things for myself, like pursuing interests outside the house and without him always, that things would be a lot better. I realize that in many ways I have put my life on hold in a strange way. I need to do some things that bring me joy. So many times I just don’t do things because he doesn’t want to.

    I don’t think that he ever mentions my feelings, although he tells me how hurt he was about my mentioning leaving him. Yet it doesn’t seem to register when I bring up the remarks he makes.

    That said, I still don’t know how to deal with some nagging feelings. I guess that’s what therapy is about. I don’t feel like I truly get all the things in my head out.

    I’m at a point in life where I feel I want to do something different. I guess I’m at that mid-life crisis stage in life, though I hate to call it that. It’s just that I think about being married another 10 or so years and I just can’t fathom it on some level. There are still the intimacy issues in our marriage and I can honestly say that I don’t feel a great deal of physical attraction to him. But how the hell can you say that to someone?! I don’t want to hurt him, yet it’s hard to deal sometimes with the feelings I have, to feel them and not put myself down.

    I worry that if I don’t go out and do some things I want to do, even live in a place I want to live, that I won’t have that option down the road. I know I’m not the first woman or man to feel this way.

    Our relationship is decent. We have similar values and tastes and such. But the things that aren’t so great, when they get crappy, they’re really crappy. But I also see where I’ve been holding on to some things that hurt me, expecting … what I don’t know. It’s hard to know whether things are signals that the relationship is over or not. I guess it depends on whether both want to work at it.

    It comes down to how much pain it would take to leave versus how much pain it takes to stay … that’s what it seems like. Things aren’t so bad. But I think about whether I could find something better, more satisfying. It’s easy for someone outside to say you should stay or go. It’s not easy when you’re that person. :)

    I have been learning some better communication skills and I really see how I haven’t done a very good job.

    That’s all for now!


    Amy replied:

    Hello Lilly.

    No one is going to be able to tell you with certainty what you should or shouldn’t do. In the end, you are going to have to make your own decision(s) about all of this. However, I do feel that “getting the cards out on the table” for everyone to be able to look at (as you seem to have been doing) is a critical step along the way. Whether everyone else “reads” the cards the same way you do is a whole other matter, but if they can’t see them they are just guessing! And probably not very well at that.


  51. I understand what you’re saying Amy. :)

    I realize that I don’t always say everything that’s on my mind. I feel that I have genuine concerns but they aren’t being heard. They’re being heard as accusations of him.

    For instance, he expressed upset and concern about my saying I was through with the relationship after our argument, but what he said in therapy was that he was upset because he didn’t know how to plan anything for the future because he didn’t know whether I was leaving him or not.

    He sees me as just a depressed personality, I think, rather than really listening to me. My concerns are just complaints. My upset is just irritating. I thanked him for something last night, made some comment about how nice it was, and he said that he’s a nice person but he doesn’t know what the point is! I just looked at him and sighed.

    It’s these types of things that I know won’t stop. And my trying to make them stop is not where my focus should be I guess. I can’t change him, but I can do things to explore what I want to do going forward. :)

    It’s all hard for me because I start doubting myself and then just trying to smooth things over so we can live in the same house. It’s a cycle I think. I try to talk, then he may get upset and I try to smooth it over and back down or deny the wholeness of what I feel. Kinda crazy making. But I’m working on communication skills that I think can be a big help.


    Amy replied:


    When one is in a negotiation process (which you and your husband very clearly are), sometimes it’s good to back off and “smooth things over”. But sometimes it’s wise and important to “stick to your guns” and see if the other party will do the backing off and the “smoothing things over” piece. It is all part of the mutual appreciation and learning process.

    As an example, you said that your husband expressed upset and concern about you saying you were through with the relationship after your argument but not in the therapy session. You clearly hadn’t backed off about that one. And so he obviously was making some attempt to be the one who was trying to take a more positive step by admitting his “upset-ness” and concern. It may not have been the perfect response, but it was clearly better than nothing.

    I like the fact that you just sighed when he pulled the “I’m a nice person but I don’t know what the point is” card. But you do need to set some clear expectations for him, as in “Being a nice person is only one part of the solution. I’m looking for the nice person who understands why he upsets me and works on stopping doing that.” Maybe that’s a good place to try to start the next therapy session. And so that he understands that you understand it’s not “all about him”, you can also ask “What do you want from me? Really. In simple day to day terms that have nothing to do with the sex issue.”

  52. I think the attempt he was making in therapy regarding my comment about being through with the relationship was more selfish. He has no trouble telling me how much that comment hurt him and how it upset him because he couldn’t “plan,” but he doesn’t really ask why I said it. He doesn’t understand my frustration.

    I told him I just cannot take all the bickering and fighting anymore and that’s the reason. He says he doesn’t like it either.

    The therapist says we both need to work on listening better, but she doesn’t offer any concrete steps or advice. I’ve found more resources online and in the library. Mostly, the therapist is helpful because it’s a safe place for me to speak my mind or get feelings off my chest without being afraid of it turning into a fight or being ridiculed.

    However, there are just some things that I know I feel that I cannot say. Yes, I’m angry that I lost some of the best years of my life to this. I spent my 20s and 30s and 40s having erectile dysfunction being the elephant in the room. The early experiences we had in the months and years following his surgery, with him being impatient about not having erections back to “normal”, were extremely hard on me. He took it out on me in and this is something that he acknowledges. He’s said that he knows that he ruined things for me.

    What he ruined was being able to relax and have sex with someone.

    Amy … that’s it. He ruined sex for me. It became work. I did things that I probably didn’t want to do. I spent hours-long marathons trying to make things work. I found pills, I found pumps, I found drugs. But all through it, I was feeling worn out, mechanical. It was just too much for me I think. I just wasn’t sexually mature enough nor emotionally mature enough.

    I’ve been angry. I’ve wanted out. I’ve wanted to be with someone my own age.

    It isn’t anything that personal against him, exactly, it’s just that I haven’t liked what I’m going through and he’s said and done some crappy stuff. We both have. But does anyone care how I have felt? It all seems focused on just making a dick work. I realize I shut all my sexual feelings down. I just don’t feel like it. I wish someone understood. I’ve had no one to talk to about all of this for so long. …

    So for years, it’s been him pushing the sex stuff and me feeling turned off by the whole entire thought of it. Add to it the incontinence, some snarky comments and other things, and there’s just no romantic feelings in me. I can have fun doing lots of other things, but mention sex, or touch my leg suggestively, and I freeze. I get scared it’s going to lead somewhere. Sigh.

    When I look toward the future, I don’t see things changing a whole lot sexually. I know we can work on getting along better. We do get along on many levels, share interests. But is it enough? Me, the woman approaching 50, knows that she’s either going to have to stay until he’s gone or make a difficult choice to leave for something else. I do not have the guts to leave. Things aren’t bad enough for me to do so. And I know I don’t hate him (though some days, I certainly have felt less than like, that’s for sure!).

    I feel bad for him and what he has had to go through. I can’t hurt him, even if maybe everything in my life isn’t exactly the way I want it to be. My life hasn’t been that bad. He reminds me of this. …

    I think approaching middle age has me scared. Scared I won’t have a “normal” sex life ever again. Scared that by the time he passes, I’ll be too old.

    So the thoughts I have … there’s no easy way to say these things. Saying them out loud makes them real. Keeping them in my head makes them my private thing, which I then try my darnedest to solve.

    Maybe I just need to say them in private with the therapist.

    But often when I try to isolate the things that are making me unhappy, they do their best to hide from me. I can reason away most of the negatives as “not that bad.” So I think I keep ending up in the same place, just going through a cycle.


    Amy replied:

    Dear Lilly:

    If you don’t tell at least the therapist the whole truth, then you aren’t being open about the whole problem — with the therapist or with your husband. This is not a math problem that one can solve by logic and reading the right books and other stuff on line. It is a physiological, emotional, psychological, and communication problem that has to be worked at, really hard, by both parties if there is to be a satisfactory resolution for all concerned.

    Of course neither I nor anyone else (the therapiest included) can tell you whether a “satisfactory” resolution is even possible. Only you and your husband can work that one out … if you are able to do so.

  53. Amy, your words really hit me. You know, I realize that the therapist I was seeing, by myself, years ago, just said the same thing to me last year. I remember her telling me that I was trying to use the logical side of my brain to solve an emotional problem.

    Wow. I realize I’ve probably done this my entire life.

    It’s why I start searching online for resources and things to read and head to the library and start finding books on the subject.

    It’s funny (well, not really …) but I can type pages about how I feel, but when it comes time to say any of it out loud, I censor myself and don’t quite say exactly how I feel or to the degree that I feel it. I think it’s because I don’t want to hurt anyone’s feelings and also because saying it out loud makes it real. I guess I really have to own it then. I tend to want to explain away my strong feelings, downplay them.

    I know, also, that I am ambivalent about what I want, so expressing my feelings feels like making that particular feeling have weight but I still don’t know what I want to do about it. Like I said in my last post, I can rationalize things away because they “aren’t that bad.” But … at the same time, when I think about those same things staying the same for the next, say, 5 years … that makes me crazy, and sad.

    I was able to speak about my feelings much more openly in the last session. I did say that I thought that the prostate cancer affected our whole relationship, and that I was too young at the time to understand just what the ramifications of it all were going to be. I have acknowledged that neither my husband nor I had any outside help through most of it. I acknowledged that he has to deal with the direct physical results in a way that I don’t and that I feel bad for him.

    I said in therapy that I’ve never really talked about how I feel about all of it because it seems selfish. Who cares about how I feel? He’s the one who has had to bear the physical and emotional consequences of it all. Bringing my feelings into it seems trivial. So it has really stayed bottled up for years, and it comes out in anger, sadness, frustration, and depression.

    There are things that I am not happy about but that I don’t see options for changing. I try my best to do what I can about the situation, but there are limits.

    I know it will take a lot of work. I’m not sure, though, to be quite honest, if things will ever change all that much. We go to therapy, but while last time he did listen to me better, most every time his responses are just logical explanations for why he does or says things. If I bring up something he said or did in the past, that affected things going forward to me, for instance, he will just say yes, but that was a long time ago, or I don’t do that anymore. The thing is that things leave their mark. I don’t feel like my feelings are important. That makes it even harder to talk about them. And as for things in the past coming back up in the conversation, I was successful in saying in our session that the reason things come back again and again is that they never get talked about thoroughly and resolved. If he interrupts me, belittles me, shuts me down, then that issue still sits there because it hasn’t been worked through and I haven’t been able to discuss it with him. The therapist really pointed that out to him at the end of the session as a major point.

    I intend to say just that in the next session and see where things go. I don’t feel like my feelings are important, so what’s the point of therapy — in other words, where are we going with all of this? What’s the goal?

    I’m approaching menopause and having a few more physical symptoms that I am (oh fun!), combined with other things like wanting to get out in the workforce again but not knowing precisely what I want to do. I’ve felt this unsureness about the future for at least a year. I suggested last year that he and I make a list of the things we’d like to do in the next 5 years or where we see ourselves or would like to see ourselves. We haven’t done it, but I think it would be helpful. I just see neither one of us getting younger. Actually, I have a bit of anxiety about the age thing which I think is pretty normal at this point, the feeling like you’re at a crossroads and wanting to do something different, realizing that you have limited time left and not wanting to waste it. Ugh. That’s a big one for me right now I think.

    Thanks Amy! :)


    Amy replied:


    Have a look at this article. It seems likely to me that no one ever had a conversation like this with your husband (or with you either, for that matter) when he was originally diagnosed and treated.

  54. That’s a very powerful article, Amy. And, as you can probably guess, no, my husband and I did not have any conversation that even approached that in detail or frankness.

    I remember an discussion in the office with the surgeon, who had all the bedside manner and personality of lint. Honestly, I can’t remember most of it; it has been over 25 years. I think the gist of it was just the details of surgery like how long the hospital stay would be, how long the catheter would be in … things like that.

    There was mention at sometime about the potential erectile issues because the issue of whether nerves were cut during surgery and the implications were made clear. It was the first thing I asked the surgeon about when he came out to brief me when my husband came out of surgery. He couldn’t tell me for sure.

    I’ve learned from reading on another forum that it can take 18 months to 2 years for a man to recover completely from surgery. We weren’t told that. I know a lot of my husband’s frustration came from trying to resume normal sexual activity within weeks of surgery. This urgency, and the frustration and upset it caused both of us, the stress … those are the things I have not quite recovered from. My husband feels horrible about all of the anguish he put me through. He has said so. It’s hard to erase and just move forward. It does have lasting effects.

    Still, even if someone had provided us with such thorough and honest information, I know that it probably wouldn’t have changed my husband’s decision. He has made the comment many times that at least he’s alive. That’s true. But the surgery, and the radiation a few years later, changed our lives forever. It likely wouldn’t have changed mine unless I could sit with it for awhile. Our relationship was new — he was diagnosed 6 months after we met. But maybe I would have been able to think clearly enough to postpone the wedding. I would have liked to take it slower.

    This is something I have brought up in therapy repeatedly. I am trying hard to make it clear to the therapist that it changed everything. It exacerbated communication problems and personality issues that were likely there in our relationship from the start. It changed the dynamics of the relationship. In the article, she mentions that there is no “make up sex” or celebratory sex. It’s so true. Sex becomes work and a big issue to deal with.

    It would seem to me that any therapist with half a clue could put themselves in my shoes and think about how they would feel at 24 years old, facing going through prostate cancer with a fiance. I’m trying to really be clear on just how significant this is.

  55. I am a 45-year-old wife, mother, and unfortunately RN. I say unfortunately for one simple reason, it means I understand a little more than the average person what we are dealing with and the possible … no probable, outcome.

    My husband is 1 week post-robotic radical prostatectomy. Only a week … and my concerns are huge. We are in our 40s for God’s sake … 40s. He is 44. My anger is insurmountable! I have been cheated and no one seems to care. I sit here typing this, as he sits across from me … JP drain hanging off one side, catheter bag on the other, and 6 incisions in his gut. … I know. I have to smile to his face and pretend we will be fine, but will we? I am going to get blatantly graphic for a second so if you are weak when it comes to sex talk, look away now. As I assume most men do, we had to have cardiac clearance before the prostatectomy. (This is due to the 45 degree head down angle men must be put in for hours on end in order to remove the prostate) … a problem was found, and exactly 5 days before his scheduled surgery he had a cardiac catheterization done. What no one thought of was that, as most couples probably do, we had vowed to have sex every day leading up to surgery. Now, we couldn’t. I felt robbed. He had a pressure dressing to his groin and minimal activity was ordered. When the last 2 nights came before “D” day, … we tried. He was unable to achieve orgasm due to stress and pain. The realization that my husband would never cum inside me horrified me. I was cheated … I had planned to breathe in every smell of him, note every sound he made, how he felt. Nothing. … I wasn’t prepared to give up sex yet. I am so angry and hurt and can’t tell him I secretly blame him. I so understand the stress he was under, I swear I do, but the thought of knowing he will never be able to have an orgasm inside of me is absolutely devastating to me. I feel like I have had a death in my heart and mind. We have only been married 4 years and this is the second marriage for both of us. How do you deal in a logical way with the fact that no matter what kind of full function your husband is able to achieve with bladder continence, erectile function, he will never have a truly satisfying orgasm. A “dry” orgasm as they call it.

    Yell at me, advise me, comfort me, … whatever you offer me is appreciated because I cannot wrap my brain around what I am losing. He has already changed. We are an extremely affectionate, touchy feely couple. He hasn’t even kissed me (a peck goodnight,yes) but I mean a true passionate kiss. It’s like he relates everything sexual back to intercourse and just won’t allow himself to feel anything. I feel anger, resentment, and pure devastation. I feel I got robbed of what little time I had left.


    Amy replied:

    Dear Tracey:

    I feel for you … and for your husband. You are both going through a profound period of loss, and none of us ever really know how to deal with this. You are right. … It isn’t fair. Your husband is almost certainly devastated by the apparent loss of his manhood. You are clearly devastated by your sense that sex will never be the same again … and it almost certainly won’t (although at 40 years of age there are certainly men who do recover good sexual function … if they had a good surgeon and if they had a bilateral, nerve-sparing prostatectomy).

    In the meantime, your husband is so devastated by what he is going through that he has no clue that it is important for him to show you — physically by kissing you and verbally by talking about it — how much he still loves you. Men aren’t good at understanding most of that … even at the best of times.

    Can I tell you how to handle this? No. I can’t. But what I can tell you is that you and your husband are going to need to find ways to talk about what is happening. You have to be able to be honest about your anger. He has to feel able to talk about his fear. Somehow you both need to be able to see an aspect to all of this that goes beyond at least the short-term loss of your normal sex lives. What that is for you both, I don’t know. It is going to depend on the entire nature of how have have related to each other to date and how you want to relate to each other in the future.

    However, I will tell you that no one is to “blame” for any of this. It’s not your husband’s fault that he got prostate cancer. It’s not your husband’s fault that he needed cardiac catheterization. It’s not your fault that you were unable to predict any of this beforehand and avoid it. It’s life! We make of our lives what we can … for better for worse, for richer for poorer (even if it isn’t until death us shall part). So if you want to try and find a positive solution to the current situation, it isn’t going to help if you are (even secretly) blaming your husband. He’s in as much shock and fear and worry as you are. He no longer knows what he can do to “be a man” … and he is going to have to come to terms with a new way to do that, which may have little to do with intercourse and a lot to do with other forms of intimate behavior in its broadest sense.

    Sometimes … in the immortal words of a whole bunch of really smart people, “Life sucks” … and the question is going to be what you want to do about it!


  56. My husband was diagnosed several months ago. At this point no treatment has begun as his doctor said it’s very mild. As of a day ago, he cannot get an erection. Just wondering if this could be related. He just turned 50 in August.

    Thank you


    Amy replied:

    Dear Tammy:

    If your husband is 50 and was unable to get an erection for the first time only very recently, it seems highly unlikely to me that this is associated solely with the fact that he has been diagnosed with prostate cancer. Erectile dysfunction happens as men get older. But that doesn’t mean it is going to happen the next time both of you are “interested”.

    On the other hand, if you both start to worry that he isn’t going to be able to get an erection, I can tell you that that will put pressure on him to “perform” … and with pressure to “perform” will come “performance anxiety” which can (sadly) increase the likelihood of failure to perform appropriately.

    You are both going to need to find a way to relax about the whole thing. And it is perfectly possible that one of those little blue pills (Viagra or similar) will help your husband to deal with any performance issues that are just related to aging. There is no good reason that I am aware of why someone with low-risk prostate cancer who is on an active monitoring program shouldn’t be able to have a perfectly good erection just because of the prostate cancer. While this is possible, it is most unlikely that a man would go from being perfectly sexually function to sexually non-functional suddenly like that. Give it a few days, and try not to pressure him about it. He’s probably more worried about it than he is trying to show.


  57. TraceyRN,

    I had to wait a few days after reading your letter to reply because it made me so sad. My husband (at 56) had a prostatectomy in 2012. I am probably — no certainly — the worst person in the whole world to give advice about your situation because mine turned into a living hell.

    But I want you to know that you are not alone — and I know that doesn’t help very much, but just in case it does, there you have it. I too have sooo much anger, as I’ve mentioned on here in previous posts. (My sorry tale is written above in several posts. I never did get a divorce because of about a million things, but we live like we have an in-house separation — it’s even worse than living like roommates. Anyway, that’s neither here nor there — our problems are not your problems.)

    My only suggestion is to try really hard to work on things NOW. Don’t put it off. Don’t ignore it because “He’s just glad to be alive.” That’s bullshit. My husband and I put off being open and honest about it, and I grew angrier, lonelier, and more and more resentful — and it even went downhill after that with me in a true depression that now just won’t lift (and an affair that completely broke my heart and further wrecked my life). I never have had a chance to have my feelings validated, and that has cause irreparable harm to our relationship — in fact, to my whole life. Your feelings, no matter what they are, are VALID and should be shared and accepted.

    So, no matter how hard it is, if you envision any sort of future with this man, don’t wait for erections, don’t wait for him to feel intimate, don’t wait for him to start sharing his feelings — start talking about it now. Start touching, kissing, and stay sleeping together. And btw, your sadness about ejaculation is fully understandable to me. It’s just one more really sad thing. I will always feel like “they” broke my husband, and I can’t fix it.

    What a mess. Please, get your feelings out there and find some way to deal with them together. I’m so sorry you are dealing with this. I know every feeling you have.



  58. My husband had a prostatectomy about 10 days ago. Unfortunately, before that, he had moved out several months ago. He told me a couple months ago that he was diagnosed with prostate cancer and that the doctor recommended surgery for his treatment. He is 53. I just haven’t gone into everything before this with him leaving but I can if it will help with any advice.

    We talked for couple hours before his surgery and talked after his surgery. He texted me to let me know he was out of the hospital and there has been no contact since. I have tried to get in touch with him but he won’t contact me back to let me know how he is doing or where he is staying so that I can help him in any way or see him at all. I don’t know what to do at this point. I have tried to let him know I would be there for him. I would help him in any way he needed and take him food if he would just let me know where he was and what was going on with him. Should I try and get in touch with other relatives to see if they know where he is or should I just wait for him?

    I just don’t want him to think I don’t care. I know he is going through a lot of adjustments both physical and mental. Any advice wound be appreciated.


    Amy replied:

    Dear Elaine:

    So I have been thinking about your message for several hours since I first saw it this morning. And I can feel your desire to make sure that your ex-husband (or whatever he now is) is “all right”. But … For whatever reason, this man decided to walk out on you. And at that point your former responsibilities to him ended.

    It is one thing to check in on him once in a while and ask how he is doing (maybe once a month). It is quite another to feel the responsibility (to use your words) to “help him in any way he needed and take him food if he would just let me know where he was and what was going on with him.” If you had walked out on him and he was chasing after you in this way, you might even feel that he was stalking you.

    Obviously I have no idea what caused the end of your relationship as a couple, but it seems very clear to me that that relationship is ended. As a consequence, you need to move on. Stop worrying about looking after him. He got your messages. If he wants your help, he clearly knows where to find you. And if he doesn’t want your help, then you will seem foolish to keep offering it.

    Maybe you miss your husband. Maybe you are concerned that he just won’t be able to cope without your help and support. But maybe what is more important is that you accept the end of the relationship and that you look at what that may mean in terms of other opportunities. So long as you go on defining yourself in terms of what you can do for your former husband, it is going to be hard to put whatever happened behind you and start a new phase of your life … but that is absolutely what you are going to need to do … and it has nothing to do with your ex-husband’s prostate cancer; that is his problem to manage and overcome, not yours.

    I am sorry to seem so blunt, but sometimes the past is the past and we need to move into the future with a sense of new opportunity.


  59. Hi Amy.

    My husband had a radical prostatectomy in October of 2012. He is now 51 and I am 55. He is a very controlling and narcisistic man. After the surgery he had the normal recovery issues, but he can get erections. We eventually resumed our sex life. He has always seemed to go in spurts of tons of sex, some sex, and weeks without sex. We did become very regular in the summer of 2014. He couldn’t get enough of me. One night on our evening walk (which has now ceased) he mentioned that he would never be the same after surgery and that he can’t get erect without stimulation. I don’t know what he meant by stimulation. Porn? Well I found many pictures of large-breasted women and gigantic boob videos on his phone. When confronted with this he denied it and as usual turned it around on me. Saying I had audacity to look at his phone. Recently I noticed some porn site coming to our shared e-mail. Most to the spam folder but don’t you have to go to a like site in order to get porn sites sent to you? And the other day I heard through the bathroom door “Ooh you’re so hot.” And this morning I heard “You are so awesome.” The last one was said while he was in the shower masturbating (I believe). I also notice that he is now really staring at teenage girls. It is embarrassingly obvious. It hurts that he has turned to porn over me. When I initiate sex he goes nuts on me screaming that he doesn’t feel good. That I needed to leave him alone. That I am putting too much pressure on him. I only want him to love me. I tell him that I need sex and intimacy. He now seems to have trouble getting an erection when I touch him. Seems to take forever! When we do have intercourse it does not last for more than a few minutes. His penis does not get as hard and it does not seem to be as long as it was prior to surgery. I feel he prefers porn over me now. He has also mentioned that he leaks sometimes. I did notice that he leaked urine onto the bed one time and another time he leaked urine into me during intercourse. He sleeps on the couch, saying he needs space and oxygen. He has been an alcoholic since day also. He has recently decided to lose weight, stop drinking, keep his truck clean, etc. Affair? He holds my hand a lot in the truck. I usually get a hug, kiss, and I love you in the morning. But true intimacy he avoids. I cannot talk to him about anything. He says I am torturing him! He hollers at me for everything from leaving the door open to throwing away two pieces of bread. (“Don’t make me go through the trash and find the bread you said you didn’t throw out.”) We have a business together so leaving would be a mess. But I cannot take the constant criticism, ridicule, and suppression. Not to mention sleeping alone. He seems enraged and he blames me. He says I am the only problem he has! What is going on and should I leave him? I have done everything to keep us together and am worn out. I go to counseling by myself. He will not go with me.


    Dear Lorelei:

    Apparently your husband is rather more than just a narcisist. Based on your description above he seems to be an arrogant, self-oriented, narcisist with a bunch of other less than attractive qualities too.

    Having said that, I am in no position to tell you whether you should leave him or not. That’s a decision you need to come to with your counselor and with friends who know both you and your husband far better than I do. Couples can have all sorts of odd dynamics that “work” for them in the weirdest ways, and I am not a therapist.

    What I will say is that I don’t think much of what is going on here has to do with your husband’s prostate cancer. It seems to have a great deal more to do with his behaviors as a person. And very little of it is something that I would put up with personally for very long. I mean I am sorry for any man who has to deal with the consequences of diagnosis and treatment for prostate cancer, but such a diagnosis and treatment is not a license to behave like something left over from the late Stone Age that also has access to the Internet! However difficult it may be to deal with your joint assets in the business you built together, one has to ask just how much of his ongoing behavior you are willing to deal with?

  60. Hi, I need some advice.

    My husband had a prostatectomy 2 years ago. He is 42, I am 28. He got diagnosed 1 year after we got married. We are here 2 years post-surgery and things are getting very rough. As it has been mentioned several times due to his age we were given the idea that his recovery rate was so much higher. We were expecting a recovery stupidly, and were completely grief struck when it didn’t work out. I love him with all of my heart, but I can’t stop being sad. I am very sad. We used to have a very good connection, sex was our connection and it was hard to admit that because its gone now. He can’t maintain an erection and he lost inches. We have tried everything, toys, oral, etc. Its not a good replacement. Not that he doesn’t try, but its awkward, uncomfortable and it leaves us both frustrated at the end, and usually in tears. His confidence is gone, his self-esteem has been damaged. We still love each other very much but we are lacking. There is a hole. Things aren’t great. There is a big piece missing. I am afraid to spend my life like this or let it get worse. I don’t want to resent him and I don’t want him to resent me. I am freaking out because I see more and more what I am not getting out of this relationship. I am on the verge of leaving because I don’t want to hurt him. I am also afraid of leaving him, wondering how he would cope with that. Would he be able to? He is very loving, calm, caring — he rubs my back, legs, etc., while we watch tv, and he kisses me, hugs me, loves me. Throughout all of this though we aren’t the same couple that we were. Lately we have been on edge; the smallest things that we never would argue about have been throwing us into huge arguments. I don’t know if I can live my life without passion, or in a relationship where we come home, make dinner, watch tv, go to sleep, get up, go to work, then die. He is dependable. I live a comfortable life. He is perfect in every other way. I just feel like we are playing house sometimes.


    Amy replied:

    Dear Can:

    It can take as much as 3 years for some men to regain meaningful erectile and sexual function after a radical prostatectomy, but … If nothing is happening after 2 years in a man of your husband’s age, I would think it was time for you both to go sit down with someone who specializes in penile implant surgery and talk about this option.

    Penile implants today can be highly effective and satisfactory for both partners. Are they “the same”? Well I have no personal experience and clearly they aren’t going to be “the same” for men, but I am aware that many men who have undergone such surgery claim to be very happy about the results, as do many spouses/partners.

    Are there risks associated with such surgery? Yes, there are, which is why, if you want to consider this, you need to have it done by someone who really knows what he or she is doing as a surgeon, and who does this regularly. It is my understanding that with an appropriately skilled and experienced surgeon the risks are not high.

    The other problem is that your health insurance is almost certainly not going to pay for this. The costs can vary considerably, but I have heard of well-qualified providers carrying out such surgery for about $20,000 (including all of the relevant costs) and that doesn’t seem to be a lot to invest in a happy marriage if that is what you both get back out of the result again.

    The discovery of just how important good sex is to any long-term relationship can be a shock for people … but it really shouldn’t be. It is commonly the tried and true tool we can all fall back on when things get rough, and so when it is not there we don’t know how to find our way out of those difficult times. You and your husband clearly love each other. It seems to me that you owe each other at least one more chance to see if there is a good solution to the problem.


  61. My husband had his prostate taken out. I heard he could have surgery to have sex back in our lives. It’s upsetting that he tells me he will and now he won’t. I am a woman who is now empty from that kind of life with him. He has turned very different now. I cry more than I ever have in 30 years with him.

    I just don’t what to do.


    Amy replied:

    Dear Linda:

    I am so sorry to hear about your situation (and your husband’s too).

    It is one of the sad facts about prostate cancer that all too many couples are either given or gain a false level of hope about the ability to regain a normal level of erectile and sexual function after surgery for prostate cancer. It is also hard to know where to apportion “responsibility” for this false hope, because while it is certainly possible for some men to regain decent erectile and sexual function (if they have surgery carried out by a highly skilled specialist, and they are able to have bilateral, nerve-sparing surgery), it is also true that this does not happen for the vast majority of men.

    It is my strong impression that two things happen when a urologist gets together with a patient to discuss the outcomes of a radical prostatectomy: (1) the surgeon tends to paint an overly rosy picture of the possibility of recovery of erectile/sexual function and (2) the patients all too often only hear the “rosy” part of the information and just mentally tune out when the doctor tells them that s/he can’t guarantee such recovery of erectile/sexual function. In other words, both parties share the blame to at least some extent.

    The very latest data, just reported at a major meeting in Europe in the past week, suggest that only about 5% of men who have a radical prostatectomy will ever regain erectile/sexual function that is as good as what they had immediately prior to their surgery! Earlier data have suggested that it might be as high as 20% or 25%. Either way, the probabilities are not good.

    The ability to get past this loss is very, very difficult … for both the patients and their “significant others”. The men often feel that they have lost what “made them a man”. The women often feel that, as a consequence, they have lost the most fundamental aspect of their intimacy with their husband/partner. Both parties all too easily become depressed and they find it near to impossible to work out how to move on with their lives. Professional counseling can help, and clear communication between the two members of the couple is imperative.

    I will tell you that if your husband really has lost the ability to get meaningful erections, even with drugs like Viagra and other methods, there are a lot of men who swear by the success of getting a penile implant. I have discussed this before in some of my prior replies. This is not an easy decision to take, and it may have financial implications, but it really does work for some couples, so you and your husband could at least try to talk about this.

  62. I was thinking about this site again recently and decided to check in here again. It’s been since September since I last posted here. Time flies!

    One positive change I made was going back to work. I haven’t worked outside the home for nearly 20 years. I realized that being at home all the time was depressing me. I found a fantastic job that fits my abilities and personality to a tee, and I work with some genuinely nice people in an industry I truly am interested in and have a passion for.

    I am still seeing a therapist but, as of a few weeks ago, I decided to attend sessions by myself. I don’t think my husband was really listening. I also think that we needed to be going at least every 2 weeks, not every month to 6 weeks, but it was hard to get appointments.

    My husband still seems to think, by his comments, that the therapy is to somehow fix me. He will say things like, “If you need me to go with you, I will …” and I told him yes, it is important but, …. So I decided to just do individual appointments now to work on myself.

    I read TraceyRN’s post and my heart hurts for her. Tracey, try going through it when you are 24. If you think you feel anger for losing something in life, you can imagine how I feel, having lost it in my 20s.

    No one has ever asked me how the surgery affected me. I realize that my depressed episodes and my anger are likely from having part of my life taken away. I’m angry that I stayed sometimes. I feel like I have just decided to make do. If I don’t think about certain things, then things are fine. It’s avoidance I guess. I know that’s probably not the best way to deal with things, but when I try to have discussions with my husband, or try to get some things out in the air in therapy, nothing really productive happens. That’s why I decided to go to a few therapy sessions by myself, so I can ask the therapist how to go forward.

    I’ve been a caretaker for a long time. Our relationship most often resembles a parent/child relationship rather than an equal partnership. The word co-dependent came up in something I was reading lately and the characteristics fit me to a tee. I’ve put aside my wants and interests to make him happy. I feel sorry for him. I put any sexual feelings I have away.

    Where do I go from here? I can just stay in this relationship. Things aren’t so bad. Then, there are times when I feel like I’m missing out, like I’m cheating myself and putting my life on hold.

    I’m so grateful for this site and the honest discussion.


    Amy replied:

    Hello Lilly.

    I am glad to hear you have decided to take some aspects of your own life back under your own control. I think this is probably important to you moving forward and deciding what you really want to have and accomplish. In addition, going back to work will have given you something else important to focus on other than “just” the relationship.

    Your husband seems to have come to his own conclusions about who is “responsible” for the current and past state of affairs. He is probably utterly unable to conceive of the idea that he has any level of responsibility. Alas, I have come across this problem before.

    Give yourself some time. Make sure that the psychotherapist you are seeing helps you to face up to some of the really tough questions you are going to need to deal with — when you are ready. I know this is all hard, but you are taking steps down an important path. Either your husband is going to “get it” and come with you (hopefully sooner rather than later) or he isn’t.


  63. Dear Amy:

    I reconnected with an old boyfriend after 35 years. He sought me out and really pushed for me to go out with him. I found myself very attracted to him and was surprised that he didn’t seem interested in me romantically. I saw him a few months after that but nothing romantic or sexual happened. I called him on his birthday and at Christmas. He always seemed happy to hear from me but did not seem romantically inclined toward me. I have been disappointed because I am very attracted to this man. After 4 months of no calls or anything, I found myself having attracted two other men into my life who have shown an interest in me.

    I suppose that I was feeling confident and called my old boyfriend. I told him that I was going to study Taoist sexual alchemy and he was extremely interested and asked if he could “practice” with me. I was delighted and told him that I didn’t think he was interested in me any longer. He told me that he had tried to kiss me and that I turned away which is absolutely not true and really perplexed me.

    We have gotten together now and had sex twice and I at first thought that his penis was altered after so many years of being apart. He also would not allow me to touch his testicles or come near the perineal region. After the second time of having sex I could tell without a doubt that he has had a penile implant. He has said absolutely nothing to me about this.

    I am being brutally honest but the feeling during sex is very strange and not satisfying to me. It is hard to explain but there is a squishiness and lack of full connection which I cannot explain completely. After the first time I had sex with him and did not suspect he had an implant I found myself extremely sad after the sex act and could not understand why I would feel this way. He also complained to me that he has to clean his house when I come and see him and that I don’t have to do as much as he does when we get together.

    This man is extremely wealthy and I am not. I have a very small, cramped apartment and know that he would be uncomfortable there. I say all this because I feel very hurt that he has not been honest with me and has not appreciated my affection and care for him in the light of this situation. I am afraid to mention anything because he obviously thinks that I cannot notice. I really don’t know what to do. I feel that I am perhaps being selfish but I don’t feel appreciated or valued by him.


    Amy replied:

    Dear Nest:

    With the very best will in the world, if this man isn’t honest with you, why pursue the relationship? There’s no good basis for a future there (or at least, no future that will be satisfying for another 20+ years).

    Well packaged toys can be very alluring … but if the toy in the box turns out to be damaged, you ain’t gonna wanna play with it for long.

    Have confidence in yourself and who you are. … If he wants to go back to being friends, fine, but you are looking for someone with whom to have an intimate and loving relationship. This man is already complaining to you, as well as hiding the truth.


  64. Dear Amy:

    Thank you so much for your wise and comforting reply. I was afraid that I was being “the bad guy” in all this. You really made me smile with your comment about well packaged toys; this man is the epitome of that! You render a wonderful service in this blog. I feel a weight has been lifted off me. Thanks so much.

    Best wishes,


  65. Dear Amy:

    I am 34 years old. My husband is 56. We have been married for almost 10 years now. However, my husband was diagnosed with prostate cancer in 2012. He had surgery, but is now struggling with ED. Since his diagnosis and treatment, I have been dealing with this issue alone with no family or friends’ support. I have isolated myself from the world, as I am very angry, confused and hurt.

    In addition to dealing with the ED, which is also taking a toll on me mentally and physically, since I do emotional eating, I am caring for an adult autistic son who beats me up frequently. I am just so exhausted to where I sometimes just want out the marriage. I am trying so hard to hang on, but feel as though I can’t keep going. I love my husband, but not being able to have sex is affecting me a great deal and taking care of his son with behavioral issues just adds to my stress.

    I don’t drink, smoke, or go to clubs. I have been running marathons to help cope, but I am at my wit’s end. I think everyone has their breaking point and I’m just exhausted. I feel very lonely. I have a graduate degree and can’t even find quality work, so I’ve been a housewife for many years now, but want my own independence.

    Any advice is greatly appreciated. Thank you.


    Amy replied:

    Dear Shauna:

    If you are being physically abused by any adult, this is a priority that needs to be dealt with. These situations can be very hard to handle for any family, but your husband’s son apparently needs some form of institutional care at least some of the time. No one should expect you to be trying to care for an adult male who is physically abusive — even if he has no idea what he is doing.

    Second, isolating yourself from the rest of the world is no way to help yourself or anyone else under the circumstances. All that will do is make quite sure that there is no one for you to reach out to for help. But you clearly need help — if only to deal with the problem of your husband’s son.

    Third, the combination of self-isolation and intellectual isolation has left you with no outlets for you to have any type of life. I don’t know what you are willing to do about this, but you clearly need to “do something” about it, starting with a conversation with your husband in which you are clear that the current situation is unacceptable.

    And then there is the sexual issue because of your husband’s ED, which sounds to me as though it is simply the “final straw” that has broken the camel’s back.

    As you well appreciate, this is a complex set of loads that you are being expected to carry, and very few of us could cope with all of these. You need to find some way to break this cycle in which (it appears) everyone thinks they have the right to take advantage of you … but to some extent you have collaborated in allowing this to happen (although obviously it is neither your nor your husband’s fault that he has prostate cancer-related ED).

    If I know one thing about happiness, it is that isn’t going to be possible in a situation like the one you describe. You need to find at least some way to be able to “get a life” of your own for some of the time. How to do this may be hard, however, because it may be very dependent on your husband’s willingness to accept the reality of the situation. One of the things you are not telling me is what he is doing to help, which tends to make me wonder whether he is doing anything.

  66. Dear Amy:

    May I talk to you by e-mail in private on my e-mail address above? It’s about my husband who no longer has his prostate. Its very hard on me … So if you have a time that is open I could e-mail you what has been happening. Only in private please by e-mail.

    Thank you.



    Amy replied:

    Dear L:

    I am very sorry, but I decided years ago that I just wouldn’t do this by e-mail. One of the reasons I do this is so that other people can see these conversations and understand that they are not alone.

    As you can see, we can control what other people could possibly know about who is participating in these conversations. No one can see your name or your e-mail address or anything else that could possibly be used to identify you. So there is nothing for you to be concerned about others finding out and everyone can feel able to say exactly what they need to say. However, it is so very important for others to be able to see these conversations too, in part so that they can understand that being secretive about the problems and their impact doesn’t help. One needs to be open and honest with oneself and others about what the problems are — but I do understand the need for confidentiality, and we respect that.

    I hope you will feel that you are able to talk to me in this way. Maybe the best thing is to start with something small that you feel you can talk about openly. I promise to protect your personal information.


  67. Dear Amy,

    I see myself in so many of the conversations above. I envy the woman whose husband/partner will at least touch her, hug her, rub her legs while watching TV. My husband was diagnosed in 2012 with prostate cancer, had radiation treatment, and is cancer free — but all of the intimacy and ED problems are slowly sapping the energy out of our relationship. I recently re-visited my therapist who suggested the communication route, which I have tried repeatedly in a few different ways. My next step is becoming a roommate (separate bedrooms) because he is not responding to the communication techniques I am trying. I never belittle or push him into anything to keep his ego intact.

    He says he wants to try satisfying me sexually but after about 5 minutes of half-hearted efforts he stops. This last year he has avoided any sexual or intimate contact at all, which leaves me very frustrated, sad, and angry. I am very happy he is cancer-free, but I agree the medical professionals do not talk about life after cancer and paint a rosy picture of recovery and functionality. Nor do they address the spouse/partner issues and what steps in general they might consider. I do understand the person with prostate cancer is the patient and not the spouse, but the depression and other feelings that impact the marriage/relationship should be something they address with the cancer patient.

    I am angry most of the time and he tries so hard to make up for it in other ways — mostly material but that is not what I want. And he is an excellent provider. I want just a little intimacy. I even defined what I wanted/needed and told him it was the effort that counted for me … but I don’t even get that.

    I am at my wit’s end and I refuse to accept that the rest of my life with him will be more of the same … no sex, no intimacy. I can tell he is afraid I will leave him by some of the comments he makes … always in a teasing manner but that hint of fear is in the background. I have been with this man for over 20 years, married for 2 (we finally decided to tie the knot after so many years together).

    I get it that there are many other women out there with similar issues, but the bottom line is, what to do to be happy? Stay and grieve, leave and grieve. I don’t want to be a bitter old lady wishing I had left and tried to start again because I decided to stay. I read this quote somewhere … if you change nothing, nothing will change.

    I am just venting, most of us just want to be heard by someone because we don’t feel our partners hear us. The decision is ultimately up to me once I feel I have done all that I can humanly do. I can’t fix anyone else, I can only fix me. I learned this from an abusive relationship I was in many, many years ago where I was almost killed because I stayed too long. That almost cost me my life; this one will cost me my soul because as humans we all need that physical contact that nurtures our soul.


    Amy replied:

    Dear Rocky:

    I so absolutely do hear you … and I do so absolutely wish I had a magic wand to wave that could make all your problems and similar ones of so many other spouses and partners of prostate cancer patients simply vanish into the ether.


  68. I have been dating a man for 2 years that’s had prostate cancer. We have never attempted to have sex. He did say he rarely think about sex, but I feel that he’s not very affectionate. I’m in my 60s, so not having sex doesn’t bother me; I really like him but don’t know how to handle this situation. I feel he’s standoffish because of this problem. Any advice would be good.


    Dear C.

    I think the answer to your question is relatively straightforward. After 2 years of dating it’s high time that you and the gentlemen in question need to have an honest and straightforward conversation about what you both want out of this relationship over the long term. It sounds to me as though you haven’t come near to having that discussion.

    You clearly each enjoy the other’s companionship, but it is going to be very important for you both to decide whether that is enough or whether you want it to go further. If the latter is the case, then he certainly needs to be able to fully understand that “the sex factor” is not a big deal for you (although I would assume that a regular cuddle might be appreciated!)

    A least one or other of you needs to put all the cards on the table!

    I hope that this is helpful.


  69. Oh my goodness, I am so relieved or happy or desperate to have found this site. I feel a little less crazy after skimming through the comments. On some level I am so angry at the cancer, at my hubby, at myself. … I hate admitting that I need anything, let alone sex, and I am scared and alone and everything is so difficult to talk about let alone talking about sex and loss and fear.

    I find that I am just plain irritable with my hubby and I am pushing him away because I am afraid he is going to die and then I feel stupid and selfish that I am thinking about sex, about never having sex again. He had brachytherapy a little over a month ago. We had sex for the first time last week and I feel so guilty asking him. I feel so guilty that I need to be touched and loved and I’m afraid to touch him and that it will hurt him. I’m also having a tough time being loving and oh my goodness I keep worrying that it is going to get worse and that since it is still early on that he is fine for now but that the radiation hasn’t done it’s full damage and soon it will be terrible. That eventually he won’t be able to have sex or anything.

    I fear that he will lose desire in not only the act itself but in me and, again, I am feeling so selfish. And when we did have sex he said he was in pain the next day and I was worried and again I felt terrible and guilty and I feel guilty a lot. And then I felt sick the next day and had diarrhea and it happened again this week the morning after we had sex and I am worried that it has something to do with the radiation and I don’t know. It’s all crazy and I just want my hubby back and he is depressed and scared and thinks he is dying but it’s all confusing because he some days he sleeps forever and other days he seems fine and if he isn’t fine would he be having sex and I could go on and on, but thank you so much for making me feel so not alone.


    Amy replied:

    Dear Ambivalent One:

    So your feelings of selfishness and guilt and pain and worry and all the other things are … wait for it … very normal!

    Of course that doesn’t help very much in the short term, but you do need to understand that you are not to blame for any of this … because it isn’t your fault. Your husband is probably going through a whole series of very similar emotional roller coaster rides as he worries about losing his sexual abilities and therefore losing you and … [you can fill in the blanks]. Whatever you are feeling, he is probably feeling the precise, corresponding male emotion (but of course being male he isn’t “allowed” to express his fears at all).

    So … The key to all of this is going to be communication between you and patience with each other. Patience can be difficult and good communication requires some hard work by all concerned, but they are both going to be essential if you want to come out of the other end of this tunnel with a sense of success and a shared responsibility for that success.

    It seems highly unlikely to me that your post-coital diarrhea had anything at all to do with your husband’s radiation therapy. You’d have had to be “at it” for hours to create an effect like that. It is much more likely that the diarrhea was just your own nervous response to the whole issue.

    With respect to your husband’s post-coital pain … He has had a serious medical/surgical procedure. It will take time to recover from this. You are both going to need to take this slowly, and “be gentle with each other”.

    Also … It’s time to be a little more creative about how to maintain your intimacy time. Get him to give you a massage (yes, the naked type, with some massage oil) as opposed to just focusing on the “sex” bit . He will know when he wants to “do more” about things … and that will take the onus off you to ask. Focus on laughing together about what you want and don’t want (or are unable) to do at the moment. Seriously. I mean there really is a funny side to this. Don’t be “afraid to touch him” … but do make sure you ask him if what you are doing feels good to him. Above all, use your imagination, and stimulate his! Most women know exactly how to make a man “want them” without ever having to actually ask … so “turn up the charm” and make him want to come to you as opposed to actually asking. And when he does, be coy, and ask if he is “sure” ‘cos you don’t want him to be hurt again.

    Oh … and dump the ambivalence … You know what you want; he knows what you want; he wants it too; and the trick is going to be finding out the reasonable limits of the possible in a guilt-free, collaborative series of experiments!



  70. Hi,

    My father had radioactive seeds implanted about a week ago. I was in his presence when he came out of surgery and then again a week later for a few hours one day. I kissed him hello on the cheek when I recently saw him on that day. I am waiting to find out if I’m pregnant or not so I’ve been a little nervous about our two interactions since the procedure, particularly kissing him hello on the cheek. I have done a bit of reading on it and the medical recommendation seems to be to stay about 3 ft away and do not touch, kiss, hug, etc. I’m a little nervous but I’m not sure if I’m overreacting. Do you have any personal experience that you or your children have experienced with this?


    Amy replied:

    Dear Layla:

    I have no personal experience related to this issue. However, my understanding is that the occasional touch or peck on the cheek should not be a problem. What needs to be avoided is any form of relatively long-term close interaction. In other words, sitting close together on a couch for 5 minutes would not be a good idea.

    Your caution is completely understandable. I don’t think you are “over-reacting”. On the other hand, I do think you need to be clear with your father about why you are being a little more “distant” that you may have been in the past. You could also ask him to ask his doctors about how long he should encourage such avoidance of close contact with young children and women who are or may be pregnant. That time period depends on precisely what type of radioactive implant was used to treat him. The relevant information may well be in materials that he was given at the doctor’s office at the time of or prior to his treatment.

    Hope this helps.


  71. I just met a man who has prostate cancer, and I really like him. How can I please him, and make him happy? Help.


    Amy replied:

    Dear Denise:

    The key to a good relationship with this man or any other man (with or without prostate cancer) is not going to be, “How can you please him and make him happy?” Rather it is, “What is it that each of you can bring to the relationship that gives you both joy?”

    In my experience, women tread on very dangerous ground when they think it is their responsibility to “make a man happy”. This is a two way street. And the first law of any two way street is that it has two way traffic!

    Regardless of all of the other things that you may do together over time … what will build a mutually satisfying and enjoyable relationship is the ability to communicate with each other about anything and everything … even when you disagree (and perhaps especially when you disagree).

    Now it is true that there are things about prostate cancer that are going to affect such a relationship, and you and he need to get those out on the table as part of the “getting to know you” experience, just as there would be if you had had breast cancer or some other form of gynecologic cancer. These issues are often difficult for men to talk about, and so my advice to you is to take things one step at a time and don’t try to rush anything. If he likes you as much as you like him, then you will both be very comfortable just spending time together and learning about each others likes, dislikes, joys, and fears.


  72. My significant other had his prostate removed. Radiation was out of the question so he decided to have it removed. It’s been 3 months since the surgery. The doctor told him that he can’t produce semen again — ever. My question is: how does or how will he be able to have an orgasm?


    Amy replied:

    Dear Lynne:

    Even though your “SO” will not be able to produce semen and will therefore not actually ejaculate semen at the time of orgasm (assuming he recovers decent erectile and sexual function after a while), he will still be able to experience what is commonly known as “dry orgasm”. This is a combination of the contraction of relevant muscles and the mental sense of “climax” for a man. There is a detailed discussion of what goes on if you click here to go to the Harvard Medical School “Prostate Knowledge” web pages.

    Now a “dry orgasm” is different to the type of orgasm your SO is used to, but (I am told, since obviously I have never actually had one myself) that it can still be very satisfying for the man. For the woman, also obviously, since there is no ejaculate there is or can be a loss of the sensations associated with male ejaculation, which rather depends on the intensity and quantity of the ejaculation that you may have been accustomed to feeling.

    Some of the pros and cons of dry orgasms are also discussed (pretty bluntly) by patients here on the Healing Well prostate cancer forum

    Hope that helps.


  73. Lilly there is 7 years between myself and my husband but I could have written your letter.

  74. My question is: I’m 56 and my wife is 45; we’ve been together for 29 years. I’m going to have my prostate removed because of high-risk cancer. I already have problems getting a erection, even pills no longer work, and I do not want my wife to have to go without sex because I can no longer have sex. She is very sexual and loves sex; so do I, but its not going to happen for me. Is it wrong for me to want her to have sex with other men so she will not be deprived of her needs because of me. Our marriage is very strong and can handle this. What do you think? Am I wrong?


    Amy replied:

    Dear Perry:

    So I have two comments on your situation/question.

    (1) It doesn’t matter a jot what I think, and it also really doesn’t matter a jot what you think either. What matters in a situation like this is what your wife thinks! If having sex with another man or men is not something she is interested in, then you are wrong! And you need to listen carefully to her point of view, because it is really the only one that matters!

    (2) If you are focused on your wife’s sexual satisfaction, and she isn’t interested in your proposed solution, then you probably should sit down and talk with her about whether you should get a penile implant put in after you’ve had your prostate taken out. Many men swear by these. And just a couple of days ago I saw that our Sitemaster posted an article about a company called which can help to arrange for this to be done by suitably experienced surgeons in different parts of the US, and provide a very clear price up front. Of course I have no idea whether you could afford this, but that’s up to you and Mrs. B. It’s certainly no more expensive than a new car.

    Hope that helps


  75. I am 53; my husband is 54. We had been married for 34 years prior to prostate cancer 4 years ago. We had sex three times a week. Now he cannot get an erection and seems to have no desire for me. Sad thing is we have been best friends and lovers since we were 18 and 19. I know that he still loves me, but I miss him intimately terribly.


    Amy replied:

    Dear Sheryl:

    I don’t often quote ex-Presidents, but, to steal from Bill Clinton, “I feel your pain.”

    The loss of erectile function after a radical prostatectomy can be completely devastating for most men. And then it can become devastating for their partners too — however much they love each other. I have no simple answer to this problem … and nor does anyone else (as far as I can tell). The one thing that I do know is that resolution depends on communication.

    Most of us never really talk about how important (or irrelevant) sex is in our lives. We just do it. And then, if it is suddenly taken away, we have no idea how to respond.

    There are a couple of things that I can suggest that you might want to try. First, listen to a recent hour-long interview and discussion with a nurse educator called Anne Katz that you can find on line here. It is all about the problem you are dealing with. If you can get your husband to listen to it with you, so much the better. Second, there is a male patient called Michael Russer who lost all his erectile function after his own radical prostatectomy but who now lectures on sex afterwards. His and his partner’s experience (according to him) is that it has absolutely transformed their sex life for the better. Now I can’t confirm that for you on any personal basis … but you could do worse than have a listen to what he has to say on the subject, and again … if you can get your husband to listen too, so much the better.

    And Sheryl … See the message immediately below from Shawn (but I haven’t been able to listed to that myself yet).

    Recovery for your husband — and therefore recovery for you too — is going to be all about him discovering that who he is is not just a matter of his erectile function. Rather, it is all about his ability to discover new ways to just “be a man”.

    Hope this helps.

  76. Since reading several of the comments here last month, I’ve been feeling so sad about folks whose relationships dissolve because of penis issues. There is so much more to a sexual relationship! This morning, I woke up to a fascinating interview on the CBC (Canada’s public broadcaster) where a disabled broadcaster Mik Scarlet was discussing orgasms without a penis. Your readers might value the conversation. Here’s the podcast link to listen to the 27-minute piece. I hope it will help some relationships to thrive despite the challenges ahead.


    Amy replied:

    Thank you Shawn. As you will see, I let Sheryl know (immediately above).


  77. Looking for a RSI/MRI availability in Maryland area? Heard it was one of the newer techniques to determine if it is prostate cancer before biopsy.


    Amy replied:

    Dear Lynne:

    I asked the sitemaster and he tells me that one of the most sophisticated centers for prostate imaging prior to diagnosis is at the National Institutes of Health Clinical Center at Bethesda, MD (in the group overseen by Dr. Peter Pinto). If they can’t see your husband/partner there, I am sure they would be able to recommend another center.


  78. I have been with my husband for 36 years. … He is 6 years younger than myself. … I am 61 and he is 55. … He has never been one for sex. … In some ways I wonder about him. … He says he doesn’t have sex with me because I have a tummy and he hates it … but when I didn’t have the tummy and put on weight, it was the same way with him. … I had to always ask and he would say “No.” … I feel like I am losing it. … I want the feel and touch of a man and I worry about cheating. … We don’t even sleep in same room and he wants to keep it that way. … I am upset every day and long for passion and human touch. … I try to talk to him but he doesn’t want to hear it. … He just smokes and watches TV and does his 40 hours a week. … Never goes out; has no friends. … Then in some ways I don’t want him. … He has called me fat f*** one too many times. … Sorry to bother u. … I am just trying to help me … as I sit here and cry another day. … Been this way for at least 20 years now.


    Amy replied:

    Dear Antoinette:

    I don’t get the impression that your problem has anything to do with prostate cancer … but that doesn’t make the problem any better. On the other hand, I have to ask … Why have you stayed with this man for 20 years? It appears that he has little to no interest in you whatsoever, and apparently you have almost no interest in him either.


  79. Dear Amy,

    All I can say is “ditto, ditto, ditto” to many of these letters. My husband, at 59, had a prostatectomy and IMRT earlier this year. He is a physician. He refuses to return to the urologist regarding his ED despite daily Cialis.

    Our marriage of 36 years is falling apart! I feel like he is throwing our marriage away because he has ED and a resting change in personality.

    I don’t have any specific question — just wanted you to know it helped me to read of others who walked a mile in these shoes! I am seeing a therapist for the first time this week.


    Amy replied:


    Good luck with the therapist. … Try telling your husband he needs to see one too. … Gently if you can manage it. He’s scared to death!


  80. Amy,

    My husband underwent a robotic assisted laproscopic prostectomy in June 2015. I had to sell my car to pay the insurance deductible, as this surgery was quite pricey … but we are told it is worth it.

    We have had three visits to the doctor [since his surgery]. After the catheter was removed on the first visit, they put him on daily Cialis. On our second visit the doctor asked if anything was happening and my husband was having some morning erections (when he had to pee). On our third office visit, the doctor asked if he was getting any sustainable erections. We looked at one another. He said, “Maybe”, and I chimed in “But we haven’t taken it for a spin.”

    Thursday night, my husband told me 2 weeks after the surgery he masturbated to porn, and had an orgasm.

    This is 4 months post-op, and he never told me about this. He has never touched me, and when I tried to be loving he was too tired. Or it wasn’t a good time for him.

    I was devastated, we have only been married 2 years … and I was so worried for him. But I always let him know I believed everything was OK. I am angry because, first of all, … he let me go thru all the extra worrying that was unnecessary and that would have made me feel better, at least on some level, for him. Then, he excluded me from the good part … from the loving part and turned to porn and worked with himself until he had an orgasm. I was excluded.

    I feel cheated on, and abandoned, and now I am worried. What if it doesn’t happen with me? Is it me? Because it happened while he incorporated porn ….

    I am angry at him for keeping the success of the surgery a secret … even from his physician … because how could he tell the doctor he was sexuallly aroused enough and could sustain and erection long enough to climax … when his wife didn’t even know?

    I don’t know if I can ever trust him again. … I was at work; he was recovering at home … and paying for porn and jacking off. And I was worried sick … none the wiser.

    I am devastated … and yes we have discussed every aspect and he really understands why I feel betrayed and lied too. But for once … I need to know … How do I put the image of him getting off to watching other women? … And what if it doesn’t happen with me? … I feel like I am in a lose lose situation.

    Thanks for reading and I look forward to your answer.



    Amy replied:

    Dear Sherie:

    So I think there are a couple of things you need to understand about what may be going on that may not be completely clear for you. And let me be very straightforward that these do not excuse what your husband did … but maybe they help to explain it.

    First, it is perfectly possible for a man to have an orgasm without having a meaningful erection similar to the ones he had prior to his radical surgery. So … one of the things you and your husband need to discuss is exactly that one, as I shall explain below.

    Second, I suspect your husband is absolutely terrified that he will never again be able to get erections of the quality he had before, and everything that he did was associated (in his head) with the idea that he was trying to find out whether he could and would so that he would still be able to satisfy you when he felt confident enough to “take it out for a spin”.

    So the great unanswered question between you is not so much, “How can you turn to porn instead of me?” Rather, I would respectfully suggest, maybe it is, “Well if you were able to have an orgasm over some porn on the Internet, whahoo! When are you going to be ready for some fun with a real woman, i.e., me?”

    Sex is probably not going to be the same as it was before — at least in the short term. Your husband probably feels very insecure about his potential “performance”. His erections may not be anything like as hard or long-lasting as they used to be. He is going to need time to recover as much confidence as he can. Did he do something stupid? Sure he did. He’s male for Heaven’s sake. They do stupid things on a regular basis. But he is also an emotionally and psychologically traumatized male. They do stupid things all the time … just like emotionally and psychologically traumatized women!

    So … In my entirely personal opinion, your best bet is to whack him over the head with a rolled-up up copy of Playboy when he doesn’t see it coming; grin broadly; tell him you forgive him; tell him that if you catch him doing it again you’ll cut the damn thing off; and then tell him it’s time to take you to bed and start working out together how to rediscover how to have fun … even if it isn’t quite the same as it was before. And if he mentions that he’s tired or has a headache again … tell him you’ll give him a real headache by whacking him with the Playboy again.

    In that context — as explained above — one of the things you both need to discover is exactly what his erectile capabilities really are, now, and how you are both going to have to collaborate on how to get sexual gratification as a consequence. And what else feels good … even if you’ve never though to doing it before. This means talking about it; trying different things; laughing about both the successes and the failures; and giving each other permission to feel angry and frustrated and sad when things don’t work in exactly the ways you want them to. But you need to start exploring the realms of the possible … either now or very soon.

    I can’t tell you how well your husband’s erectile and sexual function will recover. I can, however, tell you that until you both get back to trying to deal with this together, his anxiety and fear is only going to become greater. He needs your help. You need his commitment to accept your help. And you both need to stop fighting over something that was probably dumb but also probably not that important in the grand scheme of things.

    OK … Now you can be mad with me because I haven’t told you what you wanted to hear … but I’m actually not sure what else you thought I might be able to tell you!


  81. Dear Amy,

    What a thoughtful and thorough reply that is. I understand why Sherie might feel hurt about the porn, but I’m impressed that her husband at least cared enough about regaining sexual function (and hence their sex life) to try to figure out his current state, … i.e. what he could expect, how he could make “it” work, etc. My husband didn’t even care enough for that, he just completely gave up, dooming me to a life of perpetual loneliness. I would have been thrilled if he had had enough interest to masturbate to porn, if that’s what he needed!

  82. It’s sad to read your story, but at least he may be able to have sex with you in the future. He probably wanted to try it out himself not wanting to be embarrassed if it didn’t all work with you. My husband cant get erections or climax ever again; I am 57 and still want to have sex, but have accepted I never will. If you love him you will understand, as I do. It’ss hard — but so is prostate cancer.

  83. Hi Amy.

    Our situation as of now is meeting with the surgeon that will perform my husband’s robotic prostatectomy. We are both in our early 50s and still enjoying sex very healthily. Understandably he is very worried about the after-effects of surgery. I am more concerned (besides the cancer itself), that during a time of maybe temporary impotence, for however long it is, that he may not be even affectionate to me.

    Right now we do talk about this but in his attempt to also deal with it his way, he jokes a lot and tells people he has cancer so be nice to me, etc., and says he’s joking. I’ve been going along and not saying anything to him until recently. He can’t understand why I don’t want to always hear it and why I can’t laugh always. He says, “Oh come on. I’m just joking and let me deal with it my way.”

    I told him of some of my feelings recently regarding my own concerns of caring for him during recovery. I am a stay at home mom of five children (the youngest is 2 … who we adopted at birth), but during stress the fibromyalgia I have gets worse and so do other physical problems (migraines, degenerative disk in neck). I wouldn’t have brought it to him in the first place but a couple of days ago, he mentioned it himself. Tonight he asked me what we are going to do about it and I said, “Nothing. Don’t worry. You will have your surgery and I’ll take care of all the other things. We’ll get thru it.” But we went to bed not speaking because he said he can’t ever finish what he wants to say (I’m confused because I waited for 5 minutes for him to respond.) I know he’s scared as am I.

    After 5 minutes he did say, “Ya know I’m the one that has cancer”. I just said “I know!” I’m not sure what my actual question is … but I feel he really doesn’t take any of my feelings into account and I’ve totally been there for him since and thru this time.

    Thx for any help you can provide. We are soul mates and I just want things to work out.


    Amy replied:

    Dear Lorna:

    So let me be very clear with you … You’re husband isn’t scared. He’s absolutely terrified. In his mind his diagnosis is not only threatening his life. It is threatening everything about how he has been taught to see himself as a man. And he has been “coping” with this by doing what he has been told that “real men” do … being “strong” and making light of it.

    Conversely, you havee also “coping” with your own fears by doing what women in our society have been taught to do when a member of their family has a serious illness … the “Don’t worry … I’ll take care of it/you” response.

    Here’s the problem. You really aren’t talking about the problem at all. The problem is fear of the unmanageable unknown. Your husband has no idea how to prepare himself for a possible future in which he never has another erection again (something that defines him as a man in his own mind). And neither do you. And that’s just one of the things that could be a real problem. But it’s a pretty big one!

    I can’t tell you “how” you and your husband can actually talk about the real problem — the fear of the unmanageable unknown. I do know that you need to be able to face it together … for yourselves, for each other, and for your kids. And it is hard.

    I think (but obviously I can’t know) that when your husband asked you (the other night) what you are “going to do about it” together, your answer to him (“Nothing. Don’t worry.”) probably felt to him like you were avoiding the subject and shutting down the conversation. A better answer might have been, “I don’t know yet. What do you think you want to do? I know we need to be able to help each other through this.”

    I know how hard it is to have this conversation about things we don’t normally talk about but just do (have sex, make love, touch each other intimately when the kids aren’t looking, and all the other possible ways of being intimate together), but your husband needs a strong message from you that you are going to love him — emotionally and physically — just as much after the surgery as before it. And that “caring for him” is not the only priority. Another and perhaps even bigger priority is going to be helping him to understand (and showing to others) that he is still “your man” in all the ways that you need him and want him to be.

    So … Maybe you could start to practice that even now. The “Oh honey, thank you. I could never have done that without you” strategy can work wonders on a man’s ego when he does the little helpful things that (I hope and assume) he does do. As can all the little touches and hugs and kisses (even if the kids do see some of them!). You can also ask him if he thinks you shut down the conversation the other night — and tell him you didn’t mean to.

    Making sure you talk about everything you need to be able to talk about together is a commitment you need to make to each other … even if you both have to tread on some new ground to do that.

    I hope this helps.


  84. I am 52. Last year I had a 1.4. This year it is 1.8 blood prostate level. Please tell me what this means.


    Amy replied:

    Dear Michael:

    A small rise like this in your PSA level can happen for all sorts of reasons (and may even just depend on the time of day your blood is drawn for the PSA test).

    As a consequence — and because a PSA level is well below the level that anyone would normally worry about it — I can’t tell you whether a PSA level like this means anything at all.

    If you are concerned about this rise, I suggest you talk to your doctor and ask him about getting a repeat PSA level in a couple of months time, but there may be nothing to be concerned about at all.


  85. Hi Amy,

    My ex-boyfriend just went through radiation process. He is testing out well. We are broken up. He isn’t making good points as to why. Is it possible he is going through after effects? No sex problems, just his thought process not making sense.

    Thank you,


    Amy replied:

    Dear Lori:

    The psychological impact of a diagnosis and treatment for prostate cancer can be emotionally and psycho-socially devastating for many men … and, on top of that, they may not be used to or even able to express themselves well to others about what they are dealing with (and that’s if they can talk about it at all). You need to understand and accept that this almost certainly has nothing whatsoever to do with you.

    Exactly where your ex-boyfriend is along the path from shock and denial to acceptance of reality is obviously impossible for me to tell. And the other thing that I can’t tell you is whether or how soon it may be possible for him to come out of the other end of that tunnel. Some men can do it quickly and easily; for others it can take years … or it may never happen at all.

    In the same way, it is impossible for me to know how best you can deal with this from your own perspective. You could try to “just stay friends” — at least for a while — to see if he is able to start to deal with what is probably his own sense of loss of manhood relatively soon, or you can just decide to “move on” with your own life and let him move on with whatever he feels he needs to do.

    The one thing that I am pretty sure in my own mind about is that there is very little point in trying to “be there for him” while he is going through this process unless you get a strong signal from him that he really wants such help from you.

    We women are much more used to and comfortable with talking about these types of emotionally problematic situations. We are better at expressing our fears and our feelings and asking others for help and support. For all too many men, even thinking like that is some type of admittance of “weakness”. It doesn’t make a lot of sense to us … but that’s what a different set of hormones and socialization pressures does to men as compared to women. We are from Venus … and they are very definitely from “somewhere else”!

    Hope this helps … if only a little bit.


  86. I was 54 and my was husband 67 when he had prostrate surgery and had his prostate removed. The specialist told us that he had to remove the right nerves but but the left were left intact. Well it has been 3.5 years since the surgery and we had an active sex live before and there has been nothing since. I find myself being very depressed and my husband, I know it affects him as well, but has decided to have our company take over his life and we have become more like roommates than anything else. I love him, and I know he loves me, but it is very frustrating at this age to have to deal with the loss of passion — never mind the rest where there is no interest of any type of physical contact whatsoever.

    I know sometimes I feel guilty about our loss and blame him, and then there is other times that I just mourn the loss of our closeness. Wish I had an answer on how to deal with this. I feel unattractive, have put on 40 pounds, feel like there is no future. … I know it is just something that needs to be discussed with my spouse, but he just seems to think this is it and this is the way it is and we need to live with it and move on. I have always been a very touchy, feely-type person and find this difficult to deal with … as there is nothing between us anymore … other than we love each other … but is that enough for future to keep us together?



    Amy replied:

    Dear Peamb:

    I am really not sure what to tell you. Do I sympathize with you and understand your sense of loss and distress? Yes, of course I do. Do I know for sure what you can and should do about this? No, I don’t. If I did, I would be a miracle worker for thousands of women like you — not to mention their husbands and partners who have also lost a very fundamental part of their lives. I am not such a miracle worker!

    Yes, you are right, you and your husband do need to be able to talk about all this. But that may be extraordinarily difficult for both of you to do, and it would require a very real series of commitments on both your parts. He would have to “man up” and accept that he has been ignoring your needs and desires because he feels he has lost the ability to fulfill them. You would need to get past your sense of loss and guilt; make a real effort to get yourself back to having a positive frame of mind about life in general; and go dump that extra 40 pounds so that you can at least feel good about how you look.

    If you are so sure that you and your husband love each other, then you both need to work on showing that to each other, very clearly, on a daily basis — not just as an “oh and by the way I love you” activity as he goes off to work or you go out somewhere. And then of course he could consider getting a penile implant. They work really well for many couples who are willing to try this. But being willing to take that step can be difficult too.

    The two of you probably have another 15+ years of life together. Are you both really willing to spend 15 more years not dealing with this? That is the critical question.


  87. Here is some negative impact. You are an asshole. The man has lost everything he has been told since childhood what makes him a man. Get some acid splashed on your face and lose all semblance of your identity as a desirable female and then come back and lecture these men.


    Amy replied:

    Dear Linda:

    Thank you so much for your comment and opinions (which you are entirely entitled to, which is why it has been posted). And thank you also for your charming turn of phrase.


  88. i think there was no need for Linda’s comment, it is very rude. i am in a similar situation and it is hard for both partners. It’s not just sex: the man’s whole personality and confidence changes with the treatment. It has to be worked through together; both partners have deep feelings, love is so important and can be shown in many ways — comments and cuddles. if you want to help him just be there and carry on as normal a life as possible, as we do. You don’t know how many years you will have together so you have to make the best of them. Rudeness solves nothing,

  89. I guess “Linda Reynolds”‘s comment just underscores how much pressure everyone is under who is touched by prostate cancer. I hope you know, Amy, that you totally did not deserve that. You exist online to help the women and partners who are affected by this cancer, nothing more, nothing less; and these are valid and critical conversations.

    And, of course, a lot of people just turn crazy when they are online. …

  90. Dear Amy,

    I have a good friend that had his prostate removed 2 months ago. He tells me he is fine. Has come to terms with the fact that … it is what it is. Whenever I ask how he’s doing (always by text), he mostly just tells me he pee’s his pants — his words. We have been what I thought great friends before the removal. I knew he would change. I had a year to brace myself. That’s how long it took him to come to terms. But after 2 month now, I feel everything I say is wrong. I try to joke … not about his removal, just joke, trying to get him to joke back … but nothing. He tells me he’s fine, but even as I’m writing this it appears not. I was worried he wouldn’t get the support he needed from his wife. So I tried to rally all my support. Now I’m just lost. Do I walk away and let him be? Is he really just OK? Do I remind him of what once was, or has it just not been enough time? Should I ask him what he needs from me and our friendship?


    Amy replied:

    Dear Deb:

    We all have a tendency to ask people who have been or are ill how they are doing far too often. It is the beginning of every conversation they hear. That becomes very wearing. I can tell that you have been trying not to do that from what you are saying, but to your friend it may still feel as though you are. His consistent response that he’s fine sounds more to me like, “I’m fine but I don’t want to talk about it.”

    I think your friend still needs time to really come to terms with his situation. If he is still having problems with urinary control, then he is still being reminded all the time of the consequences of his cancer and its treatment. It’s hard to learn to overcome that.

    So I think you need to “tone down” the communication a little and let him make the decisions about when he wants to resume his side of whatever the relationship was that you had before the surgery (which sounds as though it might be a little complicated). I am not suggesting you stop the communication, just that you ratchet it back to things you have seen, read, or been doing that you think he might be interested in. I’d forget the jokes for a while. He’s probably not finding very much to be funny at the minute. Do things like ask him questions about things you know he’s interested in (e.g., whether Clemson can actually beat Alabama to win the college football championship). But cut down on the number of messages for a while … and stop asking him how he’s doing!



  91. Dear Amy,

    Make sense … although I thought reaching out in text would have been the best during what seems an embarrassing recovery. He reached out before the removal with fears. He is a very shy person and will not open up to many, which, you’re right, makes it complicated. He has a wonderful wife that I know has to deal with much more than just a friend. I will let them take the wheel and be there if he is ready to laugh again. Thanks for your words. I just had been there before the removal to support. Didn’t want him to feel abandoned after. Thank you for your words.

  92. Hi Amy.

    I am so thankful to find this site as I have been searching on and off for others who are dealing with this so similarly and I can’t talk with anyone that I know personally about this. I am amazed how eloquently, insightfully, and with great detail you respond to so many here who are struggling like me.

    My husband of 22 years had a radical robotic prostatectomy in April, 2013. He was 49 and I was 41. We researched and struggled for months prior to decide what to do with his PSA rising to 7 and Gleason 6. At that time he said if it weren’t for our 4 young children, he would rather just die of prostate cancer than risk living with post-surgical incontinence and impotence. I believed him to be a logical and reasonable man with a faith in eternity with never a hint of depression and that he believed his thoughts to be logical. I told him I thought the biopsy results, family history, and the complete devastation I would feel if the cancer took him were good enough reasons for surgery but that I knew that it needed to be his choice. I shared my belief that through years of pregnancies, sleepless nights with babies, and bouts of regular life stress causing low libido in me, and with an absolutely eternally committed marriage, that those things were all workable. I did not have the urinary strength that I once had during coughs since before natural childbirth nor as intense orgasms and with aging, so I told him that maybe we could be more in-sync sexually as pre-surgery he was always ready to go with the slightest glance or the right shoes. I had a hard time keeping up with his drive.

    Things are very, very different now. It has almost been 3 years and although it was nerve sparing and he can get erections and dry orgasm with the right stimulation and without the pump, but he never, ever initiates. He says it’s just not as good. Not long after the surgery, we regularly engaged with the pump to help in the recovery potential, and now he won’t touch me or even notice when I dress up or flirt or touch him or play with him or kiss him or make sexy suggestions, appointments, or plans. I am at a normal weight for my height and I think I am generally considered still attractive but I feel like I just turned 130 overnight. He seems no longer willing to know what my thoughts or needs are. He is unmotivated at work. He eats many courses of snacks at night until I fall asleep and won’t get in bed — it seems — unless he knows I have fsllenll asleep or he has already fallen asleep in his chair and must go straight to sleep in bed or will have trouble sleeping. (With children at home, living room sex is not an option as we must go behind the locked door.) I still love him and believe he is a good man and father. I just don’t understand why he has all the energy and care for our kids but none for me.

    I have moments, maybe once a month, of terrible sadness and frustration and so all I know to do is remove myself from family interactions so I can regain control of my thoughts and goals but he rarely even checks on me anymore, so that we could talk, except to call me “crazy” and tell me I need a therapist. He just goes straight to the food, TV, and kids.

    I realize I am blessed and have so many other things to be grateful for, but feeling of worth in his eyes has always been at the top of my needs and I just can’t seem to find that anymore. He says “love you” when parting the same as if “bye” and is a good provider financially. I have tried many times over the months to explain my perspective and tried so hard not to put him on the defense but he always just says he “could say the same about me”. It’s hard to find that accurate when it’s always after my attempts to share and discuss he comes up with just “ditto”. I have been examining this potential in me and seem to just see how hard I have tried to make sure he knows that I don’t love him any less nor consider leaving an option. Some type of connection, even if just once a month, I think would meet my needs.

    He considers himself a very strong, independent, and in control of his life man. Personally, previously having half facial paralysis disfiguration myself, I have an idea of loosing an important part of my womanhood (my smile and the ability to look at me without fear) being taken away could be like having his manhood partially taken away but his actions seem very confusing to me.

    Do you see anything I am missing here? Do you think he actually wants intimacy still or should I just learn to be happy without that? I really don’t know what to do to work on this with him. He won’t consider depression as possible for himself.

    Thank you in advance for your time and any insights you can offer.



    Amy replied:

    Dear Sara:

    The thing that stood out for me in your message above was where you said that your husband “considers himself a very strong, independent, and in control of his life man.” This may be a key part of the whole problem.

    You husband has “lost control” over something that was very important to him: his ability to “manage/control” his (and to some extent your) sexual activities. While he tried hard in the beginning to regain this, he has “given up” on regaining the level of control he felt he used to have. As a consequence, he appears to be avoiding everything that is directly related to this (i.e., any degree of emotionally significant attachment to you) and has replaced this with other activities (e.g., eating, the kids, etc.). He may not even fully understand the degree to which this is affecting you because he sees all of this through the clouded lens of his “responsibility” to be in control of things.

    Now I am not a psychiatrist or a psychologist, and I may be wrong about all of this, and it is apparent that regardless of anything else, your husband is (as yet) unwilling to accept that his attitude and behaviors are a part of the problem here. Until he is willing to even acknowledge that there is a problem and that he needs to be “part of the solution” I really don’t know how to reach a solution. However, you need help! You also recognize that you need to be able to talk to someone about about what you are dealing with. It is not a matter of “who’s to blame”. It is simply a problem that needs to be dealt with. So one way to start dealing with this would be to tell your husband that you are depressed because of his apparent loss of interest in you emotionally and physically and you are are going to go see a professional about it.

    Any half decent professional is almost certainly going to ask you whether your husband would also be willing to come too to give his perspective on the problem. Whether your husband would be willing to consider that if it is presented in such a fashion, I obviously don’t know. But it might be worth a try.

    The other thing is … Do you really not have any close friend or sister or cousin or someone who you could at least talk to about this and who you know would be able to “keep their mouth shut” about it? Just being able to have someone to talk to at all is going to help you because it will allow you to express your own frustrations. (The same is probably true for your husband. He needs a male friend to talk to who will look him in they eye and tell him that just ‘cos sex isn’t what it used to be, he can’t just ignore you entirely!) The real, underlying problem here, of course, is a communication breakdown.

  93. Amy;

    I am a 55-year old male, recently had an elevated PSA reading of 4.9, then 5.6 at Urologist, followed by negative ultrasound (negative digital exam, too). Followed by a still-elevated reading of 5.3 six months later, with a very good 4% score on the new 4K blood test. Everyone’s happy, except for me.

    I haven’t gotten over the initial shock and scare of the first PSA at the doctor’s office. (I have to admit to self-absorbed, hypochondriac personality.) I’m having a very hard time dealing with self-pity and dread that hits me hard, driving everyone around me nuts. Among feelings of anger over my self-pity and moping.
    Knowing my feelings are selfish only makes me feel worse. I feel that my spirit has been broken. All the fears (of what?) down through the years have been funneled at me all at once.

    I swear I need someone to guarantee me that everything’s going to be all right. Even though I know that’s not possible.


    Amy replied:

    Dear Rich:

    Hmmm … Well I’m not at all sure what you think I might be able to tell you that is going to make you feel better about this situation, but here is what I can tell you.

    First, at 56 years of age you are entering the prime age range for signs of benign prostatic hyperplasia or BPH — simple, non-cancerous, enlargement of the prostate (the commonest form of prostate disorder observed in males as they age). And all the data you have provided above appear to fit well with a diagnosis of BPH too.

    Second, even if you had been diagnosed with low-risk prostate cancer (i.e., a clinical stage of T2a or less and/or a PSA level of 10 ng/ml or less and/or a Gleason score of 6 or less) — which you clearly haven’t — you would still have a very reasonable prostate cancer-specific life expectancy of 15+ years, even if you just started by monitoring the condition (i.e., with no active treatment at all).

    Third, some time in the next 40+ years you are probably going to get a much more serious clinical condition than either of these, and, what is more, you are almost certainly going to die.

    Now if you are going to react like this to what is arguably “good” medical news, the key question is going to be, how do you think you will react if you get something like pancreatic cancer or have a serious heart attack? Either of these could be really devastating, but leave you alive for long enough to get really (and justifiably) depressed about the future.

    What appears to be missing (in your head) is a sense of relative perspective. Being an obsessive and self-absorbed hypochondriac is one thing, but the self-pity and dread that you are describing seems (at least to me) to be out of all context with the circumstances that have occurred. Arguably, you need to get yourself to some form of mental health counselor so that someone can help you to get a sense of perspective about all this. But please understand that I am not “blaming you” in any way for your reaction. What I am trying to do is get you to appreciate that if this has been your reaction to “good” medical news, you are in serious need of some advance training and education about how to prepare to deal with the “less good” medical news that is certainly going to be arriving over the next 40+ years! Why? Well, let me be very blunt … Some time in the not too distant future, everything is not going to be all right at all (even though it does actually appear to be at the moment). And that is something I can absolutely guarantee! You’d better be prepared for that.

  94. Thanks, Amy.

    That’s about what I expected. (Nothing I haven’t told myself, either.) I just can’t seem to make it stick. (Yet.) I have to admit I’ve probably needed counseling down through the years, but distractions have been enough to pull (push?) me through. A lot of the distractions are gone, or have little life left in them, leaving me with myself. It’s a strange thing to be confronted with one’s own failings (depression?) all at once. I have been trying (hard) to see this as a force for positive change in my life. Maybe I just haven’t drifted into shore yet. Thank you again for your time.



    Amy replied:


    Even the very best sea captains often need a good pilot to get them and their ships into harbor. Maybe it’s time to at least test out a couple of potential pilots/counselors!


  95. What is the medical name and explanation of what my boyfriend is going through after being healed from prostate cancer? Also, is there an online service I can send him to to read about this?

    Thank you,



    Amy replied:

    Dear Lori:

    Well … There are lot of different things that your boyfriend could be going through after treatment for prostate cancer. They include incontinence, loss of libido, low testosterone levels, erectile dysfunction, depression, you name it. Treatment for prostate cancer can have a whole host of different and complex side effects that express themselves in different ways in different men. Shotly after surgery for prostate cancer, a man may be dealing with “all of the above”.

    If your boyfriend wants to join our social network, then there are other men in that network that would be able to understand your boyfriend’s problem or problems and help him to start to deal with them, but this takes time and a lot of men have serious problems about even talking about what they are going through at all.

    There are also a whole bunch of other sites that he could use to read about these issues, but to tell him about which of those skite provide useful information we would need to have some sort of understanding about what his particular problems are.

  96. After 3 years with the removal of my husband’s prostate because of cancer he still has no desire, so it seems, to be close to me at all, no hugging, kissing or any other reaction to me. I feel sometimes that he has lost all love for me, we are not real young, he is now 73 and I am 68. Any suggestions?


    Amy replied:

    Dear Kathleen:

    I so wish that I had any really helpful suggestions to offer you. The impact of prostate cancer treatment on some men is psychologically traumatic. They can lose all sense of the importance of their emotional/sexual connection to their wives or partners, and of course that then affects their wives and partners too, in exactly the way you describe.

    The underlying problem is often a communication problem. The man just doesn’t even want to talk about what he is dealing with, and so he “shuts down” emotionally, and is unable or unwilling to discuss the problem or address it in any way — with anyone. They feel that they are no longer a “real man”, and it affects their entire approach to life.

    I have to assume that over the past 3 years you have tried multiple different ways to get him to “open up” about what he is going through. The chances are that he needs professional help from someone to deal with this problem and recognize what he is also putting you through. Of course getting him to accept this reality can also be very difficult too.

    One thing that might still work is to see if you can persuade him to go on regular date nights, when you can go dancing or just go to the movie together (when he is of necessity going to need to sit close together with you).

    I know all too well that I am probably not offering you any ideas that you haven’t already thought of and/or tried.


  97. Hello.

    I can so relate to this. My husband pushes me away all the time. We have been married 36 years. My husband just watches TV all day; he has no desire to go out, unless he has to of course. He doesn’t wash often or shave. It’s as if he is pushing me away. This really hurts as I’m the opposite.

    I would never stray. I love him, but its hard. I have tried talking, but he won’t. He once said jokingly, ” will buy you a dildo!” This isn’t what I meant. It’s the closeness, the compliments just being there. We live in separate rooms, literally. It’s so sad. We are caught in a trap. No one helps us women with our problems. I feel so lonely, like a lot of women on here. It’s all sad. I don’t know if this helps, but you are not alone.

  98. I have no questions to ask but was encouraged by reading the questions and the replies. Thank you Amy for taking the time to speak with so many who are looking for anyone who cares.

  99. To live or not to live and I’m not talking death, but life. I’m a 59-year-old male with ED. I have tried all the pills and have lost over 100 pounds. Still no change.

    I am married to a beautiful person. I have found my way into her heart and I am a better man now than I have ever been. I am also disabled with a number of physical issues. I have even stopped meds that can cause ED.

    My wife is also disabled and 57 years old. She has had a surgery that made her unable to make love. We have never had sex. We made love. After 7 years she now knows she can still feel like a woman. Except she is so much tighter and no matter how we have tried I’m still too large even with ED to make love to her.

    It is safe to say we need another person to help us around the house. We both need the extra care. We are moving from Idaho to Georgia to help with my wife’s illness. Lower elevation and a humid area will be better for her lungs. Staying would only shorten her life. I have lived in the south and know how delightful the adventure can be. I was in the military and came back to the northwest to be around family and found my wife Jani and have been married for the past 15 years.

    My wife has always been anchored to life, in work as an RN, a mother, and a wife. Her other husband of 20+ years was very abusive to her physically and sexually. Some men should not have a penis.

    Understandably my wife wants to enjoy the rest of her life, going out kicking and screaming. My wife is all of the best of the fruits of the Spirit in Galatians. She has never been angry, hurtful, or sworn at me ever. She is my dream come true. So as we are on this adventure she would still like to be fulfilled as a women. And that part can only be done by bring another man into our life.

    We have tried everything else, oral, fingers/touch and various toys and nothing is as natural as a penis or brings her to herself like a penis does.

    Complicated I know, but can another man be a viable option to our situation?

    We have discussed this situation and have done research and have been looking at the cause and effect side of our life story. I am now reaching out for an emotional outside perspective and and I/we will embrace a heartfelt response from you.

    Thank you very much.



    Amy replied:

    Dear Dale:

    Much as I would like to have something intelligent to tell you, I don’t.

    Your proposed solution to your problem comes with just one potential upside (your wife’s sexual pleasure) and a whole host of potential downsides — starting with all the issues inherent in having two men “share” one woman. Could this work for everyone concerned? Well, I suppose it could. But whether it really would is a whole different issue because you would have to bring a third individual into what is apparently an emotionally very tight bond (between you and your wife), but you have no idea what other factors are going to be at play here in terms of the possible needs, expectations, and behaviors of the third party.

    Only you and your wife can possibly determine what you really want to do under the circumstances, but what I will tell you is that you would be taking some very big risks in implementing the solution that you propose. And you’d better be very sure that this is something your wife is 125% bought into as opposed to something that you are thinking would be a good idea on her behalf.


  100. My husband of 18 years had his prostate removed 3 years ago. I have noticed a change in him: growing a beard; loosing weight; looking @ a Harley motor cycle and having his picture taking on it.

    I love him and have tried so hard to get him to just communicate. I ask him if we could try to have sex. He will not let me touch him. Said it’s not there. He has tried to get it up by himself. Well, I don’t understand. What’s going on? I told him maybe I could work on that but he refused to let me touch him — pushing me away.

    I feel like he is seeing someone else or going to cheat. He uses excuses towards me about car payments. I didn’t help with coming up with different reasons. Wants out. I love him but things look suspicious to me. Nowhere to turn.


    Amy replied:

    Dear Sheila:

    Treatment for prostate cancer can have some very odd effects on men. The loss of erectile and sexual function forces them to address a question that has never occurred to them before: ‘Are you a man if you can’t “perform” sexually?’ Our society teaches men from a very early age that sexual performance is one of the two, primary, defining characteristics of “malehood”. (The other one is making money!)

    When a man loses that defining characteristic of malehood, it can be a traumatic event for him. He may start to do all sorts of things to try to compensate for it. This can present all sorts of complications for everyone else around him … most particularly his spouse/partner. It seems to me that this is what your husband is trying to deal with. The unwillingness and inability to communicate openly about all of this in a straightforward manner is also characteristic of the problem.

    Obviously, I can’t tell you what is actually going on in your husband’s head. Maybe he just needs to feel that he is still potentially attractive to women. Maybe he is scared that if other men find out about his condition that they will look down on him. Maybe he thinks that riding a Harley will help him to feel/be more “male”. “Maybe” all sorts of other things like that are going on. The chances that he is actually cheating on you are really probably rather low. He’s probably much to scared about his inability to “perform” to even try and take a step like that.

    The one thing that I am sure about is that he needs help … and you need help too.

    He probably isn’t ready to accept such help … and he may never be, unfortunately. You, however, are. If you have close friends who you can talk to about all of this and who will actually listen to you, go talk to them. If you don’t feel able to do that, go and see a psychologist and talk to him or her about what you are dealing with … and tell you husband that you are doing that — just in case he decides he’s willing to go with you.

    There is no easy answer to the problem you are dealing with. And there is no easy answer to the problem your husband is dealing with either. I wish there was. Sometimes couples work this out over time. Sometimes they can’t. The essential components of being able to work it out are acceptance of reality and effective intercommunication. And some men will find that if they go and get a penile implant that the whole problems becomes a lot more easy to deal with — even if it isn’t quite the same.


  101. I am 59 and have always been sexually active. When I met my husband 8 years ago he was cancer-free but 3 months later he needed surgery for the implant or pump. That caused so many problems for him and then every year he has had some removed or inserted.

    We recently got married, on September 14, 2014, and things were OK. I retired in 2013 from the Post Office and went through some depression because I miss being around people, but to get to the point, we have made love and he leaks every time inside of me and all over the towels and carpet. He hates his condition and I can’t imagine what he is going through. Now he is gonna try injections and use a condom, but I can’t get aroused by him because I start thinking about the oral sex we had and what I dealt with with the leaking in my mouth. I’ve had a complete hysterectomy and take several different meds for blood pressure, hormone infection, etc. I’m just a wreck but don’t want to break up for not feeling attractive to him. It really hurts and I just need someone to help me with this. How do you survive a sexless marriage? Plus he is a salesman and works long hours and is around beautiful women I’m sure a lot.


    Amy replied:

    Dear Renee:

    So it sounds to me as though there are actually two quite different things going on here. One is the sex thing and the other is the fact that since you retired you don’t have anything else that you are really focused on or people to be around to distract you from your concerns, so they are festering.

    So let’s talk about the sex thing first. Good relationships aren’t based on sex, they are based on shared interests and goals and desires. Sex is cement that helps that bond. You write that you “don’t want to break up for not feeling attractive to him,” but that’s not really the problem. The problem is that you are both thinking about and trying to have sex the ways you used to think about and have sex before your husband had his problems with the implants and you had problems with things like the issues related to oral sex. You both need to get some help with this, because you both need to set some ground rules about what you are and aren’t willing to do in bed together given the situation. You might want to consider going to a sex therapist together to talk about this, but you both also need to be able to understand that you didn’t marry each other because of the sex. You married each other because you wanted to be together for all sorts of other reasons.

    Now the other thing is what appears to me to be your boredom and depression. You need to get out of the house and go do something that will allow you to be around other people and do something fulfilling. Find a local charity that needs your help. Go back to work part time somewhere. But get out of the house and find something else to do that you can feel good about — even if it’s only a couple of days a week. You are agonizing over the fact that your husband “is a salesman and works long hours and is around beautiful women I’m sure a lot.” But let’s face it, his level of self-confidence about sex can hardly be high, so I don’t think there’s a lot of risk about him philandering. The problem is that you are worried about all that because you think you may be unattractive to him. So go make yourself feel attractive to people in general by actually seeing more people, and then come home and work out how you can have the best sex you can manage with your husband. It won’t be what it used to be, but maybe it can still be good if different.


  102. My dad had bladder cancer. They removed his prostate during treatment. Now my mom and dad are divorcing. My dad doesn’t believe that any woman will want him because he can’t use his … uhhmmm … you know. … What can I do? I don’t want my dad to feel alone. I believe there is a woman out there who will love him for him, but where can I find her?


    Amy replied:

    Dear Victoria:

    Your Dad — very naturally — is being typically male and thinking with his “uhhmmm … you know.”

    On the other hand, of course, there is only so much that you can do about this because he needs to stop thinking that way and appreciate that just because he can’t do what he could do at 18 years old doesn’t define his potential to be a person someone wants to spend a lot of time with … maybe doing other things!

    Your job is to handle all this with kid gloves and help to put your Dad in places and situations where he might meet such a person without giving him a clue that that is what you are doing! That could be very difficult, so you are going to need to be patient. If he gets the idea that you are trying to “set him up” he will immediately shut you down because he is scared that what he thinks is true really is true … which of course it isn’t.

    There is another option. That is that after your Mom and Dad are divorced you just tell everyone you meet that your Dad can’t “you know what” because of the prostate cancer and he is being a dumb*** because he has convinced himself that no woman will ever want to look at him again. After he has lost his temper with you, your Dad might actually decide that you doing that is funny and get over it! But then I don’t know your Dad! And if you go that route you’d better be ready to make him laugh about it all.

    Oh … and Victoria, click here; click on “Skip ad”; watch video; laugh yourself stupid; then decide if your Dad might find this funny too. You will.



  103. I have been dating a man for 6 months … since right after he found out he had prostate cancer. I have known this man on and off for 5 years. He was living with another woman but whenever they would break up, he would find me. He always finds me when he is hurting. So on and off for 5 years. He did not tell me he had prostate cancer until yesterday. He lives with his female best friend, and they have been best friends for 25 years. I wrote him this morning and told him he needs to date his best friend. That I will be his friend and be here for him. He was very aggrieved I said that, and told me to never say that again. I am lost in what to do here. Help me, please.


    Amy replied:

    Dear Heather:

    I get the strong impression that this man has “commitment” problems. He seems to want to have several cakes and be able to take bites out of any one of them just when it happens to suit him. I think you were exactly on track when you told him that you were willing to be his friend but no more than that. I am as sure as I can be that if he was to move in with you he would still be seeking bites of cake elsewhere too!

    This has nothing to do with the gentleman’s prostate cancer and everything to do with his perceptions about relationships with women. He is simply using you for his convenience as and when it works for him.


  104. I am contemplating an intimate relationship with someone I’m fond of. There are issues outstanding. I’m wanting a committed relationship before I venture into intimacy I’m doubtful he’s interested in to the same degree. So I’m hard to get at this point (ironically, seems to always get men to up their game). So it’s heating up.

    He’s told me that he had a cancer scare, waiting to find out if he had an aggressive form of prostate cancer. During that time, he kept fantasizing about me (how romantic) as in, if there’s one woman he has his last fling with, it’s me. Not exactly the degree of involvement I’m hoping for, but it does show interest. He since learned it’s a very slow-growing form; he may well reach his end of life before it has a chance to affect him. (We’re both early 60s but very youthful.)

    But there’s a notion that’s bothering me that nobody seems to be talking about. Since we are basically talking about being injected (sorry to be blunt) with live cancer cells, could there be a risk to a female? It doesn’t seem like a good idea. Has anyone ever studied this? I realize women don’t have prostates for prostate cancer cells to live in, but could it be that a cancer cell is a cancer cell and it’s not a good idea to be injecting them inside your body?


    Amy replied:

    Dear Linda:

    I’ll let you manage to “hard to get”/”maybe interested” bit all on your own. However, …

    As far as I am aware there is absolutely no possibility whatsoever for you to “catch” the prostate cancer.

    Your (our) biology is such that the microenvironment isn’t receptive to survival or prostate cancer cells at all. Men with prostate cancer have been having sex (and making love too) with “unprotected” women for at least a few thousand years. As far as anyone is aware, no case of prostate cancer has ever been identified in a single woman to date! It’s pretty much impossible for men to get vaginal, ovarian, or cervical cancers for exactly the same reasons (in reverse, so to speak).

    Oh! … So now you’ll have to think harder about the “maybe interested” bit after all, and I said I’d let you manage that on your own. So much for my good intentions!


  105. As I sit in the dark late at night reading this and crying, I realize I am not the only one struggling with this issue. It has been almost 3 years since my husband’s surgery and things are not getting better. I have gone through most of the stages of loss and have tried to keep myself busy (hobbies, working out, etc.) to distract me from being a sexual being and not wanting to cheat. We have only been married for 2 years (found out he had prostate cancer right after we were engaged) and now feel like roommates. I swore that I would never do this again (bad marriage earlier in my life) but now feel stuck. Why are there not support groups for spouses? I think it should be mandatory with surgery since we are the ones affected the most. This is my next move … trying to find a therapist that will listen. Wish me luck. …

    *****Amy replied:

    Dear Kari:

    I am so sorry that you are having to go through this. Can your husband even talk to you about any of it?

    You’re right. There should be more support groups for wives/partners. Every prostate cancer support group around the country should have a separate wives/partners section. And there most certainly are some therapists and nurses out there that understand — among whom Ann Katz who works in Manitoba, Canada, may be one of the better known.

    Have you talked to anyone from Us TOO (for example) about starting a wives/partners section for your local prostate cancer support group. Have you talked to anyone at Women Against Prostate Cancer? Are you aware of the web site


  106. Can I respond to Kari?

    Hi Kari. Your post made me sad. My husband and I are on year 4 of no sex. It’s been a rough 4 years. Very rough. I tried, but failed, to get a divorce. I had an affair — and all that accomplished was that it completely broke my heart. (Don’t do it!) And I suffered a bad depression. But, just recently, I think I’ve finally truly accepted that this is my new reality.

    My husband and I are friends, we are some sort of companions to each other, and we are financially stronger together. It’s certainly not the life in my 50s that I imagined (hey, I’m still young, aren’t I?), but I guess it’s the hand I’ve been dealt. I also work out, and I always have, but I added yoga to my workouts about a year ago and honestly it’s saved my life.

    I try to enjoy and look forward to the activities I used to care about. We’ve even gone on a couple of very nice vacations that were lovely (although, admittedly, it’s a little depressing to be a romantic place with no romance), and I enjoyed planning those trips and I enjoy the pictures and the memories. I focus on the great times we have with our adult children (limited though it may be). I am gladly anticipating retirement and whatever changes that might bring — new geography maybe, new lifestyle, new gym classes (ha).

    Yes, there are times when I suddenly realize: I’ll never have sex again! And, yes, it feels like being stabbed in the heart, but I try to accept it and let it pass.

    I’ll spare you all the “but it could be worse” crap, because surely we all hear enough of that. And I don’t know if you’re stuck — it probably depends on your financial situation. (I know I’m stuck.) But I thought maybe my story would give you some hope for eventual resolution, if not “happiness.”

    Good luck to you.

  107. Hello Clara.

    I’m Sylvia. My husband has prostate cancer and 3 years of hormone injections. I haven’t had sex for 2 years now. I know it’s so difficult for you as it is me. People think I’m selfish to think about sex. I just accept I can never be loving again, but it’s killing me. It’s not just sex; it’s being together. My husband has shut me out since the diagnosis; doesn’t compliment me or notice me; doesn’t even talk. We live in separate rooms in the house. We don’t have money so don’t go out; at least you are able to do that. I feel for you. It really destroys marriage. We’ve been wed for 37 years. I am 58 and still have feelings, but I have to stifle them. Prostate cancer is cruel in many ways — to him and to us.


    Amy chipped in:


    You are not being selfish when you think about sex! Not, NOT, NOT! You are being human.

  108. My husband is a long-term prostate cancer sufferer. He has been treated with hormone implants, including “holidays” from the drugs, for 5 years. Not only is he now impotent, he has lost all interest in the physical side of marriage. Even kisses and cuddles are perfunctory, and we can’t discuss this any more because he gets upset about his “inadequacy” — his word, not mine. His consultant is not interested or able to help us. I miss the closeness we had, more than the actual sex, but it’s as though my body is threatening to him. I tried talking to a prostate cancer charity, but they more or less said “deal with it”, so I do, but very badly. Is this a common experience?


    Amy replied:

    Dear Ingrid:

    Unfortunately, yes. This is an all too common set of experiences — for the patients themselves and for their wives and partners too. And it makes me feel “impotent” to know that there is very little truly useful help that I am able to offer. If you look back through some of the other questions above, you will get some idea of just how common this type of experience is.

    Many men’s sense of self-worth is extremely highly connected to their sense of “masculinity” and sexual capability/prowess. The loss of sexual capability can therefore be devastating to their sense of self-worth, and they withdraw from all forms of intimacy because they are overwhelmed by (to use your husband’s term) their utter sense of “inadequacy”. Of course this doesn’t happen to all men. Some get past it with no problem at all. Others can get past it with time. But there are those that just can’t or won’t, and often they will be unwilling or unable to even consider the idea of any sort of psychotherapy to help with this because, for them, that only reinforces their sense of “inadequacy”.

    Quite why so many men seem to be unable to disconnect their ability to “perform” sexually from the value of other forms of intimacy (kissing, cuddling, touching, telling you that you look beautiful today, quite apart from all the other possibilities) is something I really don’t understand at all. It makes no sense to me. But it is clearly a very real problem for many men with prostate cancer — and therefore for their wives and partners too.

    So there are three things I can suggest: (1) Tell your husband that you are going to see a psychologist because you need help with this — and actually so does he if he’d like to come along, but you are going with him or without him. (2) Ask your husband if he would be willing to talk to the doctors about getting a penile implant because if he could get an erection that way then at least you might be able to start talking to each other again. (3) Tie him to the bed one night while he is asleep; take all his clothes off; take all your clothes off; wake him up; and then tell him that you and he are going to need to work out how to deal with this!

    Are these the best ideas in the world? Probably not. But at least they would be a very clear message to your husband that he needs to re-think and re-learn what it really means to “be a man!”

    And one last thing. Have a look at this video. It will make you laugh. And if you can get your husband to watch it too, maybe, just maybe, he will realize that others have been able to deal with this and come out the other side. The speaker in this video also has a lot more information on line about dealing with intimacy issues.


  109. Hi Clara,

    It has been a long time since I’ve commented here but after reading your post I just had to.

    I read it and felt like I was reading something I wrote. I feel the same way you do.

    I’m a young 51. I feel like I still have a lot of life to live. My husband is almost 75 and I feel like his life is winding down although he has always been active. There are subtle and not-so-subtle things happening with him now.

    Your comment about it being depressing when in a romantic place really struck a nerve. I cannot watch anything romantic on TV. I almost cannot stand being around people who are openly physically affectionate. Anything sexual on TV makes me feel horrible. I realize that I shut this part of me off after decades of trying so hard to make things better. I simply don’t have the energy anymore. I don’t have the interest anymore.

    Quite frankly, I’ve realized that I don’t find my husband physically attractive any more. It’s hard to admit to myself.

    I find myself wondering what it would be like to be with someone my own age. I think I would be happier. Right now, I feel like there isn’t much of a future. As he ages, some things like travel become less practical. I’ve realized we’re not that compatible in where and in what type of house we want to live, but I’ve also realized that I have played the caretaker and although I hate labels, the behaviors of a co-dependent fit me.

    In the last year, I have really started to turn the focus to me rather than him. This, I learned, is crucial for a people-pleaser like me. I see the behaviors that I have that need fixing and work on that every day. It’s not easy. It’s hard to focus on what I want.

    Instead of making myself miserable because I don’t have a sex life, I have accepted it. I have accepted that until I am with another man, if ever, I won’t have a sex life.

    We did marriage counseling but my husband never realized that he was part of it — he’d ask me before every session if I wanted him to go that time and sometimes he wouldn’t go because he had to do something else. He always approached the sessions as if I had a problem to fix. He never either listened or “got” that it was about my unhappiness in the marriage and that I was unhappy enough to be considering a divorce.

    Instead of feeling ashamed that I have no sex life, I’m trying to move on.

    One thing that I cannot hide or make excuses for is that I don’t like my husband to touch me. We can talk about all sorts of things, go out to dinner, etc., but if he tries to touch me, it feels like he’s invading my space. I tend to flinch a little, uncontrollably, because I think I’m so used to protecting my space. He gets angry and says he should be able to touch his wife. To me, that comment feels like he thinks I’m his property.

    I ask myself what the point of staying in this type of marriage is. When we we’re in therapy, my husband even brought up the fact that this isn’t really a marriage (no touch, sex, etc.) and was angry about it.

    Like you, Clara, I have that stabbing pain in my heart from time to time when I consider that I may never have sex again or that by the time I’m released from this marriage because of my husband dying, my prime years will be over and I’ll just be an old woman. Those types of thoughts put me into a funk every so often and make me so sad.

    A divorce isn’t really practical for lots of reasons. I guess we’ve both just decided that it’s easier to just ignore or deal with the negatives and enjoy some of the positives we have.

    I feel like 2016 is the year I’m ready to improve myself and confront these thoughts and feelings head on. Therapy helped a little. Being honest about my feelings and thoughts, though, I think is crucial. I’m always afraid to admit how I feel because it will make him angry or hurt. But the pain I feel sometimes makes me miserable.

    I’m focusing my eyes ahead and focusing on me more and more. That’s the best I know to do for now.

    Amy, thank you again for this site and your insightful comments. I don’t really have anywhere else to turn or anyone to talk to so candidly about such things. :)


  110. Thank you for responding to my comment, Clara.

    Yoga does help with the healing. I too feel way too young to be dealing with this (I am 45) and have been in mourning for 3 years. I know things could be worse, but sometimes I don’t care. I just feel so trapped. I feel like I was robbed of a chance at a great marriage and now I am just wasting time until it is over and, by then, I will be an old woman too. I guess all we have is reaching out to those that are going through similar situations and supporting them.

    Thanks again.

  111. Lilly:

    Ha! I can’t watch anything romantic on TV either! I want to just throw something at the screen. What a mess. And yes, getting physical again with my husband is something I consider now and then, but it’s been so long, and I just don’t know what to expect physically from him — it’s like I honestly don’t know how to have sex with him — it’s so awkward and definitely unsexy.

  112. Hi Kari.

    I completely understand when you talk about the fear of becoming an old woman before you can fix your life. It’s something younger women just take for granted, I guess. They get a divorce at 35 and they still have options. Not so much over 50, and although I know there are exceptions, the statistics are against women. It’s one of the main reasons I gave up on my divorce (finances being the other big one); although still attractive and fit at 59 I just know I’ll spend the rest of my life alone — even more alone than I am now. Things just didn’t turn out the way we expected, did they? Blah.

  113. Hi Amy,

    I am glad I ran across this site, that offers someone to ask questions regarding.

    My husband had back pain and could not urinate. He goes to hospital ER. He learns that he has 4th stage prostate cancer that also was in his bones. Now I am going by what he told me he found out was wrong. Because , he did not allow me to go with him instead he had his friend and the friends wife take him. Well that was okay I thought maybe to the ER .However, this did not stop at the ER. Those two friends has taken him now after the ER , Hospital and they are at the Hospital every day then after he was released from hospital they are still taking him to all his Dr. Appointments. Or any thing else he goes for regarding this problem. While in the hospital he even put those same two friends on his power attorney. For some reason he does not want me to know anything about this problem. And it is my own guess is he does not want me to know what it is he has. I am thinking maybe what he told me he has is not all the way the truth. I believe he has this behavior because a few years back he started hanging out with gay men secretly. However I caught him with a gay man two times and I know there was many other times as well. Of course he denies anything to do with gay men, but I know better. At the time when I saw this I told him that nothing good would come from what he was doing. I told him if he kept on doing this that he would someday regret this.

    Well I believe that day has came and I believe he is doing everything he can to keep me from knowing the truth about his problem. Now I know nothing about this prostate cancer but according to him they have not done anything except run a lot of test while in hospital then released him with a catheter. So I suppose that he could pee. And they gave him radiation pills for a week. After that he had to go back to the doctor and I don’t know what happened on the last doctor’s appointment. These are things he told me that had been done, which does not make it the truth, by far. What I was wondering about is why would the doctor leave the prostate and not remove it if it is in the 4th stage like he told me. Is this strange or is it me thinking it is — for him to have his two friends to go every time and placing them on his hospital power of attorney and using every excuse that he can to keep me away from his doctor’s appointments. He did the same at the hospital. I would not have known about him putting the two friends on his hospital power of attorney if his nurse had not said something to him about needing a copy for the hospital file. I thought that was different for the nurse to say that. When I heard the nurse say that to him he got all upset that I had found this out that I was not the one on the power of attorney. This was my only trip to the hospital while he was in there. The only reason I was there that time was I just went there and did not tell him I was coming, so that he could not give me an excuse as to why I could not come.

    I googled this — about why would his prostate cancer grow so fast to be 4th stage now — but 1 year ago I was with him when he had another problem that he could not urinate and the hospital did tests and also did an exam on his prostate and they told him that his prostate was enlarged but that he did not have any cancer. So here it is 1 year or a little less than a year later, and he goes back in hospital and he says that he has 4th stage prostate cancer that has gone to his bones. I just have a hard time believing this could be true. Oh I mentioned about me googling this. What I learned from Google is that gay men, with their sex behavior, can put a lot of trauma on the prostate and that the prostate cannot take that kind of trauma and this is a reason that prostate cancer has a high rate in gay men. It also said that is also a reason for fast-growing cancer there. And it said that it can invade other parts of the body such as the rectum and nearby lymph nodes, bone, etc. Please give me your thoughts regarding this if you can. I would appreciate it.

    Thank you

    J. Wondering


    Amy replied

    Dear J.:

    So there are clearly two very different — albeit closely related — issues going on here. (1) Your husband’s sexual behaviors and interests, i.e., whether he really is either gay or bisexual, which he may well have discovered that he is. (2) The fact that your husband clearly has a very hard time talking to you or involving you in a straightforward fashion about any of this.

    I think that to start with you should just forget about “why” he does or doesn’t have what he is telling you is metastatic, Stage IV, prostate cancer that has spread to his bones. Either he does or he doesn’t, and I am not aware of any good data that proves that this is any more likely in gay or bisexual males as opposed to the rest of the males in the world. The important question is only what the truth is about his clinical condition.

    I also think that you and your husband need to begin to see if you can resolve the communication problem somehow. I obviously have no idea why he feels the need to keep you out of the conversations with the doctors about this. Clearly, however, he does. You aren’t going to be able to resolve any of this until you can make sure that he is telling you the truth — even if the truth is hard to deal with. It certainly appears that he doesn’t feel he can trust you with the relevant information for some reason, and I can’t tell you why he feels that, but you may know yourself.

    There are problems that I can sometimes help people to deal with, and then there are problems that people need to resolve for themselves. In my opinion you need to ask you husband, gently and kindly, how you can help him. If he can’t or won’t let you help him in a situation like this, there is no relationship left between you, and in that case I am not at all sure I understand why he is staying with you or you are staying with him. You may well be upset about his sexual behavior, but that will resolve nothing. The real question is whether you have a relationship left that is worth trying to rescue, and if so how.


  114. Hi Amy.

    Thank you for being available to answer some questions. My husband had the DaVinci prostatectomy 4 years ago. We were grateful that he was still able to achieve an erection and orgasm. His erection, although present, unfortunately, is not penetratable. Although I miss that part of intimacy, there are certainly alternatives so I wasn’t extremely bothered by this. He, on the other hand, is bothered by it all.

    We’ve been married over 30 years, after dating all through high school and college. He is the nicest and best person I know. Right now, he’s really making me mad though and I don’t know what to do. In the past, the biggest complaint about sex in our marriage from his perspective, was frequency. He could do twice a day and with 2 children, I was good once a week. Now, he’s not even interested in me. He barely shows me any affection but I know he watches pornography and gratifies himself. This is what shoots me over the edge. If he’s going to do that, why can’t he share that with me too? He feels he can’t please me anymore and he says his libido has significantly decreased. We’ve had this discussion before but things haven’t changed. We go over a month without even a serious kiss. Really? I know he loves me. He feels inadequate and I just don’t know what to do. Any ideas and advice would be welcomed. We have had such a good marriage, relationship and life together but I’m not liking him much these days. I feel like I simply have a roommate.


    Dear Melanie:

    You are far from being alone with this a problem. You might like to have a look at some of the earlier Q&As above, but including at least this one and this one from just the past few weeks.

    The basic problem is that everything about what makes a man feel like a man often gets completely mucked up by his loss of ability to have a meaningful erection. You need help … and he needs help too …. You could try stopping talking about it and go back to being the sweet and “coy” young thing you used to be when you were first dating. Get him to just take you out on dates again. Good out to dinner. Go to the movies. Make him take you out to dance. Just hold his hand. Anything that can help him to get used to the idea that you just like being around him and like to be seen with him, and that the sex thing isn’t a big deal. And then you can give him a kiss on the cheek when you get home!

    The only real alternative I have ever been able to think of is the one I suggested as item (3) in my reply to Ingrid recently. That isn’t going to work for a lot of women (or the men either) … but I have long suspected it may work for some. Some men have a whole secret “thing” about dominant women!



  115. My husband can not have sex using anything currently available. And he has told me his has no desire for me at all. I feel so rejected, he won’t even really kiss me or anything. We have been married for less than 2 years.


    Amy replied

    Dear Susan:

    I am so sorry. You can try some of the things I suggested to Melanie in the message just above this one … but the real problem here is that your husband is (somewhat understandably) still grieving for his “lost manhood”, and he may not even recognize what this does to others around him.

    Of course that sort of behavior would be acceptable for a while … but once it starts to stretch out beyond about 6 months it is becoming a sign of self-pity, and your husband needs to realize that feeling sorry for himself is not going to achieve very much for anyone — least of all him.

    He needs professional help. Indeed you may both need professional help.

    However, you could start by just watching this video. It will make you laugh. And, if you could get your husband to watch it too, then maybe he would start to realize that there are other ways to look at his problem!


  116. My husband had prostate cancer surgery 4 years ago. At year 3 his levels went up. Then they did radiation for 7 weeks. At 6 months his levels were up a little again and at 1 year even more. Now they are doing hormone therapy. He is 64, me 63. During our 30 years of marriage we were very sexually active. After the radiation he kinda had a crisis? Started talking to a lady he has known for years on the phone. Told me I wasn’t attractive anymore because of gaining weight and wasn’t sure he wanted to be married. We are trying to work on things but it is so hard because he has no interest in even cuddling anymore. I even last 30 pounds, bought sexy nighties. I know we can’t have intercourse but we can do other things and we were until the hormone shots. I am thinking of an affair or divorcing. I just never know if he loves me and it’s the medicine or he doesn’t. I am also worried he will die and I feel selfish for wanting to be cuddled and physical. All I do is cry all the time cause I am so confused.


    Amy replied

    Dear Ann:

    First, I apologize for not getting back to you sooner. Life has been a tad chaotic for a couple of days (in the way that it always can be).

    Second, I feel for you. Prostate cancer can do very strange things to men — and it’s probably not the hormone therapy (or at least not just the hormone therapy) in the case of your husband. It seems to have more to do with the way in which the disease undermines everything about what men have been taught are essential elements of “being a man”, starting with the whole business about sexual prowess in and out of the bedroom and the importance of believing one is seen as a man who is attractive to women.

    As I have to say to a lot of wives and partners (and sometimes to the men too), you both need some professional help and some real honesty between you about what is going on, and that isn’t necessarily going to be easy. Your husband may not really even be able to explain what is going on from his perspective, but I feel very sure he is as frightened by the idea of dying as you are for him. Being frightened and being unable to resolve all the related issues is not selfish of you. It is normal. Whether your husband is willing to go to get professional help — ideally with you but on his own if that is the best start that can be managed — is a whole other question.

    If I had a magic ball that I could rub for you to make this problem go away, I would do it. Alas, I know of no such magic ball. However, you do need to be able to talk about this with someone — even if it is only a close friend who can be trusted to keep this to herself (assuming that that is what you would want). You might want to look through some of the other questions and answers that appear above, because what you describe as happening between you and your husband is something that comes up all the time.


  117. Hi Amy,

    Just spent a considerable time reading all the messages and your responses. My husband has prostate cancer — recently diagnosed. His PSA is 11.5 and his Gleason score is 6 with intermediate-risk category. His biopsy indicated that of 2/12 cores had cancer, one with 95% cancer. His prostate is 69 grams, so it is enlarged.

    Initially he did not want any surgery and would rather die (his words). He is 59 years old, in great shape. We’ve been married over 30 years. I’ve encouraged him to think of our daughters, one of whom just finished high school. We found a doctor with some very good post-op results and have scheduled the surgery.

    After reading most of these comments I see in him the reactions of many men already. He is already shutting down and told me he is not interested in sleeping with me almost 2 months ahead of the surgery. I was shocked. I’m wondering if we should consider radiation instead of surgery. He is a very fastidious man and I think a bad patient … based on past illness. I realize prostate cancer is slow growing, but is there any chance of him not needing surgery in, say, the next 10 years? I know that if he could make it that long he may just not have surgery.

    All options scare me and after reading about the future I’m depressed. We have always loved each other but we are both strong personalities and the last couple of years have already been tough, since discovering he seems to prefer porn to sex with me.

    If I sign this heartbroken in advance I know it sounds dramatic but I’m feeling it.



    Dear (Heartbroken) Elizabeth:

    First, and again, as I just had to tell Alice (above), I am sorry it has taken me a little while to get back to you. I try to be much quicker with my responses, but life intervened.

    As you will know already from reading through all the other questions above, I am not going to be able to provide you with any type of brilliant answer that will resolve this situation. However, …

    Is it possible that your husband will still be alive with no sign of metastatic prostate cancer a decade from now if he has no treatment? Yes. It is possible. However, it is also possible he would have died of metastatic prostate cancer. It is almost impossible to predict with any degree of accuracy for a specific individual how a cancer like his might progress over the next decade if he does nothing, but there is an online tool that you and your husband could use together to project his risk levels if he was to do nothing: you can click here to access that tool. If your husband really is in excellent health, then this tool suggests there is a 70% or higher probability that he would still be alive 15 years from now even if he was to have no treatment at all.

    Only your husband is going to be able to decide what he wants to do. And only you and your husband can decide together how you are going to “get through” the current situation. If your husband was 70, I know that some really expert clinicians would be looking at him and saying, “Let’s just keep an eye on things and manage the symptoms when we need to”, but here in America we have a tendency to think that all disease needs to be treated immediately, without wanting to recognize what that can do to people’s quality of life — which in the case of your husband appears to be suffering already.


  118. Okay soo i met this guy in mid to late April. … If you have advice, based on experience, or not, please please help me!!! I don’t know what to do :(

    Amy replied:

    Dear Baylee:

    I am sorry. I am not a relationship counselor. I try to offer help to women (and men) who are dealing specifically with problems related to prostate cancer. Your problem is of a very different nature.


  119. Amy,

    I had a prostatectomy 18 months ago. My recovery is going very well. I can sustain an erection and have penetrative sex. I’m very thankful for the quality of my recovery. I don’t date woman because I am concerned that when they learn I cannot ejaculate they will not want to continue in the relationship. What is your opinion? Is my situation a show stopper?

    Concerned older gentleman


    Amy replied:

    Dear Concerned Older Gentleman:

    I think that it is time for you to realize that there is a big difference between a relationship between two people that is based primarily on their enjoyment of each other’s company and a relationship between two people that it based on their mutual desire to have mind-blowing sex! (Of course the two forms of relationship can and do co-exist — throughout an entire lifetime for some couples.)

    If you want to date because you want to have sex, and everyone appreciates that that is the primary objective, then if you make sure your partner has an orgasm and that she understands that you have enjoyed yourself in giving her one, most women are probably not going to beat themselves up over the fact that you can no longer ejaculate. Conversely, if you want to date because you are looking for someone with whom to share the rest of your life, the precise nature of how you both enjoy sex together is likely to be a good deal less important than the enjoyment of each other’s company.

    I think you are are more concerned about all this than is justified by most women’s expectations. You just need to explain that your inability to ejaculate is not a problem for you and then make sure that the sex is still fun for all concerned!

    Of course if you are hoping to date 25-year-olds who have expectations of children and motherhood, there is a whole other problem that you do need to be very straightforward about.



  120. Dear Amy:

    So much pain in these posts and I understand because I have been through it too. My husband had radiation for prostate cancer in 2002. We were married in 1994. He always had some problems with an erection but we worked through it. Although he has never been very demonstrative, he is a good man. After the radiation, intimacy stopped. I realize that was when I started to gain weight, which he doesn’t like. However there is absolutely no intimacy in our life. We talk about family, finances, take trips, and walk our dog. (More affection goes to the dog than to me.) He says he loves me, but he never puts his arm around me. I feel so alone. Each night he goes into the TV room and watches TV until 11:30 and I am left alone. I busy myself with my painting and he spends his time golfing, having coffee or lunch with his guy friends. Our intimacy revolves around going out for meals.

    I have accepted my lot in life. I am 78, but a young 78. Life should have been different, but I have accepted what is and I try to feel grateful for the fact that he is alive and for what I do have. Those women who are in their 40s and early 50s should not settle. Have a life. I appreciate your column . There is no one I can talk to about my sadness.


    Amy replied:

    Dear Karna:

    As I have to say to many women, I wish I had something sensible and helpful to tell you. The psychosocial and emotional problems cause by prostate cancer can be so devastating for so many spouses and partners — quite apart from the physical loss of intimacy — that it is hard to put one’s arms around.

    You have my very deepest sympathies — as do nearly all the people who reach out to me for help and hope — but I am so dreadfully aware that most of the time there is very little that I can really do to help except be here to listen.


  121. I can so relate to your post. My husband is exactly the same. He is 63; I am 58, our love life stopped as soon as he was diagnosed. He also stays up watching TV till late. I get no kisses or cuddles or affection. He won;t do anything or go out despite the last three blood tests being OK. He has been on hormone shots for 3 years. We won’t ever have a love life again. It’s sad. i still love him but feel alone. We stay in separate rooms of a day. I hate this prostate cancer. No one cares how it affects the wives.

  122. Dear Amy:

    My husband was diagnosed 3.5 years ago with Stage IV metastatic prostate cancer (lymph nodes and pelvic bones involved). He had radiation (seed implants); Firmagon, then later Eligard/Lupron; Provenge; Xtandi to Zytiga then doxataxel (Taxotere), along with prednisone; Flomax; Lasik; potassium and Zometa for his bones.

    He can’t remember from day to day — and he’s lost a lot of his hearing, seemingly overnight. Age + cancer + treatments and you have these issues according to research I have done along with just a little common sense.

    Right now the doctor says his scans are “stable” and that he is in remission — not “total remission”. He took him off the chemotherapy for a break so his body could regroup a bit. I realize that this chemotherapy kills cancer cells, but also the good cells, so a break for the former live good cells could rejuvenate is a good thing, I’ve never really heard of “remission” but not total remission.

    My husband is nearly 70. He’s managed exceptionally well on all of the treatments given. Very few side effects and I am thankful for that. I am just wondering — what next?

    We’ve been married nearly 38 years. I am not concerned about a lack of love life — I am concerned about losing my best friend. I can handle anything else — but I am not prepared to not have the man I married when I was 20 years old to not be here. For the past 3.5 years, I’ve found that my strength came from GOD — and I am asking for more strength. This does affect wives, but in very different ways. For me, it’s about educating myself — it’s all about reading everything I can — asking questions — and I used to have questions answered and they were all pretty much on cue, but at this point, I seem to have stumped everyone with the “What’s the next game plan?” No one has any answers. He will still have doctor visits monthly with lab tests and Zometa infusions — but when do I call the doctor at this point? I jokingly told all of the doctors that they are to refer to me as the PITA wife … Pain in the A$$ wife because I would call them if I felt that anything was not right.

    I know more about blood work than I ever wanted to know — I can read a bone scan with 85% to 90% accuracy now and have started learning more about what the CT scans tell us. I’ve asked for a CD of every scan he’s ever had so that I can compare them myself. I compare every set of CBT results we’ve received and have seen how the WBC went down after chemotherapy and realized that the third week afterwards (the same time he had to do chemo again) his WBC (NEU and ANC not as fast) would rebound. I learned the chemistry of the way his body works. RBC — down still — he is anemic; iron count still low.

    But … the question is: What’s next? Is there any other treatment that would help him? When should I call the doctor now? Of course, there are obvious reasons to call — but I cannot get any answers as to what would constitute a phone call revolving around “something isn’t quite right”. Everyone tells me I will know, but is there something definite that would alert me that I need to get him back into the doctor?

    What normally happens when or if they put him back on chemotherapy in the future? I don’t want the doctors to just say “no more drugs” and just wait for him to go back into the cancer spreading again mode. I know he’s 70, but that’s still too young to just forget about him. I want my husband to be cured and I want the 50 years he promised me — but after saying that, I will add — I do not want him to suffer in pain. I just don’t know what to expect at this point.


    Amy replied:

    Dear Mrs. Mueller:

    I am not a doctor, and I really cannot tell you exactly what may or may not happen to your husband over the next few months or even years. God’s plan for each of us is unknowable, and you clearly understand this.

    The term “remission” can be used in a whole range of contexts. I think that what your doctor has told you and your husband is that his cancer isn’t progressing quite as fast as it was, and so in the interests of his quality of life it seemed most sensible to stop his treatment for a while. How long that might be, I don’t know (and I doubt that the doctor knows either), but again I suspect that we are talking a few months rather than a year.

    What I am most worried about for you is being able to cope with losing your best friend. Why, because there is nothing that we know of today that can cure a cancer like this. For someone like your husband, who has apparently received every known form of approved treatment, the only other “new” form of treatment would be a clinical trial of some type (although chemotherapy and other forms of therapy can be repeated if it seems like a good idea in a specific patient). Access to specific clinical trials depends on where you live and your individual resources, and whether there is a trial that your husband is eligible for, and a whole bunch of other things, but the sitemaster tells me that he knows of no ongoing trials of new therapies that are expected to have really long-term impact (i.e., a further remissiono f a year or more) on men like your husband.

    I don’t know if it will help you, but what you might find helpful is this series of 14 short articles written by Bill Manning. He started to write these in January 2014, when he had already progressed on docetaxel chemotherapy. It has been now more than 2 years, and I understand from the sitemaster that Bill is still alive, but that he has decided not to write any more. I have never communicated with Bill directly, but it is clear that he weakened and became tired more easily over time. This is what happens. Gradually patients with advanced disease start to have all sorts of minor failures of their bodily functions, and, in the end, what most patients really die from is some form of organ failure (heart, liver, kidneys, brain, something).

    You are right to want to make sure that your husband has minimal pain. There is no good reason for any prostate cancer patient to suffer from the types of pain that used to be common. And if you haven’t done this already, you do need to make sure that you have an appropriate pain medication available — just in case.

    But having said all of this, I think you need to start to find a way to address the fact that your best friend is going to be leaving you. This will be hard … and probably very hard. And one of the things that I suggest is that you actually talk with your husband about this. He knows what is happening. He knows you are devastated at the idea that you are going to be left behind without him. And he may have words and a smile for you to tell you that he is always going to be there.

    There is no one specific “what next” event that I know of. People like your husband can die suddenly overnight, with no warning, or they can live for much longer than anyone has good reason to expect. You are going to need to be prepared for either of those possibilities. If I knew what was “next” for your husband or for you, I would tell you, but I don’t. … On the other hand, I do know what it is like to lose one’s best friend, and that can be very hard to get over and accept — especially if one isn’t “ready”.


  123. 78 years old; prostate cancer; spread in adjoining areas; Gleason score 8; bone scan negative; lymph nodes also affected. Taken three Zoladex injection 10.8 mg so far. PSA came down from 13 to 0.5. Please advice if I should go for radiation or wait or not to for radiation. My BP and sugar are normal. No other problem. Actively working for 10 hours a day.

  124. Dear Sanjay:

    If you join our social network, that is where we can deal with individual cases and issues like this, and help you with questions for you to ask your doctors.

  125. Thank you Amy. I will read the 14 short articles that Bill wrote. Still not wanting to accept that there is nothing else out there and, of course, hoping that something is out there, “tailor made” for my husband and for the other men out there. I am thankful that the medication given my husband has prolonged his life — still in prayer that he will be cured one day soon. Checking out clinical trials available to him — not finding a lot of potential prospects there, but I am not done searching.

    When this journey began his Gleason score was 10 and his PSA was “well over 100”. Affected: bones and lymph nodes, along with all quadrants of the biopsy positive for cancer — ranging from 75 to 100% (most at 100%). November 11, 2016 will mark the fourth anniversary since we knew exactly where he was: Stage IV metastatic prostate cancer. As of the 16th of this month his PSA was down considerably — which has happened before — that roller coaster of up and down over and over and over.

    I don’t think I will ever be prepared for him to not be here. Sometimes, my mind wanders back to all of the good times, the bad times, the laughter, the tears, and I never want another woman or man to go through this emotional roller coaster. I pray daily for the cure. I keep reading that “Early detection is the best” — but as with my husband’s case, there were no solid symptoms … nothing that jumps out at either of us that says “Wow — something must be wrong!” Maybe if I’d had some warning, I could have prepared myself more — but for the past 3.5 years, we’ve been to three different doctors: scans; chemotherapy; Zometa; more scans; Provenge — running like crazy. … Now that we’ve slowed down, the mind tends to wander to the “what ifs” and the “If onlys”.

    Please Indulge me with this request:

    Men — get checked. If you love your wife, girlfriend, kids, parents — get checked. If early detection is the key to cure – please get checked.

    As if those reasons listed above aren’t enough, here’s an eye opener: cancer is an expensive illness and is not fully covered by any insurance. I am talking about thousands and thousands of $$$ out of pocket if you can’t get patient assistance and — even if you do — you will still be out thousands and thousands of $$$. If you can get it under control before it gets into the Stage IV range, you have the chance to live a long life and save $$$ in the process.

    My husband has been off the chemotherapy for 6 weeks as of today. He’s developed a cough (yes, I, the PITA wife, have called the doctor), but he has actually had a few good days — where he has a little energy. Not many, admittedly — but some is better than none. He doesn’t seem to be in pain. He has had some infections here and there — but seems to be OK. He is not much of a complainer about it — not a whiner at all. His hearing is failing (effects of the chemotherapy and Lasik) and of course, he’s lost his hair too. I keep telling him that bald is beautiful!. Hoping the hearing gets better — but seems to be worse daily. Thing is, I wish I could take all of this cancer from his body and throw it back to the pits of hell, from which it came.

    Research — we need more $$$ for the cure of cancer — all cancers.

  126. Is there any special considerations for giving head to a prostate cancer survivor? Do the balls still enjoy stimulation through licking and sucking?

    Amy replied

    Dear Lisa:

    Nothing like a clear and straightforward question! :O)

    My experience is limited to one man in this situation, and I think it probably depends a lot on the individual man.

    What I can tell you, however, is that after surgery there is significant risk that a man will leak urine and/or fluid from the Cowper’s gland during orgasm (as opposed to ejaculating semen, which is no longer possible). This might be something you want to be aware of before you offer the particular services you are suggesting. The consequences may not bother the man in question one jot. On the other hand, whether you are up for that consequence is a whole other matter!


  127. I am so sad. I have dealt with the reality that in this relationship I will not have a sex life.

    Marriage counseling was weird. It felt like a waste of time. My husband was fake many times.

    I feel alone. I don’t want to live the way he does. I feel like my life is passing me by. And I realize my putting myself second has created most of this.


    Amy replied:

    Dear Lilly:

    When you write that, “my putting myself second has created most of this”, you are actually putting yourself second yet again. You can’t afford to do that. Your situation is at least as much a consequence of your husband’s unwillingness to face up to reality as it is a consequence of your behaviors.

    You need to give yourself some hope of something valuable beyond the present situation, and you need to make it clear to your husband (if you think it is worthwhile) that his behaviors are unacceptable and need to change.

    While I sympathize with what has happened to both of you, he seems to have withdrawn into his own little world of self-absorbed self-pity, and has assumed that you should be satisfied with the consequences. That’s not a marriage.


  128. I don’t know what to do anymore. My husband had a radical prostatectomy 3 years ago. No intimacy or sex in that time. I try talking to him about it; he gets defensive. I really don’t know how much longer I can do this. Any advice?


    Amy replied

    Dear Karen:

    If you read back through some of the other questions above, and my answers to them, you will see that your experience is a recurring problem for the spouses and partners of many men who rush into having surgery as a treatment for prostate cancer. And it is all too possible that at least a significant percentage of these men (especially if they were diagnosed with low-risk disease) may never have needed immediate treatment at all.

    With regard to your and your husband’s situation now, the only meaningful solution is going to come with his acceptance of the reality of the situation and his willingness to talk about it. Alas, this is a very real problem for some men because their sense of themselves as a man is so closely tied to their ability to have an erection and (at least potentially) procreate.

    You may also see that I have told other women like you to watch this video, because it will make you smile (and you probably need to be able to smile more). But it may also be something you tell your husband you want him to watch too. The ability to recreate intimacy between a man and a woman is commonly “all in the mind” of the two parties and may have little to nothing to do with the precise nature of the physical parameters. Sadly, however, all too many men just go into “lock down” once they realize they will never be able to “perform” again in the ways that they have been taught that women expect of men — however misguided that learning experience may have been. The man who made this video also has a web site on which he talks about the changes he had to make to recover his understanding of what it really meant to “be a man”. Whether your husband can “hear” any of this is, alas, not within my control.

  129. My boyfriend of 2 years has been clean from postate cancer for 6 years. The whole time we have been dating he has not tried to have sex with or even use toys. He says it is because if he thinks hard enough to get a hard-on he will pee on me.

    I try to make the subject no big deal but in silence I feel as though he doesn’t want me. I have caught him sex-texting to women he say he would never bring home and that’s why he can talk to them that way. He is a very shine person. Am I being fed a line of bull shot? If not how can I get me even to or use toys?


    Amy replied:

    Dear Tamar:

    There is no way that I can tell you what is going on in your boyfriend’s head. Men are from Mars anyway … so men who are trying to deal with the psychological and physical issues that affect them after treatment for prostate cancer can sometimes appear to be from parts of Mars one wouldn’t even want to think about visiting!

    What you boyfriend needs is professional help. But getting him to seek such help … with our without you there too … is likely to be a challenge.

    I doubt that your boyfriend “doesn’t want you”. I suspect it is much more likely that he is absolutely terrified of being judged as “unable to perform” in an appropriate manner. This is a common situation that men find themselves in after treatment for prostate cancer. Of course he doesn’t want to admit that. Online “sexting” is a way that he can pretend that he is “capable” without being at any risk that anyone will actually be able to “judge” him.

    What you are going to need to do is work out in your own head what the upsides and the downsides of this relationship are from your perspective and what your boyfriend needs to do to make the upsides more valuable. If he won’t go there, then you are going to need to rethink your own needs. If he isn’t willing to “play with you in the sandbox,” then you might want to point out to him, gently, that he is already being judged as “unable to perform”. This is not “all about him”. It is “all about you as a couple”.

    Hope this helps just a little. Alas, I don’t have magic answers.


  130. Hi Amy,

    I agree: It’s not a marriage.

    I don’t think my husband has retreated into self-pity. Not sure. I do not think he is completely happy with the relationship, pretty much like I am.

    I have long ago given up on any kind of sex life. Sex repulses me after all I’ve been through.

    Lots of material things are great but I find myself being lonely. I don’t like him to touch me for various reasons: I don’t find him physically attractive; he comes off as if he is entitled to touch me and says so if I back away from his touch; I don’t feel comfortable given some of the things he has said in the past and things he says now. So as a consequence, I am a little starved for physical contact.

    He makes comments, like the other evening, that when he dies, I will be relieved. I don’t say anything. Part of me knows this is true.

    We have a marriage of convenience where neither of us really wants to throw in the towel. We have a friendship at best, but I would never allow a friend to speak to me the way he has in the past, calling me bitch or saying F*** you if we get in a disagreement.

    After marriage counseling he has started being much less grouchy. I suspect his anger and irritability is due to depression that he would never admit he has. He usually turns the depression accusation to me, telling me that he is “happy go lucky” and that’s how he got through lots of the terrible things in life.

    I realize that I just need to have a straightforward discussion with him about all this. I think he realizes I am not completely happy, but he continues on as if we are a happily married couple. I feel like I have to pretend, even though I don’t have those types of feelings for him. I respect his education, enjoy talking to him most of the time, etc., but then he will throw zingers at me like accuse me of being full of anger because I talk about some difficulties at work. … He acts too much like a parent than a partner. I find I do most of the house work, pay all the bills, do all the grocery shopping, while he gets to putter outside and garden, all activities he loves. I meanwhile work full-time.

    I’m 51 and I can’t imagine spending another year or five like this, but at the same time, it could be worse. I’ve been reading several expert books on co-dependency and recognize my behavior patterns that I’m working to change. A passage I read yesterday said that if you can’t figure out whether to end it or stay, then the relationship isn’t over and there is still something there. When it’s over, you will know it.

    In the meantime, I am teaching myself to focus on ME. I find myself focusing on him so much instead of me and taking care of me.

    I’m too scared of him being angry to questioning my judgment of where things are to bring up the subject of the status of our relationship but I think it needs to be done.

    Thank you for allowing me a place to air my thoughts. It’s apparent to me that I’m stuck because I have been trying to find answers for a long time. I think I want therapists to give me permission to leave.


    Amy replied:


    If you really do want to leave, the only person who can give you the permission to do that is you.

  131. Hi Amy,

    I wanted to say I empathize with all the comments here, but especially with Lilly because I am in almost exactly (and I mean exactly!) the same predicament. I am 17 years younger than my husband who is now 76. He has had prostate cancer for 9 years, now Stage 4 but well controlled with drugs. Our sex life ended the day he was diagnosed, and communication between us has been poor, despite my attempts to talk about it, it has put a terrible strain on our marriage. Like Lilly I think some of the personality/communication issues would have occurred anyway, and were there almost from the start 24 years ago. The cancer sure didn’t help. I am almost at the end of my rope for various reasons, but it is the guilt and shame I would feel (were I to leave) that is most difficult to reconcile with.

    I agree with you Amy, that only I (and Lilly) can decide if we can take another 5-10 years of living in a marriage which is so unsatisfactory on so many levels. It requires great effort, faith and endless patience. Big empathy with you Lilly! Although it has brought me a little comfort to know I am not the only one out there.

    I also wanted to add, in reading others’ posts, that some men become very tired during prostate cancer treatment, it’s a side effect of the hormone treatments and radiation. Often their ability to have sex is less about the mechanics, than about their sheer energy levels and puff! This is my experience, certainly my husband would have been too breathless (Casodex) and I get the feeling some wives overlook this significant point. I never wanted to push my husband for this reason, and I so agree there are other ways to be close, for those fortunate enough to have a mature, secure (in himself) and respectful partner.

    Thank you for this outlet Amy. There’s not enough help out there for the partners of prostate cancer survivors!!



    Amy replied:

    Hi Mandy. Thank you for your thoughts.

    If you ever wanted to join the InfoLink social network to be able to help other wives and partners, I am sure you’d be very welcome there.


  132. Is there any potential issues for performing oral sex with someone diagnosed with prostate cancer?


    Amy replied:

    Well, the one that might be a real turn-off for some partners might be the fact that when men have an orgasm during sex after a prostatectomy they are not ejaculating sperm. Rather, they may ejaculate a little Cowper’s fluid and many men are going to leak urine too.

    If what you are worried about is the idea of prostate cancer being passed from the man to the partner during oral sex, there is no evidence that that is either possible or that it has ever happened (but, to coin a phrase, it might be wise to remember to “never say never”). Of course women can never get prostate cancer because they have no prostate.


  133. Hello Amy,

    My partner just told me he has an enlarged prostate. We’re both in our 60s. I’m really sexually active; he used to be, but lately he hasn’t been in the mood. What can we do to spice up our sex life?


    Amy replied:

    Dear Dulcy:

    I don’t mean to seem disinterested, but your problem isn’t one related to prostate cancer. And I don’t pretend to be a sex therapist.

  134. Hi Amy,

    I will try and make this as brief as possible. My husband was diagnosed with prostate cancer earlier this year. He underwent surgery to remove the prostate. He is 53 years old (no children), and I am 26 years younger than him (no children as well). We have been married for less than a year and things have been seemingly well for us, up until the past 4 months.

    I have uncontrollable anger with him and resentment. I knew going into our relationship that there would be problems but the surgery has been very hard for me to cope. I have tried to be supportive and understanding but I am left with selfish feelings that I can’t talk about with him.

    I am struggling big time. I am very young and deserve to have an active, hearty sex life. I become so angry knowing that I might not ever have that again.

    We are currently doing IVF treatments (we started when we found out he had prostate surgery) to have a child but have been unsuccessful so far. Going thru IVF was very hard for me. The medications were insane, and when I would have a hormonal outbreak, I would hear, “Wow, those meds are really getting to you!”. Perhaps my outbreaks were indeed irrational but anyone going thru that kind of treatment would feel the same. We (mostly me) have been having a very hard time. I am torturing myself reading online forums, and posts about post-prostatectomy side effects but I just can’t help but feel angry. I need to know that I am not being completely selfish and that it is my life too.

    How do I get back to where we were when I have no idea what our future is going to hold for his recovery? How do I stop my anger about his illness before it ruins and dissolves our marriage?


    Amy replied:

    So let me be very blunt.

    First. Of course this is your life too and you are not being entirely selfish. However, …

    Second. When you think about yourself and refer to yourself as “hopeless” you are not going to help yourself or your husband or your marriage.

    Third. You say that you “can’t talk to” your husband about your “selfish feelings.” But you’d better be able to work out how to do that because if you can’t and don’t you are only going to make matters worse. Communication about the really hard things is the foundation on which all good marriages are built. So I think you are going to have to bite the bullet and be completely honest with him about all your fears and worries.

    Fourth, the IVF treatments probably haven’t been helping the situation, but that’s a necessary evil if you want to be able to have children now.

    What this is all about is learning to live with someone and something that has turned out not to be quite what you had expected. (Okay, nothing like what you had expected.) The question is going to be whether you really love each other and are both willing to adapt or whether one or other of you simply can’t manage to do that.

    The fundamental question here is what and/or who are you angry with? Yourself having got yourself into this situation? Your husband for something he probably had little control over? The situation itself? What?

    You need to find a way to open the door and have a completely honest conversation with your husband about how you feel, what is going on, and what you want to do about it together. And you need to stop calling yourself “hopeless”. Now. This minute!



  135. Hello Amy:

    I’m a 6-year survivor of stage IV cancer and had my prostate removed. Sex has been out of the question. Recently I met a beautiful lady and I need to know, how do I tell her of my condition?


    Dear Al:

    So that’s one of the easiest questions that anyone has ever asked me. The answer is “Honestly.”

    However, my suspicion is that what you are really asking about is not so much “How do I tell her about my condition?” but “How do I tell her how I feel about her, and my condition, and the implications of that condition?” That’s a little more complicated, but the answer is still the same one: “Honestly.”

    Be yourself, take a deep breath. First tell her how you feel about her. Then tell her about the cancer. Then tell her about the implications. And then let her ask all the questions she wants to ask.

    Oh, and this is probably not a good conversation to try to have at a nice restaurant with waiters interrupting. You may want to do this somewhere where the focus can be on the conversation as opposed to the food!

    Good luck



  136. I tell young women who think they want to marry these old dudes, read online how they feel when their sex lives are cut short by, oh, 20 or 30 years. … Then shop around in your own age group.


    Amy replied

    Dear Clara:

    While I and others may understand your point of view, and why you say this to young women who are considering relationships with older men, it is important to remember that marital relationships are often based on factors that have less to do with sex and much more to do with other forms of compatibility. We all need to be rather cautious about projecting the impact of our personal experiences onto other people.


  137. In 2008 I had my prostate removed. I’ve never been able to get an erection since. I feel bad for my wife as we had a normal to very active sex life before and I feel maybe she should get what she needs elsewhere and we can be just room mates. I have no problem with this arrangement, but my wife disagrees. I’m thinking … why does she have to suffer with this cancer crap along with me? I would feel better if she could enjoy sex again. I can’t be a part of it, I know and accept it for what it is. I’ve had my good times as a younger man and my life has changed to say the least. I want my wife to be happy and content. I can find other interests in life to keep me going.

    Amy replied:

    Dear Steve:

    I think that you need to listen very carefully to what your wife is telling you. You might “feel better if she could enjoy sex again” but maybe it would only be enjoyable for her if it was sex with you again. There is something you could do about that if you wanted to. … Have you ever thought about getting a penile implant. Maybe you should talk with her about that.

    Men and women often think very differently about what sex means to them. Certainly there are women who miss the physical aspects of sex terribly when their husband gets something like prostate cancer. But for other women what they miss much more is the emotional closeness — and that doesn’t have to be lost just because the physical side is different. I’d be surprised if your wife was interested in “just being room mates” with you. She wants someone who she loves and who loves her back … and shows it.

    As the man in this video would certainly tell you to your face, intimacy is far more important than the missionary position. I suggest you watch it. As far as I am aware, he doesn’t even have an implant.


  138. I have a husband that had prostate cancer. During sex he urinates inside me sometimes. Am I in danger to have this bodily fluid inside me?


    Amy replied:

    Dear Yoya:

    The problem that you describe is not uncommon among men who have had treatment for prostate cancer (particularly surgical treatment). They can “leak” urine (and sometimes quite a bit) when they ejaculate. The condition is known, medically, as “climacturia”. Here is a link to a commentary about research on this condition (from back in 2011).

    As far as I know, you are at no more risk for any problems from this than you were from having intercourse with your husband before his surgery. Urine is pretty much sterile in healthy men and women. In other words, one of the biggest risks of intercourse is if one partner gets some form of genitourinary tract infection (a virus or a bacteria or similar) and then passes it to the other partner (and that can happen either way around). The only way to avoid that type of risk is by the regular use of condoms, and if both partners are healthy and monogamous that’s usually not something either of them want to do.

    The best way to minimize this problem is for your husband to make as sure as he can that he has emptied his bladder before you have sex.

    Hope this helps.


  139. Actually I am so tired of my husband googling all the reasons he feels like he feels. I love him and like I told him … If you lose the use of your legs do you just tell your hands you are no good to me anymore or do they take over and be your legs? Yes you use them to make the wheelchair go. So if you lose the use of the sex organ why would you not compensate with your lips and hands to please your wife?

    I know when my husband did not even want to kiss on me anymore or touch me it made me question what the purpose of God creating me female was. I do not want to be my husband’s buddy!!! So simple … just kiss, hold, caress, talk, and a woman feels love. Prostate surgery didn’t take any of those abilities away. So … Do you sit and feel sorry for yourself possessing those abilities to make your wife feel loved or do you watch her slip away? Because I know touching and kissing is so simple but a man refuses to allow himself to let go and do this and just forward all the second-hand “Googleland” info on why he doesn’t desire you anymore. … How can a woman not feel her feelings are of no concern? I don’t feel worth the effort, therefore I feel like I am supposed to sit around wondering why I’m not enough to give a little to make me feel loved. It gets old being the one dishing out all the praises to make your husband feel loved and you just get … I’m sorry I just don’t like kissing you and touching you like I used to. Frustrated and giving up!!!


    Amy replied:


    Feel free to vent as much as you like. Alas, I don’t have a good answer to the problem you are posing. If I did have a good answer, I would be giving it away for free!


  140. I know exactly how you feel. I am in exactly the same position. Since my husband’s diagnosis, we are strangers in our own house. No affection at all. I don’t feel like a woman anymore; I still get urges, but have to ignore them. I love my husband of 37 years, but he just watches TV all day and ignores me, plus we have money troubles. I don’t feel like going on.


    Amy replied:

    Dear Sylvie:

    I wish so much that I had a simple way to be able to help you and the many other women who are affected in this way.


  141. We are just about to go for surgery. I have no idea what to expect after my husband’s operation. Can you help? I am really worried.


    Amy replied:

    Dear Giĺl:

    There is a web site called the Caregiver Partnership that can probably offer you relevant information. Have a look at these articles on that site:

    This is how many men feel following prostate surgery
    The after-effects of prostate surgery

    There is also an article called “Recovering from prostate surgery” on the HealthDay web site.

    From your point of view there are two important things that you need to be focused on:

    (a) Don’t let your husband lie around on the couch feeling sorry for himself and worrying that he will never be able to have an erection ever again. That’s just not a healthy way to approach recovery.
    (b) Try (gently) to get him to talk to you about his fears (and yours). Good communication is the key to getting past any obstacles.

    When he goes to the hospital, ask the nursing staff if they have specific recommendations about post-surgical recovery. Usually each hospital will have specific guides for the patient and his family. Also, ask if there is someone like a Macmillan nurse or a “patient navigator” who you can talk to about what you need to be able to do to help your husband. It will take time for your husband to recover after his surgery, and it will probably annoy him a lot too (especially if he is not a patient man).

    I hope this helps a little.


  142. Amy and all,

    It has taken me this long to realize that the prostate cancer surgery was just part of the problem. The underlying issue that complicates things is my being what is commonly referred to as co-dependent. I hate labels but the behavior fits. I have done a bit of reading over the last year.

    I put my husband’s needs over mine instead of making them equal. I put aside my wants and needs because his recovery; the seriousness of the surgery and the subsequent radiation about a year later were more important.

    I am a people-pleaser who grew up with a dominant father who would get angry. I felt shame growing up because I was never good enough for him. I was self-conscious because of his criticisms and perfectionism. My mom was passive and people-pleasing as well and, looking back, I know she was unhappy for many years of their marriage but never left. People of her generation and upbringing just didn’t do that.

    So I’ve continued this pattern of being the good girl, although the years have been sprinkled with arguments of varying degrees and times when I really thought it was over. Truth told, if I had more self-esteem and wasn’t made to feel as if all the problems were my fault or lack of doing enough, I would have left. A woman with more self-esteem would not have stayed as long as I have stayed.

    Instead of having an opinion of my own, I agree to things and them am sad and angry because it’s not really what I want. I never learned how to really express my feelings or speak about them.

    My husband uses anger and irritation to shut me up. If I continue to talk after he has gotten angry and frustrated, I am accused of “wanting to fight.” I have learned some communication techniques and know that I have to use “I” statements. I have to be calm and steady and firm when I make statements or else the emotion gets in the way of the message.

    I realize the depressed feelings I have frequently are because of the years of this behavior.

    My communication with my husband has gotten better. Marriage counseling, I feel, was not a great deal of help but I think it may have opened his eyes a bit. Still, I observe his behavior as a little narcissistic and I think he thinks the problems are all with me.

    He is quick to anger at everyday items. Hitting the wrong button on the TV remote causes him to cuss. He grumps about petty things. I have come very close to telling him I won’t ride in the car with him again because he constantly points out the idiotic behavior of other drivers, calls them names, cusses.

    I’ve realized the way he talks to me is verbal abuse. Just last week we were talking and I accidentally talked while he was talking and he yelled at me at the top of his lungs to stop interrupting him. I told him to not yell at me but he always has an excuse … usually it’s because of me. Last weekend, he blamed it on the fact that I didn’t feel 100% — he got sick of hearing my comments about it. I try to tell him I won’t stand for his behavior. I realize I have provided no consequences to back up that statement. Here I still am. It seems like it would be so weird and nearly impossible to leave.

    It all sounds crazy when I type it out. He acts like we’re a couple that will be together forever.

    I know I need to talk to him and express my feelings, lay this out on the line, but it never seems like the right time and I don’t know how to start that conversation. I’m stuck because I never take action. I doubt my feelings and assessment of the situation. I suppose talking with the psychologist again would be a good idea.

    Any suggestions would be appreciated. But then again … I think I’m too scared to act. Al Anon has been suggested to me for support and because hubby drinks. I have drowned a lot of my feeling in alcohol over the past decades as well and just this week decided to put the breaks on that.


    Amy replied:

    Dear Lilly:

    It is often very hard to change years of habitual behavior, just as it is usually hard to give up smoking (which took me years, but I did it in the end by just going “cold turkey”). I think that some more talk with the psychologist and Alcoholics Anonymous may be helpful, but the most important thing is to make sure you make time to do some of the things that you really want to do so that you can build some self-esteem.

  143. Hi Amy.

    My name is Gladys and my husband has not touched me for 3 years since he had his prostate removed. His Gleason scores were all 6 and one 7. Would like to know why he keep sleeping in that room all alone. I have tried to make him feel sexy but he wants nothing to do with me. He still has a little urine leakage. I have told him we can buy condoms. We don’t do anything together anymore. I feel lonely all the time. We own houses, and all he does is watch CNN and go to the houses after work

    I don’t know what to do or say anymore. Any suggestions.


    Amy replied:

    Dear Gladys:

    I am so sorry to hear that your husband’s prostate cancer treatment has affected you both in this way. Effects like this are far too common, as you will see if you read through some of the other conversations above.

    You have obviously tried talking with your husband about at least the sex piece of all this, but the real question, I think, if whether he understands how lonely you feel. Have you tried to talk to him about that?

    You need to understand that your husband probably feels emasculated by what has happened to him. He may not be able to get and maintain a meaningful erection at all. And he is probably too embarrassed to even think about talking about this to his doctors or to anyone else. To get past all of this can be a real problem, and the most important part of it is likely to be whether you and your husband are actually able to talk to each other with compete honesty about what is going on. Sometimes that can be very hard for couples.

    When I am asked about all of this, I often tell men or women to watch this video. It will probably make you laugh — and perhaps cry too. It will also show you that some men do manage to get past this problem — but it takes effort and insight. I can’t possibly know whether you think your husband would also be willing to watch this video. That’s a decision that only you can make. But the other thing that you might want to do is go and get some professional help for your (apparent) depression and sense of loneliness, and tell your husband why you feel you need to do this. It is possible that if you seek such help, he would be willing to come with you — but I can’t make you any promises.


  144. My boyfriend had his prostate removed 9 years ago. I’ve been with him for 5 years. Sex was great at the beginning but this past year he does not perform. He blames it on his prostate.


    Amy replied:

    Dear Linda:

    Obviously it is impossible for me to be able to know exactly why your boyfriend no longer seems interested in sex. There are all sorts of possible reasons for this, and blaming his long-lost prostate is an easy explanation for a man who has been treated for prostate cancer. However, if he was capable of having a good erection 5 years ago, his absent prostate may be a part of the problem, but probably not the only part. Other factors could include his increasing age and the state of your interpersonal relationship — most particularly including your ability to communicate honestly with each other about everything.

    Loss of erectile function can be psychologically devastating for some men. It can make them feel completely emasculated because their entire concept of manhood may be based on their ability to “perform” sexually. However, only your boyfriend can tell you exactly what is going on with him — physically and psychologically.

    I am aware that this isn’t going to be of much help, but I really don’t know what else to tell you.


  145. Hi. My husband had his prostate cancer 6 years ago. Since that time he has been healthy.

    My problem is we used to be close in every way. We have always done things together, and still do. But the one thing we are not close in is sex. It’s like he just doesn’t care about sex any more. He is 70 years old; he loves me; but I know I need help. I don’t understand why he only may want sex every 4 months. What should I do? I am Christian. He is not. He doesn’t go to church. I am a 67-year-old person. We work out together. We do like being with each other. He tells me he is tired a lot and he sleeps a lot.


    Amy replied:

    Dear MC:

    I don’t mean to sound unkind, but many of the women who come to me asking for help might think you were lucky because your husband does lots of things with you, on a regular basis; he apparently still loves you; and on top of that he at least seems to be interested in sex sometimes (even if it is only three or four time a year). If you read some of the other stories above, you will begin to see what I mean.

    Your husband is not as young as he used to be. It may simply be true that he really just isn’t that driven by sex any more. You are obviously able to talk to him about this (and many couples can’t even seem to do that very well).

    The one thing you and your husband might want to do is talk to his urologist about whether using testosterone supplements might be a good idea for him. They might help him to feel less tired; they might give him a little more energy; and they might help to perk up his interest in sex a little more often too. But because he has had prostate cancer in the past, it would be important to discuss this with his urologist. However, I don’t think that even testosterone supplements would help to persuade him that he should be going to church with you.


  146. My husband takes one Cialis tablet twice a week. He is not interested in me as for sex but has started looking at a lot of porn pictures. Do you think this is related to the tablets?


    Amy replied:

    Dear Di:

    Alas (or maybe thank goodness!), I am unable to read men’s minds.

    Could taking the Cialis tablets be associated with his increased interest in pornography? Well, I suppose so. Why don’t you ask him what he thinks?


  147. Hi Amy, thanks for your reply. I never realized that looking at porn could become an addiction until I read an article yesterday. In actual fact my husband had books hidden 40 years ago. Then DVDs were being hidden. Sometimes I have asked him about them, which he denies all the time. When I told him I found some in his bag or a drawer he never knows where they came from. Ridiculous I know. I have sometimes told him I don’t want to be married to him anymore because I don’t like being lied to. He always promises he won’t do it any more. It continues. It’s actually worse now. I can’t talk to him because of his denial. I don’t know what to do but I do know I can’t live with him this way.



    Dear Di:

    So I suppose that the fundamental question is what is really bothering you … that he looks at porn (which I gather you have known for years) or that he lies to you about it?

    Maybe if it’s the lying bit then you can just tell him that if he wants to look at some porn occasionally, that’s one thing (that you don’t necessarily like but you can live with) but if he goes on lying to you about it, that’s a real problem.

    How men’s brains work when it comes to their sexual fantasies is beyond my pay grade! :O)


  148. It’s the lying I hate and being so stupid to try denying it. That’s what I don’t understand, he a very well educated guy and holds a high-power job. Why does he treat me like this? He has contacts for either meeting or just watching women in all the areas he travels. He went to play golf today and left his i-Pad at home so I sneaked a look — which I hate but it’s just getting me neurotic about it now.

    What shall I do? It’s good to be able to talk to you. I can’t talk to my friends. I’m too embarrassed about it. Do you think I should go to the doctor?


    Amy replied:

    Dear Di:

    I am in no position to be able to tell you what to do. But I don’t think you need to see a doctor (unless you need something to make you feel a little less stressed). On the other hand, what you and your husband may need is some marriage counseling. You are clearly having a communication problem. That’s not a medical issue but it can still be serious for all concerned.

    Now, leave the iPad alone. “Sneaking looks” at the iPad isn’t going to help anyone. What you both need to deal with is your concern about being lied to and whatever it is that he is feeling concerned about. It may not appear that way to you but he is clearly concerned about something ‘cos he can’t seem to talk to you about it.

    You both need to find a way to talk to each other!


  149. Thank you, I think I may try to confide in a friend. That way I can probable get really upset and then I may be able to come out the other side with some sort of conclusion. I seriously can’t see him agreeing to counseling.


    Amy replied:


    I do think that talking to a friend first would be a good idea. It would help you to be able to confide is someone who you know and who you feel you can trust as a first step. But don’t write off the idea of counseling. You could start by simply telling your husband that you need help.

    You also need to make sure he understands it’s not the porn per se. … It’s the unwillingness to be honest about it that’s the problem.


  150. Thank you so much Amy, I have wanted to talk to someone for such a long time but have been scared of making my husband a dirty old man. He’s 70; I’m 75. I will tell him I am going to ask for help to understand his phobia. Do you think this is the best idea?

    Best regards




    I’d be surprised if he is a “dirty old man”. I suspect he is just sad about his lost youth and unwilling or unable to “transition” into a man who is comfortable with his increasing age and — probably — some degree of loss of vigor. He may just not know how to deal with it.

    I wouldn’t mention his “phobia”. I think you just need to tell him that you need help in being able to regain the honesty you used to feel you had in the communications between you as a couple … and he’s welcome to come along or not. Putting medical labels on things is not often very helpful. It tends to start to paint things in black and white as opposed to the varied shades of differing colors that surround us all the time.



  151. I understand the loss of vigor but like I said earlier on in these conversations he has always had girly magazines hidden under cushion, etc. it just got so much worse now what with the Internet and him taking Cialias. I will try to talk to him but even today on the computer that faces the wall in his office when I walked in and asked him if we were going out to dinner he said he was checking something, but I saw sexy pictures in the corner and we were already late to go out with the grandkids. It’s like these pictures are taking over his life.



    Dear Di:

    One of the things that you need to do is to calm down a little about all this. You also seem to be becoming a little bit obsessed by it, and that’s not good for you either. Try to take things one step at a time and to stop “checking” on your husband at every opportunity. The thing to focus on is the lying issue.


  152. Hi Amy,

    I have been reading the letters from other wives and yes I’m so sorry for them but none mention their men watching porn on TV or DVDs. Is my husband unusual?

    Is it the porn he prefers rather than me and maybe not the prostate at all.



    Amy replied:

    Dear Di:

    I can’t answer that question for you. Some men like watching pornography. Some women like watching pornography too (although I suspect it is a lot less common among women than men).

    The roles of sex and sexual fantasy as forms of “entertainment” go back thousands of years. Millions of women (and men) over that time have made a living from providing sex and sexual fantasies for men (and for women too).

    For those of us who it does nothing for, it is incomprehensible. For those of us for whom it apparently does a great deal, explaining why may be near to impossible. Society treats all of this in the same way as it treats other “deviant” behaviors … by classifying them as “deviant” and then doing its best to ignore them. But maybe they aren’t really that “wrong” at all … maybe they are just more or less unusual.

    The question is not what your husband is doing or why. The question is why you and he can’t or won’t just put it all out on the table and talk about it to each other. Only you and he are going to be able to resolve that question … although some professional assistance may be able to help.

    I’m sorry if I seem unhelpful, but there are no magic resolutions to issues like this. You and your husband need to be able to talk to each other.


  153. Hi Amy,

    I am getting better about doing things for myself, speaking my mind instead of what I think others want to hear, etc. I have read several books on codependency and I see myself in those behaviors. It was eye opening for me.

    I find myself down because I can’t imagine my life continuing the way it is going, from a relationship standpoint, for years to come. I feel young. I feel like I’m missing out and giving up on a part of my life. It makes me sad. The age difference between us feels larger to me.

    My husband is now 75. I know he is trying to be more helpful around the house, now that I’m working full-time (that made a HUGE difference to me…) and he does everything he can to keep us from having arguments. I’ve seen a big change this way. It’s like he’s just trying to do whatever to keep me around, make me happy. The “whatever you want to do is what I want to do” sort of thing.

    We aren’t physically close at all. I pretty much gave up on that after so many hurtful comments from him and just plain being tired of dealing with the impotence … and the incontinence and his temper tantrums around the incontinence. I feel for him, but at the same time it’s emotionally draining for me. It’s a marriage of convenience.

    Should I just be happy that I’m healthy, have enough money, a nice house … and be done with it? Would telling him I not exactly happy with our situation help? I feel like at 51 I have a lot of living to do, but my life doesn’t include some of the romantic stuff. I’m just not physically attracted to him, although I respect him. I’m angry and hurt.

    Often when I start to talk about some things I would like, he shuts me up or gets angry. He’s gotten better, but still. … I would like to not always live in the boonies. With his age and his being alone most of the day due to my working, … I think I have some valid points. I thought once he retired, we’d travel. My working full-time again was never really in the cards, but it is good for me. It’s just that now I see that we maybe won’t have the no working time together. By the time I quit working he may be too old or have passed. When I worked from home we had more free time but it seems once I started back to work several years ago, he suddenly came up with all these travel ideas. I’ve told him that it’s not in the cards for awhile. …

    It always sounds like I’m not grateful when I open my mouth and that’s not it. He prefers the country life, tinkering outside, and doesn’t much like people. I’d love to live where I’m closer to things, not have the outside to worry about and just live sometimes without all the maintenance.

    How do I start a conversation about how I feel? Should I?


    Amy replied:


    There are things I can help you with and then there are things that you and your husband need to help each other with.

    We all have periods in our lives when we are dissatisfied with the situation we are in. Sometimes we can get ourselves out of that situation with ease. Other times, and particularly when it involves other people that we are or have been close to, it can be a lot more complex. The situation you are describing falls into the latter category.

    Your husband seems to have made a considerable effort to try and see your point of view about a lot of things. It may not be a perfect situation, but I think he deserves at least honesty from you.


  154. True. He does deserve honesty. Many times when I try to talk about things he uses irritation and anger as a way to shut me down.

    My situation is complex and has been going on for a long time. Prostate cancer and its effects have dominated and hurt an otherwise decent relationship. It exacerbates other dynamics that are already there. My young age, our age difference, doesn’t help things much either.

    I will keep plugging along. This site has helped me express some feelings and know that I’m not alone. I realize I’ve been posting here for several years. Thank you for your feedback Amy, and thank you to others that have posted. I plan for this to be my last message here. Time to move forward and on.

    My heart goes out to every woman who is dealing with the effects from their partner’s prostate cancer surgery and recovery.



    Life is rarely an easy journey. I hope that yours can improve with time.


  155. I am a 40-year-old woman who has been married for 14 years to a wonderful man 15 yrs older then me. We have two beautiful children: a daughter (14) and a son (6). I was told at 18 I’d never conceive on my own but miraculously had our daughter. Seven years later, in spite of my husband having prostate issues, I again became happily pregnant with our son.

    Two months after our son was born my husband was diagnosed with prostate cancer at the age 49. At the time we had very little of a sex life — once every 2 or 3 months, but with very busy lives and his medical issues I was OK with it. Three months after diagnosis my husband had his prostate removed; I supported whatever decision he made, and we made the decision together. Afterwards we were giving options for him to successfully get an erection.

    Medication with Viagra and other pills does not mix well with high blood pressure. He would suffer through the side effects, I am sure, just to please his younger wife. We still at that time would have sex every 4 months or so. He then saw a specialist who prescribed an injection medication which works wonderfully.

    So here we are 6 years after the prostate removal and I am turned down night after night. The excuses are old. They have become hurtful. I feel very unwanted. He has told me recently he has no sex drive. It’s always later or tomorrow. His famous line is “It’s not you, it’s me”. It sure as hell feels like me. Going on 6 months maybe 7, I’ve lost track it’s been so long. I’m still so in love with my husband, and I know he loves me. But it’s starting to make me question his love for me.

    At times after being “pushed away” with an excuse I just cry for hours until I finally fall asleep. Its not only the reaction that hurts, it’s the empty feeling I have that I miss my husband. I miss being with him, I miss him touching me, I miss him satisfying me, I miss being with the man that gave me two beautiful children which were made out of love-making not sex, that’s what I miss. I don’t think he misses it all. I think it bothers him that it bothers me … but not enough to change!

    Please help me to understand or offer a solution to his lost sex drive. If 15 years ago someone would of said this would happen I never would of believed it. We never had any problems. We would be together twice a month if not more. I have no girlfriends to talk to. I have a few male friends but it’s an embarrassing subject for me, us.


    Amy replied:

    Dear Jenny:

    I understand and feel your frustration. Loss of intimacy like this is far from uncommon after treatment for prostate cancer, but is not always specific to the prostate cancer, and I feel I have to tell you that your husband may be telling you the truth when he says he has lost his sex drive.

    One possibility that you and he may want to discuss with his doctors is whether he could try testosterone supplements to see if they might be helpful. This is still a controversial topic for men who have been treated for prostate cancer, but there is increasing evidence that — for many men who have been successfully treated for prostate cancer — testosterone supplements present no significant risk for return of the cancer, and the testosterone supplements could well help with your husband’s interest in sex.

    The simplest first step would be for him to ask his doctor to check his serum testosterone level. In most normal men this ranges between about 300 and 1,000 ng/dl, but serum T levels often start to fall as men get older. If your husband’s serum T level is low, this might help to explain what is going on.


  156. How can I check my self for prostate cancer?


    Amy replied:

    Dear Doug:

    I have checked with the sitemaster and with Ask Arthur (just to be sure) but …

    No man can “check himself” for prostate cancer. It’s not like breast cancer or testicular cancer where a patient may actually be able to “feel” a lump her- or himself.
    However, here is a link to some relevant information that may be helpful.


  157. Dear Amy:

    Well, life has gotten a lot more stressful. My husband has been battling Stage IV metastatic prostate cancer now for 4 years, and has had some setbacks.

    I don’t know what to do anymore. I am not angry about the lack of intimacy. I am angry about the cancer and what it’s done to him.

    He is not only battling Stage IV metastatic cancer, but add in lymphedema, cellulitis, and edema; the beginning stages of dementia coupled with chemo-brain; blood clots in the leg not affected by the lymphedema, etc.; … and add in neuropathy in his hands and feet.

    His WBC is down; RBC is also down (anemia). I feel helpless to do anything. Liver function OK for the time being; good blood pressure; kidney functions OK.

    The doctors have started him back on chemo — but there are few options left after this round of chemo. The bills are piling up and I no longer have the ability to do much about them. My heart is breaking watching this all play out.

    To the caregivers … wives … girlfriends — I give you all a huge shout out! It is not easy. Praying for all of you for grace and mercy.

    To you guys battling this mean and cruel disease — I am praying for all of you — that your needs will be met and that a cure is found soon.

    Eat right, exercise as much as you can, and know that someone out there is praying for miracles for everyone of you as well as for my husband.


    Amy replied:

    Dear Ellen:

    I am so sorry to hear about your husband’s setbacks.

    You are right. None of the issues related to dealing with late-stage prostate cancer are easy. And because of the nature of prostate cancer, all the associated pain of living like this is commonly played out slowly over time as opposed to the speed with which it can happen for some other cancers. I often feel that this can be as much a bad thing as it can be a good thing.

    Have you been able to look into getting some sort of home nursing services or “hospice at home service” to be able to help you to care for your husband and optimize his (and your) quality of life? The availability and quality of such services vary from place to place, but your husband’s medical oncologist and his support staff should know what might be available in your area.

    Thank you for your “shout out” to all the other patients who are dealing with these types of ramification of their later stage prostate cancer … and to their wives, partners, girlfriends, and whoever else may be carrying the burden of helping the patients to have as much of a life is possible under such circumstances.

  158. Thank you Amy.

    Actually, this discussion is coming up on the 28th (this coming Monday). We have to find some sort of nursing services home health. You are correct also about how playing out slowly =- then aggressive again, then back and forth. It’s a very cruel disease for men and for the family as well. I will keep in touch — feels much better to be able to just type away the feelings that no one can possibly comprehend unless they have gone through this or are currently experiencing it.

    I appreciate all of the blogs — some have given me the “questions” to ask; others have just felt like a great big hug that says, “Everything will be OK”….

    Thank you again Ms Amy. I sure appreciate you. God speed to all! Praying for all of us.

  159. Hi Amy.

    My name is Charles and I am prostate cancer survivor who also became impotent after the surgery and especially so after I had a recurrence and had radiation. My reaction was more of acceptance instead of depression because I always enjoyed the foreplay as much as the act itself and knew beforehand that orgasms can be reached without an erection.

    My story is this: My spouse, after our attempting to have sex after a reasonable amount of time, said that was disgusting and left the bedroom. and slept on the couch. This was 52-year-old woman. Every day for the last 10 years since then it’s been, “Why don’t you take testosterone?” (which I gave in to and did and my cancer came back, hence the radiation) or “Why don’t you do more about your problem?” (I took the pills. They didn’t work to her satisfaction). If she saw another woman look at me she would say, “Boy, wouldn’t she be disappointed”, and when I went to please her it was not enough.

    These are just a few examples and not even the tip of the iceberg. It got me to the point where I did not even want to bother any more.

    I understand it’s a loss to both people but it could have been much worse. It could have been a funeral.

    My advice to men when you elect to have surgery is to expect the worst and prepare for it.

    My advice to partners is the same, with the caveat of having an attitude of “Glad you’re alive and well and let’s see how we can make this work for both of us.” Don’t berate and belittle and challenge his manliness. Be patient and tell him you love him no matter what. He will come around sooner than you think.

    Have you heard of female reactions similar to this before? I finally got to the point where I had to leave. I’m retired now and 65 years old and I’d rather live alone than deal with that



    Amy replied:

    Dear Charles:

    I don’t usually hear from the men, so no, I haven’t heard this particular tale before, … but I have been expecting to hear it (or something very similar) for years. Some women can be just as insensitive about sex as are some men … and just as tactless and cruel.

    Some marriages are held together almost exclusively by the quality of the couple’s sex life, and if that deteriorates then the entire relationship can fall to pieces — slowly or suddenly. Sometimes the couple doesn’t even understand before the event just how dependent they are on this particular type of glue to hold their relationship together.

    I am sorry you had to go through this. You were clearly trying as hard as you could, but your wife just wasn’t on the same playing field with you. Apparently for her the foreplay simply wasn’t anywhere near to being as much fun as the act itself.

    In the end you were probably right to walk. Being someone’s “whipping boy” on a daily basis doesn’t really appeal to most of us, and I hope you can meet someone else with a rather greater degree of understanding and appreciation.

    Relationships between couples are often not as mutually acceptant as we like to think they must be. I am hardly the first to point out that cohabitation with a single partner for 30 or more years is a comparatively recent development in human evolution. Back in the early 1700s, life expectancy was short, and things like prostate cancer were rare (by comparison with things like cholera, plague, smallpox, and all the problems of childbirth for women). We are still very early in the process of learning how to manage long-term relationships that can go through the sorts of changes that you and your wife were faced with. Some of us may be a lot better at this (or maybe just a lot more patient) than others.


  160. Thank you for reading my letter and putting it on your site. I appreciate it.

  161. My husband didn’t tell me that he was getting a penile implant. Does the doctor have to tell me, or ask about my husband’s physical situation? He lied and manipulated, said that he had to go to the hospital for some another treatment. But something went very wrong — he is back in the hospital again — for a second time. Who is right!? I haven’t seen any honest American around here — they are all liars, cheaters, maniacs — no moral values!


    Amy replied:

    Dear Lydia:

    I can understand your anger. It seems bizarre to me that any man would go and get a penile implant without discussing it with his wife. However, …

    No one has done anything illegal or technically “wrong” here. There is no law that says your husband “has to” tell you that he is doing this, and the doctor is legally required to abide by the wishes of his or her patient (if your husband even told him that he hadn’t discussed this with you). The morality of all this is certainly questionable, but that particular issue lies squarely at the feet of your husband.

    The best I can say is that your husband is yet another foolish male who makes decisions without considering the ramifications of those decisions on others. He certainly isn’t the first … and he quite certainly won’t be the last either!

    What you want to do about this is something I don’t know. However, I don’t think you should be judging everyone by the behavior of your husband. For example. the doctor would, in fact, have been breaking the law to discuss this with you if he didn’t first get permission from your husband.

    Of course I doubt if anything I am telling you is going to be very helpful under the circumstances.


  162. I was reading and it said that semen fluids are made in and come from the prostate gland. I also read that at times though it is in prostate, it can spread. My question is if giving oral sex to a partner can cause problems for me when he releases his sperm?


    Amy replied:

    Dear Felicia:

    Prostate cancer isn’t an infectious disease, and women’s biology is very different from men’s biology in a number of ways. Most importantly, you don’t have the biological ability to get prostate cancer, just like men don’t have the ability to get ovarian cancer or cervical cancer. So … you aren’t going to get a problem from oral sex — even from a man who has prostate cancer. However, there are a whole bunch of other disorders that can be and do transmitted by oral sex … including viral infections like HIV and HPV, so you do need to make sure that any partner you are having sex of any type with is free of these types of sexually transmissible infections.


  163. Hi.

    My husband was diagnosed last year with prostate cancer. He immediately opted for surgery and the prostate was removed. We started the process of healing and recovery. Well to make a long story short … His PSA levels have been zero and I thought all was well. After many years of marriage he left and moved in with his G’friend.

    I’m looking for any kind of support groups for the women who are going through this battle with a loved one. Any info would be greatly appreciated.


    Amy replied:

    Dear K:

    The experience of prostate cancer can make men do all sorts of odd things … and the one you describe is one of them. And obviously this can be very distressing for all sorts of reasons. However, …

    The question, of course (to which there may be no good answer) is whether the prostate cancer is actually directly related to your husband’s decision to move in with this other woman or whether it merely seems to have accelerated the decision for some reason. My point is that, from your point of view, the real issue here is whether you want to get your husband back or whether you want to let him go and get on with your life. The prostate cancer may actually be irrelevant.

    There are a few good prostate cancer support groups and organizations specifically for women, but not many. If you want to reach out and find other women who will understand exactly what you are going through, your best bet may be to join the online forum, For Ladies Only, which is exclusively for wives, partners, and family members. It’s a very active forum and the women are extremely supportive. You must become a member to view and enter posts.


  164. I would like to know has anyone else experienced this. My husband had prostate surgery in 2008. He is doing OK, but not in the sex department. He uses a pump machine, which I do not like because he uses it and we start to have sex but he has to keep getting up and pumping himself up, which makes me feel angry because it takes him 10 minutes to get up again. Sometimes he goes off; sometimes he doesn’t, and he seems to be OK with not going off. I need help. I am 67.


    Amy replied:

    Dear Geral:

    Many, many, many men and their partners have serious problems with sexual function after surgery for prostate cancer (especially when they are older, and since you are 67 years of age, I assume your husband is of a similar age). The problem you describe is just one of these.

    Reading your message, however, the one thing I did wonder about is whether your husband is using the “rings” that are usually provided with the pump devices (properly known as vacuum erection devices or VEDs). The “rings” are designed to keep blood in the erect penis after it has been “pumped up” and, when properly used, should be able to help your husband to maintain an erection for long enough for you both to achieve orgasm, but it does take experience to learn to use these rings properly. And in the beginning this needs to be done with some caution. Even if he is using the rings, maybe he isn’t using one that is sufficiently tight — in which case the blood that causes the penis to be erect will rapidly flow back out of the penis again after it is pumped up (which seems to be what is happening).

    There are two places where you and your husband could seek specific help about this. The first is a web site called “Frank Talk“, were you can both find detailed information about how to use VEDs of different types (and the associated rings) safely and to best effect. The other place (which is only open to women) is the “Ladies Only” online discussion forum, where you would be able to communicate with other women who have also had to deal with the frustrations of sexual activity after prostate cancer that can seem more like a “job” to be put up with than an actual pleasure for both parties involved.

    And I would share one additional thought with you. I don’t know how well you and your husband are able to communicate with each other about this problem and similar related problems, but (whatever he is telling you) my guess would be is that he is just as frustrated and upset about all this as you are, and you need to make sure he knows that you understand this.

    Hope this helps a little.


  165. Dear Amy:

    My husband had nerve-sparing prostatectomy over 3 years ago and our marriage has never been the same since. He is unable to get an erection no matter what he tries. However, after a year had gone by he never tried to touch me in any sexual way again. Also, he claims to be in pain since the surgery but no physician has come up with a solution for it so he’s also on heavy duty pain medication on a long-term basis.

    I would imagine by now he’s also addicted to the pain meds and that could be part of the reason why his ED is still an issue. He moved out of our bedroom also and into another room so we’re now basicall:y roommates.

    I’m very bitter about the whole thing. What kind of surgery is this when it takes a loving husband and turns him into this? I’m so lonely and yes I’ve tried talking to him numerous times and it never goes anywhere.

    I’m just over fifty years old and still think I’m attractive for my age. I’m too young to live the rest of my life this way. I don’t know what to do anymore. :(


    Amy replied:

    Dear Anne:

    Alas, far too men men and their families really don’t appreciate the high risks for erectile dysfunction associated with “nerve-sparing” surgery for the treatment of prostate cancer … and far too many surgeons are not as blunt as they should be about those risks. On top of that, far too many men with low-risk prostate cancer insist on getting invasive treatment of some type (surgery, radiation therapy, etc.) when they could probably just monitor their condition — possibly for years and not uncommonly for decades — before they needed treatment at all.

    Obviously I know nothing about your husband’s diagnosis, so I have no idea whether treatment was really needed or not. However, what I can tell you with absolute certainty is that the percentage of men who recover their full erectile and sexual function after surgery for prostate cancer (i.e., the same level of ability as they had before the surgery) is small — certainly less than 20% and maybe a lot lower.

    Your husband’s reaction to this is all too common. He feels emasculated and “unmanned”. Like many men, his sense of maleness is so deeply associated with his ability to “perform” sexually that he has been stripped of the single most important aspect of who he was … and so he is no longer who he was.

    Your anger and bitterness are entirely understandable and justifiable … and I wish I had something brilliant to tell you that could help to resolve the problem … but I don’t. Some men seem to be able to get beyond this problem easily and can adapt to a new way of thinking about intimacy in all of its forms. For other men it can take a while but they get there. And then there are some men who seem to be utterly unable to adapt to considering different ways of “being a man”.

    If your husband isn’t going to be able to pull himself back out of the situation he is in, I don’t know what I can tell you to do about that situation. You may also be right about the pain and the pain meds. Again, I just don’t know.

    What I do know is that there are plenty of men who have gone and got a penile implant as a way to resolve this problem, and many of them absolutely swear that it has given them their lives back. It may seem like a drastic solution to the problem, … but if it works to resolve a problem that has destroyed your and your husband’s lives, then maybe it is something you should both be considering (even if it is hard to talk about). You never know, it may even resolve the pain problem too (if that is as much in his head as it is in his lower abdomen).

    And one other thing … If you and your husband do want to consider getting a penile implant, please make sure you get it done by someone who absolutely specializes in this type of procedure and not just any urologist “down the street”.


  166. I’m a 7-year survivor of stage IV prostate cancer. I had a RP without nerve sparring. I would like to say to the women, you need to get involved with your husband and the doctors to understand the toll it has on a man once he goes thru something like this. It has a mental impact on a man that women not being involved will never understand. I hope all the best for all the ladies going thru this.


    Amy replied:

    Dear Al:

    Thank you for your comment.

    I think many women do indeed make a major effort to ensure that they are “involved” during the entire process from diagnosis to treatment and afterwards too.

    What is certainly true, however, is that many (but certainly not all) physicians often ignore or “pooh pooh” questions raised by wives and partners during office visits before and after treatment (because they are uncomfortable about not having good answers to the questions or just because they have less than stellar communication skills) and many patients themselves simply “shut down” all communication with their wives and partners because they are so traumatized by what has happened and they never understood that that could or would happen.

    I am quite sure there are wives and partners that really don’t understand how traumatic this can be for the patient. I have met and communicated with such women. I am equally sure that there are many who really do understand and do everything they can to try to help (and I have met and communicated with them too), but it can be traumatic for them when their husbands simply withdraw all signals and signs of affection, love, and physical contact, and sometimes almost all communication too.

    The problem with this situation is that everything depends on the precise set of dynamics in each particular relationship. For some couples, the empathetic and mental bond is so strong that the problems of the physical one can be (relatively) easily overcome. For other couples the physical intimacy has been the absolute and fundamental foundation of the entire relationship. Take that away and it’s not just the man on whom the impact is traumatizing.

    And then there are the men who won’t let their spouses or partners be involved in any way at all … for all sorts of potential reasons, from shame and fear to religious beliefs. I have been privileged to have spoken with a few men who have never even told their wives they had prostate cancer or treatment for it or why they no longer are “interested” in sex. I don’t understand that mindset, but I can imagine how and why it happens, and the potential trauma it may cause (for both parties)

  167. Hello Amy.

    You are absolutely right and I was speaking from my personal experience. I was married for 26 years and my wife didn’t support or get involved with me or my doctors. Needless to say it was very hard for me. I am divorced now because she didn’t and wouldn’t try to understand. She didn’t do the things a wife should have done.

    There were many ladies that asked me out but I refused because the way my ex made me feel. I recently came in contact with an old friend from high school. Her name is …, she gave me the strength as well as you to talk openly about my situation and my life is great. I’m 60 years old and my sex life have never been better than it is now.

    Thank you very much, Amy.


    Amy replied:

    Hi Al. Please tell ….. that I am glad she has been able to help you make “a new beginning.”

  168. Thank you, Amy.

  169. Hi Amy,

    Are you aware:

    (1) Where one can get the PSMA-PET scan?
    (2) How much does it cost?
    (3) What level of radiation is involved?

    I am located near New York City.


    (4) What do you think of the Oncoblot test to determine if cancer exists, after finding out that one has elevated PSA? This could be a necessary step before plunging into a biopsy?

    Thanks for your help,



    Amy replied:

    Dear Alex:

    These are technical questions that I really don’t have a lot of knowledge about, but, after checking in with the sitemaster, he tells me the following:

    (1) There are several different types of PMSA-based PET/CT scan currently in development here in the USA and most of them are only available in a few centers where they are doing clinical trials. However, given where you live your best bet might be to contact the Sidney Kimmel Center for Prostate and Urologic Cancers at the Memorial Sloan-Kettering Cancer Center in New York City. They will either have at least one of these tests in clinical trials or be able to tell you where else in the New York City area you might be able get access to such a scan. The other option that is also available to you and which may be appropriate would be the recently approved Axumin PET/CT scan (see here for info), which is probably available by now at most competent prostate cancer diagnosis and treatment centers. However, please also see the last paragraph below.

    (2) Cost is going to vary by center and by whether you are eligible for inclusion in a clinical trial. Only the individual centers could tell you the answer to that question. However, if you are eligible for inclusion in a clinical trial the cost may be zero.

    (3) The level of radiation exposure involved is relatively low, but not negligible. Again, it would depend on the precise type of scan carried out and the technology used, and so that question can again only be answered accurately on a center by center basis.

    (4) Neither the sitemaster nor I had ever heard of the Oncoblot test before you mentioned it. After a little homework, the sitemaster tell me that while it is possible that, in time, there might be some data that could tell us whether this test had any value in the diagnosis of prostate cancer, there appears to be absolutely no such data at present, and so he thinks it would be a complete waste of your money.

    Finally, although you didn’t ask this, the sitemaster tells me to inform you that if you simply have an elevated PSA level (of between about 3 and 10 ng/ml) at this time, and you are trying to determine whether a biopsy would be an appropriate next step, the simplest and most accurate current method is to get a 3 tesla (3 T), multiparametric MRI scan of the prostate carried out. If that scan shows areas of your prostate that are suspicious for cancer, then you would need to have a prostate biopsy (ideally under MRI/TRUS fusion guidance). Many competent prostate cancer diagnosis and treatment centers in the New York area would now be able to arrange for such an MRI scan today, and the follow-up biopsy if needed, including the center at Memorial Sloan-Kettering. Again, the price is likely to vary from center to center, and so we can’t provide any accurate price information. On the other hand, if your PSA is 10 ng/ml or higher, you should probably just have the biopsy done anyway.

  170. I am so frustrated. My husband has been battling aggressive prostate cancer now for 2 years. He did radiation and Lupron. We are done with both and now it’s the waiting game waiting to see how he does. However, he does not give me any affection. It’s like living with a roommate. I still have desires and miss him so much. We had a great relationship (physical) but nothing — no kisses, hand holding, telling me I’m pretty. Nothing. He just sleeps😞


    Amy replied:

    Dear Sue:

    I understand and I feel for you … and if I had a magic wand that I could wave to make this problem go away, I would be waving it on a pretty regular basis (as you will see if you look back through some of the other messages I receive).

    The diagnosis and treatment of prostate cancer (with and without the use of androgen deprivation therapy or ADT, also known as “hormone” therapy) tends to have deep psychological effects on many, many men. Our society teaches them from a very young age that their “maleness” is highly associated with their ability to function sexually. Since one of the effects of treatment for prostate cancer (especially when ADT is a part of that treatment) is to suppress all of the normal male sexual capabilities, all too many men respond in the way your husband seems to be responding — by withdrawing into himself and either forgetting or ignoring the fact that he is and can still be there for you as a real partner.

    I don’t know how to explain how and why this happens. It doesn’t happen to all men. But it does happen to an awful lot. I suspect it has something to do with a sense of shame and fear that they can no longer “perform” in the way that has been customary in the past … and they have no idea how to talk about this or deal with it at all. So they simply withdraw.

    Communication between you and your husband is the only key I know of to get past this. Hopefully, after a while, the effects of the Lupron will wear off, and your husband will recover his libido and with it his interest in you, and remember that he is indeed meant to show you the affection and interest that is currently missing. But you and he need to be able to talk about this too, and that can be hard for many couples. If you bring any of this up, there is always the risk that he will feel he is being criticized, and that can sometimes add to the emotional roller coaster that he is dealing with.

    My suggestion is that you need to “do as you would be done by.” In other words, tell him every so often that he looks sexy. Give him the occasional hug or kiss that he isn’t giving you. Try to make him laugh about things. Make him go on “date nights” and do things with you together. Show him that you love him anyway. Praise him for doing the things he does do well (even if it’s just taking the garbage out).

    This may or may not work to help to “break the ice”. But what I can tell you is that he is probably going through something that he doesn’t understand at all. He is probably scared that he is “no longer a man”. And you need to help him to realize that “being a man” is not entirely dependent on how he may think he needs to demonstrate that because of your past strong physical relationship. He may need a lot of help to rebuild his confidence in himself as a “male”.

  171. I have had a penile implant since 2008. When we first tried to be intimate using it, she said it was too thick. After a few times she said it hurt too much and does not want intercourse. Now she says she is too dry and not making enough moisture for sex. I feel depressed and feel that if I masturbate I get brow beaten. I am beginning to feel their is no processing forward. I do not know what to do for her. Any help or advice?

    Thank you


    Amy replied:

    Dear Vern:

    I am sorry to hear that you and Mrs Vern are having to try to deal with this problem.

    I have no idea how old/young you both are but as women age it is not uncommon for them to produce much less lubricant at time of intercourse — and that would particularly be true if the woman in question was not 100% “into” the whole idea of sex — for whatever reason.

    I am also not sure what sort of implant you got and whether the “size” is adjustable when it is erect. That might be able to help. However, … the real issue that needs to be dealt with here is what you and you wife want to do about this situation together. This is as much a communication problem as it is a physical problem. I feel pretty sure that your wife is as frustrated by this situation as you are … and she may or may not even feel that you are actually hearing her.

    Issues like this can be extremely difficult to deal with. All too often couples’ ability to actually talk about sex in a truly constructive manner. But that is what you and your wife need to be able to do.

  172. Mrs. Vern simply needs to pay a visit to her doctor. I am post-menopausal and I use an estrogen cream called Premarin. It is a miracle. It’s also expensive, so you need health insurance.


    Dear Clara:

    There are certainly products like Premarin that can help women who need to be able to stimulate vaginal lubrication during intercourse. However, I would respectfully suggest that the situation described by Vern may be a little more complex and involve emotional and other factors that can’t be solved by such products alone. This is why communication between Mr. and Mrs. Vern is a key part of addressing this issue.


  173. My husband and I have been married 15 years and sex has always been an issue. It is not a priority for me, but it’s extremely important if not the most important thing to him. His ED started maybe 5 years into the relationship, eventually making oral sex the only option. We have have had many many fights over this but no conclusion no matter how I try to compromise (say once a week). He was diagnosed with prostate cancer and of course feels like it’s just a cruel joke. Neither of us knew of the leakage problem. (Not a big deal for me.) Yesterday was the first time I went to touch him and I was taken back by the size and lack of life. (Surgery was only 8 weeks ago.) I tried to be honest about my surprise after a bit and have been met with such anger. I have a side in this too but he didn’t see it. … What am I supposed to do? Sex and intimacy are the most important thing to him. … How can we survive this, if I can’t be honest?


    Amy replied:

    Dear Barbara:

    You husband’s entire attitude to sex and its importance relative to the rest of life appears to be one that is near to delusional, so it is very hard for me to be able to give you any meaningful guidance here. But you are, of course, asking absolutely the right question when you say, “How can we survive this, if I can’t be honest?”

    I have no idea how old your husband is, but if he has had ED for 5 years already and he was thinking he was going to have any type of meaningful erection 8 weeks after a radical prostatectomy (with or without any help from you), he is living a very long way from reality and (in my humble opinion) needs some serious professional help. Getting angry with you is a child-like response … and most of us grow out of that by the time we are in our late 20s (or a lot earlier).

    I have been thinking about this for an hour now, since I first saw your message this morning. I cannot even imagine what you are going to be able to do under the circumstance other than tell him it’s high time for him to start to grow up! (Of course I also recognize that that is a potentially rather risky course of action since he is apparently missing an anger control gene.)

  174. My new mate has an enlarged prostate and we will some day have sex. Give me some does and don’ts.


    Amy replied:

    Dear Kathy:

    Without knowing exactly why your “new mate” has an enlarged prostate and how it is affecting or has affected him, it is impossible to give you any specific “does and don’ts”. For example, some men can have an enlarged prostate but it may have no real impact at all on their urinary or erectile function or on their sex life. For other men, having an enlarged prostate can be a real problem for all sorts of reasons, and either the condition or treatment of the condition may have impacted the ability to get an erection or the ability to “perform” sexually or his ability to manage his urinary continence during sex.

    The only real “do” that I can therefore give you is that whenever you and your friend are ready to think seriously about sex, you and he need to have a serious conversation about the impact of his enlarged prostate so that everyone’s reasonable expectations can be fully understood and appreciated up front. The blunt question you need to ask is, “So does your enlarged prostate affect your ability to have sex, and if so how? Tell me the details!” It may not be the most romantic of questions, but at least it will tell him when you are willing to go there!

  175. Dear Amy,

    I feel lost and sad at the fact that it seems like my husband and I will never again share the intimacy that we once shared. Before all of this, we had a healthy relationship and usually had sex three or so times a week. He had surgery and had Stage III prostate cancer that had just started to move to the outer portion of the prostate.

    I feel guilty because I am the one that pressured him to have the surgery after the second opinion also stated he needed to have it removed, but now we are both depressed. Eleven months later and our sex life is gone. At first after the surgery we tried regularly, but now he doesn’t even seem interested. Between the leakage, the shrinkage, and the ED it seems like we are finished.

    I have tried to let him know that I am patient, interested, and willing to “work” the sex life out but he just doesn’t even seem to care anymore. I am lonely and sad and at 44 years old this isn’t how I see the rest of my life.

    Suggestions appreciated, I am out of ideas and patience.


    Amy replied:

    Dear Lisa:

    First and most importantly, stop feeling guilty. This is not your “fault”. You and your husband made a decision together at a point in time. Despite the outcome, it may still have been the right decision. How would you feel if I (or anyone) could tell you with absolute certainty that if your husband hadn’t had surgery when he did, then he would be dead 4 years from now with metastatic prostate cancer?

    Second, you don’t tell me anything about what you and your husband have actually done to try and recover his erectile function. This can take up to 3 years — even if he had nerve-sparing surgery that worked. And if none of the things that can work do work, there is still the option of penile implants.

    Third, while I utterly understand how this is hurting you, it is part of my role to remind you that even if your husband may appear to be “uninterested” in the whole thing, it is likely that he is also hurting terribly, deep down inside.

    What you both need is some professional help to talk to each other about what is going on and what you want to do about it together. This can be a very hard thing to deal with, but there is no reason for guilt and there is no hope if you both become resigned.


  176. Hi Amy,

    I bring hope to this online community but also a bit of sadness and confusion. I am dating a 62-year-old man who had prostate cancer surgery 5 months ago. We enjoyed a wonderful friendship and sex life until he found himself fully incontinent after the surgery. He responded to his new reality with feelings of anger at not being fully informed about post-op side effects; however, his interest in me was intact and our relationship was unchanged until he leaked urine on me during an act of intimacy. Unfortunately, from that moment on he shut down, pulled away, and retreated into a deep depression because he was utterly mortified and embarrassed.

    Believe it or not we are having intercourse this soon after his surgery as ED is not an issue for him. However, what I find confusing is his depression has not dissipated and he remains morbidly afraid that he may leak urine on me again which he finds totally unacceptable

    As a result, I miss my man’s friendship and have assured him that even if it does occur it makes no difference to me, but this doesn’t seem to sink in or make him feel better. I’m afraid I’m losing him to depression and don’t know what to do at this point.

    Any thoughts on the matter would be appreciated.


    Amy replied:

    Dear Sadandconfused:

    Some men’s need to feel “in control” of things all of the time (or at least most of the time) can be one of their biggest problems when they have to deal with situations in which complete control is impossible. The problem you and your friend are facing may be a deep-seated one for him that has less to do with you and the cancer and more to do with his own sense of self-worth.

    There are only two ways that I know to get past this particular problem.

    The first is for him to make sure he urinates prior to sexual activity and to use a condom during sexual activity, thus lowering the risk for in the first place and being in control of it if it does occur in the second. The problem with this is that, in all probability, neither of you want to be using condoms.

    The second is to just talk this out between you … which is going to take time and patience on your part because the chances are high that he will be unwilling to consider any professional help related to this.

    The one other thing that might be helpful is for him to understand that this is a well-defined medical condition known as climacturia. Click here for example. If he is lucky, he may find that this occurs relatively rarely and can be ameliorated or at least minimized by making sure he empties his bladder prior to sex.

    Of course this is probably just one more thing that his doctors didn’t tell him about prior to his surgery. They should have (as the link I have just given you points out).

    Hope this helps a little …


  177. My partner was just diagnosed with prostate cancer. Is it still safe giving him oral sex?


    Amy replied:

    Yes … You can’t “catch” prostate cancer from him. You can’t get prostate cancer just like he couldn’t get ovarian cancer or vaginal cancer.


  178. Shocked I am actually posting, but I have to after reading all of the above.

    I met “him” in 2014 long after his surgery and early on he had biochemical recurence (in early 2015) and then had radiation. We are not married — he has never been married. He professed his love but I think he really wants a caretaker as he nears later 60s. I am still in my mid 50s and very vibrant. I love sex (obviously not having it with him) and with the very limited and way too sporadic “intimacy” — so much so that he can take it or leave it — I have been wavering, but no more. I am leaving this dysfunction now as I see the writing on the wall. I needed so, so badly to read everything that was posted and slap myself upside the head again. I love him, but I also love me and my young kids and the rest of my life more than a “project” that will just suck the life out of me. Thank you for waking me up and reorienting me to what I am really looking at and helping me save my life. If he was my spouse I might hang in — he’s not and I am not.

    My heart is breaking for each and every one of you amazing women.

    Betsy Ann

  179. My husband diagnosed 2 days ago; told 60% high-grade cance;r having scans to see if it has metastasized; if not I want him to have prostate removed; he won’t as been told risks! Our consultant also won’t operate past age 70 my husband is 75; very active lifestyle. I want to look for another consultant. My husband says no! I am struggling!!!

  180. Dear Jackie Taylor:

    Almost no good urologic surgeon who specializes in prostate cancer treatment will operate on a man of 75 today unless the patient is in an absolutely phenomenal state of physical health. The risks for serious long-term incontinence are too high, and there are other excellent ways to treat such patients.

    If you join our social network we can discuss all of this with you in detail, but I can assure you that after 25+ years of experience helping patients to understand their options when diagnosed with prostate cancer, there is no way that I would have surgery at your husband’s age, and I am now 69 and in very good health myself.

  181. I met this guy in the dating site .. I liked a lot his profile and his picture. Then we set a date for a coffee. I got to the place and he said that he wanted to take me for dinner. … I think we were so attracted.

    During dinner we start knowing each other and he said, “You’re the girl was I was looking for.” Then he told me that he had gone surgery for prostate cancer.

    I didn’t know too much about that. I told him that I didn’t care, but then I start reading all about it. I’m very hesitant. I don’t know want to do. I really like him a lot. It was “love at first sight”.

    I have gone on three dates. We have kissed. But as I said I’m hesitant, sad because I’m very sexual. … I like sex a lot. I’m 46 and he’s 53.


    Amy replied:

    Dear Marlene:

    “Love at first sight” is a wonderful feeling. (Even though my last experience of that was a long time ago, I can still remember it.) However, there is a big difference between LAFS and a meaningful long-term relationship, and the most important part of that is the development of a completely honest communication channel between you and your friend.

    You need to talk to him about what is on your mind. And then the two of you need to decide what you want to do about this. Just because he has had prostate cancer surgery doesn’t mean he doesn’t know how (or can’t imagine how) to give you sexual satisfaction. But much more to the point is going to be whether you will both be satisfied by whatever is possible 6 months from now and 2 years from now, after the initial excitement has worn off to some extent.

    I know that I am being boringly practical, but if it was to turn out that sex for him became a chore and sex for you became unsatisfactory, then that could have a disasterous effect on the relationship unless there are some very, very strong other ties to hold you both together.

    There is no way that I can tell you “what to do” under these circumstances, but what I can tell you is that this is very definitely a case of “honesty is the best policy”.

    Hope that helps a little.


  182. Dear Amy,

    I appreciate your candor and insight. I see a common thread of “anger” and feelings of “neglect” from the women, and a “wall” and “disengagement” from the men. Boy, can I relate!

    My man of almost 19 years had prostate cancer surgery 7 months ago. It went well, and he has recovered from the incontinence. But, his ED remains. He has become angry and bitter. His surgeon told him to watch porn and look at nude photos to try to stimulate himself, which I just found out about. He got up from bed to do this, thinking I was sleeping. I was so hurt that he chose to do this at my home, and while ignoring me. I threw him out. Now, the wall has gotten higher and wider. I want to be there for him, as I do love him and he is a good man. But, I am so sick and tired of being shut out.

    I am so lonely. At least I now feel I am not alone.

    Thanks for having a forum to vent.



    Amy replied:

    Dear Laurie:

    Life is rarely easy … but sometimes it seems to be utterly incomprehensible.


  183. I wish all the women on this forum the best with their partners but just want to share my experience. I am currently going thru a divorce because my husband decided that’s how he wants to handle his unconfirmed diagnosis of prostate cancer. I say undiagnosed because all he knows is that his PSA increased from 4.9 to 5.96 in 2 years. He went and did a MRI and told me that everything is alright — about which I don’t believe him.

    Anyway he has being suffering from ED for the last 7 years but seems to want to blame me. I have caught him masturbating and watching porn. He has since filed the divorce papers and moved out of the home and now spends his time on the phone e-mailing, texting, and talking to three other old flames. He claims he is in love with one but she is married and he is waiting on her.

    It’s being a nightmare and heultseems to have lost his mind. Now he has made up all kinds of stories to mask what is happening to him. It hurts after 34 years but this is how he is dealing with it. I wish him all the best and hope he will come to the realization that it is not my fault.


    Amy replied:

    Dear Dawn:

    This is absolutely not your fault. Whatever is going on in your (former) husband’s head seems to me to have nothing to do with his prostate and everything to do with his own inability to deal with the consequences of aging. He is using his prostate problem as a surrogate for whatever the other problems are that he wants to believe you are in some way responsible for. This is all going to come back to haunt him later, but you are well out of it, in my very humble opinion.

    Change can be hard to deal with, but maintaining the status quo when one member of a marriage is behaving the way your husband is behaving is going to become impossible for both of you. Time to take what you have learned and move on. There are always new opportunities for those who are willing to look positively on life.

  184. I have been reading just about all of the post in regards to problems with ED and incontinence after radical prostatectomy. It appears to me that most of these folks writing about their experiences with especially ED problems the men who are victims end up pulling away from their wives or partners. I have some post to share but I am the man who just had this procedure and it is much different from my experience dealing with my partner. How do I write a post similar to what I have been reading but do not want to use any of the three icons to log it?


    Amy replied:

    Dear B. Harrison:

    If you want to write a “guest” blog post on this subject you are welcome to submit it to the sitemaster for this web site by e-mail at this e-mail address. He will let you know whether he is willing to accept such a guest post.


  185. My wife won’t help me to get an erection. I have to try and do it all by myself. She won’t even touch me.

    Sometimes I get a semi-erection long enough to masturbate and reach orgasm using a vaccuum pump and watching porn. My PSA has been zero since radio beam therapy, but I miss sex badly. We are getting further apart … not speaking for days sometimes.

    Any suggestions?


    Amy replied:

    Dear Steve:

    You and Mrs. Steve need professional help. You have a communication problem as well as a physiological one, and someone is going to need to know a lot more about your sex life together (before your treatment and now) if he or she is going to be able to help you both.

    What has almost certainly happened is that your treatment has changed the nature of how you and your wife interact sexually. You are now asking her to do things that she probably never needed to do before. This is making her feel very uncomfortable. At the same time, you do indeed “need help” to be able to get and maintain an erection if you are going to be able to have “normal” sex … and the loss of “normal sex” is affecting you too.

    There is no simple answer to this, but there are things that can be done, and I would encourage you to talk to your doctors about other ways to be able to get and maintain an erection and to talk to your wife about whether you could both go to get counseling about the breakdown in your communication. This is not your wife’s “fault”, and it is not your “fault” either. No one is to blame. Changes like this can be profoundly difficult to address successfully, and they are going to need patience and understanding on both of your parts if they are going to be overcome.

    I hope this helps just a little.


  186. My husband had surgery last October. He has become distant and mean. He says that he has not, but he has. He refuses to act in helping with being affectionate. He says that he does not want to help me with intimacy because he does not get anything out of it.


    Amy replied:

    And alas, Michelle, so long as he thinks like that, there will be nothing that he can possibly “get out of it”. He needs help, but he may not able able to understand that.


  187. This is a very challenging and overwhelming time in both of your lives. My husband has been cancer free for 8 years, but went through so many surgeries until now he has become more and more distant.

    This has been so hard for me because I feel that part of life should still be enjoyed, but unfortunately it’s over. My heart goes out to you because at times I want to just end the marriage. I know the vows we took but I’m just tired and so is he. I suggest counseling if you both agree. We haven’t and probably will just live life as it is. The hard part is we have only been married 2 years and now I’m dealing with his meanest and my wanting to feel love and romance.

    God bless you both.

  188. I would like to know if I can have oral sex with my husband once he gets radioactive seeds implanted for his prostate cancer.


    Amy replied:

    Dear Antonia:

    I checked with Arthur and the sitemaster to be sure, and we all feel that one of the problems with the “permanent” radioactive seeds that get implanted as a treatment for prostate cancer is that some of them can be shed from the prostate while they are still radioactive. Thus, there is going to be some risk associated with oral sex after implantation of radioactive seeds — at least for about 6 months or so after implantation, while the seeds are still radioactive. You could check with your husband’s radiation oncologist to find out exactly what type of seeds have been implanted and how long they would remain radioactive.

    We think the risk from being too close to the seeds with your mouth is probably less significant, but — from an abundance of caution — maybe you would be wise to minimize any risk associated with oral sex for about 6 months after the implantation.

  189. Dear Amy,

    I have no idea what to do next and I’m hurt, confused, but mostly hurt. My husband of almost 6 years had nerve-saving prostatectomy in March, which only saved the nerves on one side.

    Prior to his surgery, he had an idea in his head that he didn’t want to expose me to any possible cancer, so our sex life stopped in November 2016.

    Since this was a long holiday weekend, I thought it would be fun to finally have some intimacy with him and primarily have my husband touch me and make me feel wanted. When I say things were starting to go great and the foreplay was fabulous — the D#$%^ cell phone rang — it was our neighbor who needed to drop something off. I told him not to answer, but he did and an hour later … everything was back to nothing. His focus is so much on a stupid erection and not having one, but I decided not to give up trying to show him that wasn’t important to me, but being with him was what I wanted. I tried to pick up where we were before being interrupted and he just wouldn’t do anything.

    We live in a 6-bedroom house, so after he started snoring, I left and went to another room and basically cried myself to sleep. That was Saturday — today is Monday and I’m still crying. Our sixth anniversary is in 20 days and if this is the life that we are going to have, I honestly cannot see there being a seventh. No, my focus is not on the sex and I told him that, but it is on being held and touched and made to feel like my body is important to him. Right now, I’m very, very lonely and I never imagined that would be possible.

    I’ve done a lot of research, watched videos, I think I’ve read more and watched more on this topic than most doctors and sadly, there isn’t the information for the wives of these men and the future looks quite dark and empty. He added me to some support group that he has completely absorbed on Facebook, but I don’t care to hear about these men and their issues — what about me and the issue with my husband not loving or trying to make me feel wanted in this mess? I’m 47, he just turned 59 and I can’t do this for the rest of my life. No, we don’t have children and prior to this diagnosis, we weren’t sleeping in the same bed because of the snoring. I have a semi-stressful job and if I don’t get to sleep first, which I don’t because I’m usually up on my computer doing stuff, then it’s impossible to come into a bedroom with that noise. I opt out of it and take a different bedroom — I’m very serious about getting sleep. It’s either get the sleep or be evil and nasty to him the next day because I didn’t get any sleep, so I prefer being a nice person, especially to the man I love. Sleeping separately didn’t impact our sex lives severely (we still had sex and it was great), but this man who won’t hold me or touch me is not someone I can see myself living with until the breath leaves my body. I just can’t and I don’t know where to turn or what to do — and I can’t stop crying. Please help me.


    Amy replied:

    Dear Katherine:

    I can entirely appreciate your frustration and your anger. To have seemed to be getting past the problem only to have a phone call put you back to square one is so unfair.

    Whether I am able to really “help you” or not is a rather harder issue to deal with because the person who really needs help is not you at all. It is your husband. He needs help to understand that his prostate cancer is not the end of his or anyone else’s world, and unfortunately many men who get diagnosed with prostate cancer become so disoriented and distressed by their inability to have an erection that everything else (for them) vanishes into insignificance. And I don’t have a solution for that problem (yet).

    But here’s an idea for you.

    Get some good earplugs.

    If you weren’t able to hear your husband’s snoring, then maybe you could both sleep in the same bed. If you could both sleep well together in the same bed, he would be more used to you “being there” and that might make it easier for him to realize that you need to be held and touched and loved even if the normal intercourse isn’t going to work. The more time you spend apart, the harder it will be to give each other a chance.

    It takes men time to get past the idea that they may never have a meaningful erection again. It takes away from them the thing that they have been taught all their lives defines being a “male”: the ability to get an erection and use it to impregnate a woman. (The fact that this is a very poor definition of “maleness” doesn’t help, either!)

    The other problem that I see get in the way over and over again is that both partners in a couple may be “trying too hard” to either recover from or “deal with” what has been lost. Sometimes there is just a process of “grieving” that needs to be gone through before a couple can move forward again together.

    I can’t tell you what will or won’t work for you and your husband. I wish I could. But what I do know is that you are both going through a traumatic series of events and their effects. It does take time to accept things like this and them be able to move on. For some it is easier than others, but it isn’t “easy” for anyone.

    Maybe this will help just a little bit.


  190. Hi. My husband had his prostate removed last year (October 2016). Since then he gets very angry quickly and says some horrible things. It’s like walking on eggshells, not knowing what he’s going to be like from one day to the next. It’s really getting me down. Is this normal?


    Amy replied:

    Dear Gill:

    Is this “normal”? No. However, if you’d asked me if this response was well known, then the answer is a very definite, Yes.

    Your husband is almost certainly in mourning for something that, all of his life, he was consistently told (in hundreds of different ways) defined maleness: the ability to have an erection.

    The loss of that ability, for many, but not for all men, is devastating. It makes them feel inadequate. It makes them worry what others will think of them if/when they were to find out. It makes them feel “weak” (which, of course, is also unacceptable to certain types of male). The list goes on and on.

    And, as you have noted, it can make them angry — unpredictably, uncaringly, and explosively.

    Your husband almost certainly needs and would benefit from professional counseling to help him deal with how he is feeling — but for many men the idea that they need counseling to deal with something like this is as unacceptable as the loss itself!

    Obviously, I have no idea what your “normal” relationship with your husband is/was like. However, if you feel able to do this, you need to see if you can help him to understand that: (a) you do recognize that he is angry and upset; (b) you know that what he is dealing with is not easy; and (c) being mad with you isn’t going to help anything. He needs some ground rules so that he starts to understand what he is doing to you (and perhaps to others around him as well). One of the simplest ones would simply be to stop and count to 10 when he feels like he is going to explode at someone. Whether and when you can tell him something like that is rather hard for me to determine.

    What you might also be able to do is to talk to one of the specialist urology nurses at the hospital where your husband had his treatment. They may be able to offer you better advice than I can. And your husband’s doctor needs to be asking your husband how he has been dealing with the side effects of his surgery.

    I hope this helps a little.


  191. Dear Amy:

    I have been reading many of the posts of issues with the different procedures in treating prostate cancer. I would like share my situation and I would like to see if you have any comments or suggestions.

    My wife and I are in our 70s. We have been married for over 41 years. Recently, after I had my physical, which included the results of my PSA, I found out I had prostate cancer.

    I included my wife in helping me decide which procedure would be best for me as well as for herself, and also she was present for all consultations that I had with two of the urologist/surgeons and one oncologist/surgeon. She was included for all my final thoughts of what I should do.

    It became evident that things had changed from what I thought I understood between us, and after the surgery she made a statement she was not interested in sex anymore. She felt she was too old and had no thoughts about sex and also said she had no desire because there was no more estrogen in her body as it was removed while she was being treated for breast cancer.

    She made comments about my ED, which we both were dealing with. I did consult my primary physician and he prescribed medication because he felt I had BPH. There was some enlargement when my prostate was removed. I did not think about going to a urologist to help with the ED as I thought working with the ED and having BPH, I was trying to get a handle on it. She also said I have had the ED problem for many years and when I said after I heal and recovered from the surgery it could help with the condition. I had asked the surgeon to use robot-assisted surgery and please spare the nerve bundles around the prostate. He said he does this in all his surgeries and said he felt I could recover and it could take 12 months and plus 6 more. My wife did say she did not think anything would change? So, I said do you want to separate so you can find another man who could have normal sex with you? She said no she loved me and really did not want to live alone but I really feel that me as a person was not that important she just did not want to live alone. As we talked about her feelings now about no sex, she even said that it has been so infrequent she really did not miss it. She also said it did not matter if it was someone else that was pretty much normal with sexual functions she would feel the same way. I really think a lot of these feelings from her were to get back at me for the issues we had with my ED.

    I did notice some of our intimate actions had also changed and she always liked me to give her rub downs and liked me to hug her and kiss but she wanted just a quick kiss and hugging to be short. I would ask about this and she would say I seemed to go overboard? She would touch me but because of the ED we would end up stopping the activity. She liked me to do the rub downs and she did allow me to touch almost all of her body except for her vagina. We would even be naked in bed and would be close together and that seemed to be ok. I have been feeling recently like a room mate many times not her husband of over 41 years.

    After she had made the statement about no interest in sex I had suggested we try stimulation like in the shower and she did told me after we worked in our yard let’s go take a shower together. It seemed to be ok but right after we started with the touching she said she wanted to stop. Another time later on again after I had finished my surgery, I was in the shower and she came in and got into the shower with me and then looked at me in the face and said, oh no sex … I did not want you to think I wanted it, just wanted to be close to you in the shower? Then a week or so later we were in bed together and she indicated she wanted to be naked and I began to do foreplay and she became aroused and said I was turning her on. She asked me to get the vibrator and she had a great climax. I did not want anything for me because I had only been recovering for only about a month or so and I told her I would have to wait until things improved, but I really did like stimulating her. I asked about this at another evening and she said she only needed this maybe once every 6 months.

    We would talk about her needs and my ED causing possible disappointments sexually and said it was not a big deal for her as she would have left some years ago if it was that important to her.

    I did ask her if she wanted to go to counseling and she no that she had told me many times she just has no desire and that the lack of estrogen in her body that was removed during her breast cancer treatments was part of the problem.

    I have kept doing the hand holding and she will ask me to give her a kiss and I would tell her I loved her very much and she would say, she loved me also. I understand about women and affection. Just do not get why she does not think how I feel with this terminated sex feelings. I know we had issues in the past years of my temper flares but there was never any physical abuse, drugs, me drinking, spending family money, or running around with other women.

    She has noticed I have changed my ways and have been much different in the way I talk to her.

    I really do not know what to do, so I told her I need to get into counseling and find out how I can deal with many issues that have come about. I really do not want to separate because I do care and love her. Just trying to figure out how to deal with how my wife feels about what has been going on as I will have to take care of my feelings toward her.

    From most of what I have read in the blogs it is very clear that the men having problems with the results of treatments for prostate cancer, they end up pushing their wives away, move into another room, and feel like they are not a man anymore, but these wives, for most of them, really are trying to do all they can to help their husbands through this bad time for them. All I can say is that these guys need to really take a hard look at the way they are treating their wives who really love them and want to do anything they can to help them. I wish my wife felt like many of these ladies I have read about because I feel what is going on for me is the opposite and I understand how this is affecting many of the wives of these men with them working through the results of procedures for prostate cancer.


    Amy replied:

    Dear Bill:

    I’m a little puzzled.

    It sounds to me as though your wife is being very honest with you. Most of the time she just isn’t interested in sex any more. She still loves you, and she does indeed like having you around. Furthermore, you say she has told you at least twice that she has no interest in anyone else. But you seem to be implying that you think she is lying to you, and that, “I really think a lot of these feelings from her were to get back at me for the issues we had with my ED.” However, perhaps you need to consider that she’s just telling you the truth.

    Now, I don’t know exactly how old your wife is, but I do know that just as having prostate cancer has affected your ability to have an erection, significant changes in a woman’s estrogen levels can profoundly impact a woman’s interest in sex. It is not exactly unusual for men and women to lose interest in sex by the time they are in the 70s.

    I’m also perfectly capable of understanding that this is upsetting to you … especially if you are still interested in sex (which clearly you are). But people’s need for (and interest in ) physical intimacies can and do change over time.

    Could the prostate cancer have had something to do with all this? Well, yes! Of course it could. Your wife may may not have been particularly interested in sex for quite a while. She may have been “going along with you” to whatever extent was possible while you had ED and before the prostate cancer, and she may have hoped that the prostate cancer would wipe out your interest in sex too. She was apparently wrong if that was her hope.

    You need to appreciate that there may be “no foul” and “no blame” associated with any of this. I have to assume you want your wife to tell you the truth, and I think that that is what she is doing. But all I can tell you at second hand like this is that, from my perspective, that’s what it sounds like she is doing. I have no glass ball that I can stare into to divine “the real truth”.

    Conversely, it sounds like you are upset because she’s not excited (physically or emotionally) at the idea of having sex with you. Well, if she’s telling you the truth, and she’s really not that interested in having sex any more (with you or anyone else either for that matter), then maybe you need to appreciate that this is just something that happens to a lot of people as they get older. Sex just loses its attraction as a way to be intimate with someone else.

    What you are talking about does have one thing very strongly in common with the many other men and women who seek my help because of breakdowns in their sex lives after surgery or other forms of treatment for prostate cancer: there has been a breakdown in the ability of you and your wife to really communicate with each other. You are talking at each other from entirely different perspectives. As a consequence, you are both at risk for not being heard accurately by each other and you are also at risk for making mis-assumptions about what each of you are actually thinking. From that point of view, I do think that you might both need some professional help, but you are going to need to find a way to explain to your wife that you need her help so that you can work through this together.

    I hope this helps a little, but I am also worried that this may not be what you “wanted to hear”.


  192. God bless you for continuing to show desire for your wife. You are rare because, as you have noted, most men push their wives away. Although I am not a wife, I was very seriously involved with a man who had prostate cancer surgery last December. Prior to his surgery we had a great and very loving sex life which abruptly ended after his surgery. All of a sudden this very loving and communicative man became very uncomfortable around me because he was embarrassed about his incontinence issues. In fact, he told me he could fake being “his old self” around everyone else but me and began to seriously withdraw from me to the extent of shunning my touch and sleeping on the very edge of his side of the bed to avoid all contact. What a strange twist of fate! I decided to walk beside this man when he finally confessed to having the need for surgery and to offer the emotional support he would need after his surgery and now I am the one who has been abandoned. After 6 months of his ever waning libido and emotional state he packed up his things and left telling me he no longer had desire for the opposite sex.

    I realize he is in a great deal of emotional pain and it’s obvious that this is a battle he chooses to deal with, or not, on his own. I thank you for giving me the opportunity to express myself as I have been a non-entity in this perilous journey of prostate cancer. I sympathize with your struggle and admire your willingness to push through your difficulties and remain faithfully interested in your wife. I do not know what it’s like to be a breast or prostate cancer survivor so I can’t comment on your wife’s feelings or behaviour — all I can do is include you in my prayers of healing for all who suffer physical and emotional pain.

    God Bless!

  193. Dear Amy:

    Here’s a different kind of letter:

    Well, here I am again, writing to you with reference to my husband. Though there are no treatments available to him — less is more in his case — the blessing to me is that he is still here. Intimacy isn’t in the cards for us and hasn’t been for some time — but that’s OK. I married my best friend — not just a lover. I am his primary caregiver and I feel that while he is preparing to “go home”, God is giving me the time I need to “let go” and I will, when the time is right. In the meanwhile, I will fight the insurance company and fight for any treatment available to him that in itself won’t make things worse (and some treatments can do that, as we know first hand). I am in this for the long haul — ’til death do us part.

    I must say, I am surprised at the number of people who are really concerned about intimacy when they / their partners respectively, are battling cancer. I am 59 years old and, while my husband and I had a wonderful and romantically playful sex life, our marriage has never been based primarily on that part of our relationship.

    We’ve been happily married for 39 years. I wanted 50 years at least — I won’t get that without a miracle … and this is what makes me sad. Not “ragging” on any of you — I don’t live in your world … I just know that spending time with my husband is all I want to do right now.

    I’d give anything for 10 more years of just being us — the spontaneous people who decided to do something and then just did it. That’s no longer possible. Other issues have come into play with my husband — all cancer related — spreading — and right now, my heart is broken knowing that, without a miracle, I won’t see a 40th anniversary with him. I will be blessed to have him here this Holiday Season. His blood work is nothing remarkable — but he can no longer stay awake for any length of time. He struggles to walk. Outings are short lived, yet he wants to go places so we just go. Chemo brain / dementia is there, and his eyesight is fading. He is confused. Nothing anyone has tried with him has worked to make these things better.

    Praying for all of you battling cancer and for all of the partners who are devastated. Both of you are affected by this devastating news. My husband has Stage IV metastatic prostate cancer and he was diagnosed nearly 5 years ago. Lots of good days; lots of bad days. … My goal is to keep him comfortable and that God gives him peace.

    Thinking of all of you! Wishing you all the best outcome possible.


    Amy replied:

    Dear Ellen:

    You are a good person, caring for someone who you love and will miss. Just remember that, after he has passed, he would want you to go on enjoying as many as possible of the things that you have long enjoyed together — along with any new ones that come up.


  194. Like Lily, my wife and I have not been able to comfortably share our private sexual thoughts and fantasies with and of each other for most of the 10 years since prostate cancer “screwed” up our relationship. But for the most part we continue to express our sincere, intense love for each other, and on occasion talk briefly about our physical/psychological needs.

    With the help of a therapist only I see (as my wife initially did) we have both learned two primary values: (1) Marriage can be much better when we have fun together sexually and in every other way. And (2) our lives together are more enjoyable when we do not just “-tate” (cogitate, meditate, agitate) but instead “-cate” (communicate) gently and with good humor.

    Knowing we are here with and for each other in all kinds of ways — including sexually, is itself not “work” (in the sense of one-way service). Rather we’ve tried, and often (but not always) expressed our goal of doing our best to be mutually supportive and helpful in whatever way possible. For me that’s the essence of marriage.


    Amy replied:

    Thanks Dr. Ed!


  195. My boyfriend has recently had a higher than normal PSA level and a digital exam showed that one side of the prostate was harder than the other. These were followed up by a biopsy. His urination was slow at times. How much of a chance is there for cancer? I’m kind of worried.


    Amy replied:

    Dear Elaina:

    If your boyfriend has an elevated PSA level and one lobe of his prostate feels “hard” on a rectal exam (which sounds like clinical stage T2b to me) then there is a significant likelihood that he could have prostate cancer.

    If you know the following: his age, his ethnicity (race), his exact PSA level, and whether he has any family history of prostate cancer, then you can use the PCPT calculator to get a reasonably accurate assessment of his risk. For example, if he is Caucasian (i.e., white and of European origin), 60 years old, has a PSA level of 7.0 ng/ml, and you don’t know whether he has a family history of prostate cancer or not (but you do know that he had a positive rectal exam), then you can use the calculator to estimate that

    — He has an 11% chance of high-grade prostate cancer (that would probably need treatment)
    — He has an 18% chance of low-grade prostate cancer (which would be very unlikely to ever lead to his death)

    Try the calculator for yourself. It’s pretty straightforward. (It must be if I can use it!)


  196. Hi Amy,

    I am at a complete loss and don’t know where to turn. My “husband” and I have been together for 22 years. We are 46, our kids are grown and gone and I felt life was good. Until the big “C” word took over.

    I had been pushing him to go have a complete physical since he turned 40. He never had any odd symptoms and our sex life was great but just like we get routine checkups, I felt it was time for him too. The diagnosis of prostate cancer struck him hard, but we immediately started doing research to weigh options. He underwent Cyberknife treatment and we have dealt with the physical aftermath as best we can. He is a manly man and his ego is hurt. His testosterone levels are on the floor and his libido is gone. He takes daily pills to help and sometimes they do, for a short period of time, but I can deal with that.

    The problem is his anger and constant aggravation. It doesn’t matter what I say or do, it is always wrong and he blows up about the smallest things. I try to reason with him, talk calmly to try to bring him down, but eventually I just leave the room and let it go. I know it’s not him; he has never been like this before. But I am really hurt and concerned.

    I have asked him to talk to his doctor but he refuses. We are supposed to finally get married in 2 weeks, but now, after all this time, I am having second thoughts.

    Any suggestions would be appreciated.


    Amy replied:

    Dear Trisha:

    Alas, your “husband”‘s reaction to what has happened is more common than you might think. He appears to be one of those men whose self-identity is very closely tied to his sense of “maleness” and masculinity. And that has been seriously damaged. Worse still, he may have an unexpressed (or an actually expressed) sense that in some way this is “all your fault” because you pushed him to go and get a check up in the first place! Of course it is not your fault! However, we all have a tendency to want to “place blame” when something goes wrong.

    The one thing that does puzzle me somewhat, however, is why your husband’s testosterone level should have fallen so radically if he had CyberKnife treatment. That is unusual. What are the “daily pills” that your husband is taking? Cialis?

    What may have happened is that his hormones are now “all out of whack”, which could explain both the problem with erectile function and the unpredictable flashes of anger. (You have probably known some women whose tempers and behaviors could become unpredictable during their periods; the biological effect is similar.)

    Somehow you and he need to find a way to have a serious conversation about all this. He needs to understand how hard it is for you to have to be constantly feeling like you are “walking on eggshells” around him because you never know what might set him off. While he may have limited control over these flare-ups, its still no fun to have to be on the receiving end. At least if you know that he is really trying to control this, and you know that if you just “walk away” when it starts to happen that he will “get the message” that he is over-reacting to whatever you did or said, then you may be able to reach a reasonable accommodation.

    I don’t know how long ago your “husband” was treated. These sorts of reactions may “fade away” again after a period of time. Unfortunately there are no guarantees about whether that will happen or how long it might take.

    And yes, he does need to see a doctor about this — preferably an andrologist, who is a urologist who specializes in male endocrinology. However, I suspect your husband now has a profound distrust of all doctors — and all urologists in particular! This is not going to be an easy problem to solve, and I have no easy answers for you.

    Maybe something I have said will at least help a little.


  197. Amy,

    You hit the nail on the head with your response. He has made some comments about this being my fault, in a joking manner, but I do realize that deep down he really sort of means it. His maternal grandfather died of prostate cancer. He never went and got checked and when he finally found out, it was too late. I know it is not my fault, actually quite the opposite. If I wouldn’t have pushed him who knows how bad it would have been before he got diagnosed.

    The drop in testosterone happened after the treatment. They put him on some medication because he wasn’t sleeping and his PSA counts kept fluctuating. The medication totally stopped his body from producing testosterone. They tried three different medications to fix it and they finally just took him off all of it. And yes, the pills I referred to are Cialis. They told him that he had a blockage, which was causing part of the ED problem. Which is more of an issue for him than for me. Yes, his manhood has been taken away and he is rightfully pissed off. I have thought about suggesting counseling or a support group for him. I think he could really use it; however, deep down, i know it will cause a negative reaction and that is the last thing I want.

    He has an appointment later this week and I am really hoping that he will talk to them. He was treated very well at all of the doctors he has seen but he never wanted me to go with him so I can’t even put my two cents in. I thank you very much for your words of advice and wish you the best.


    Amy replied:

    Hi again Trisha.

    So if you could find out exactly which three medications he had been given after the surgery to try to deal with the sleeping problem, I could probably talk to Arthur and the sitemaster to see if we could explain why one of them had led to the ED problem.

    Had it crossed your mind to tell him that you wanted to go and get some counseling for you (so as to help you not to make him upset and angry) and then asked him if he’d like to go with you? Maybe if it was presented to him as you having a problem, then he might be more receptive to the idea. Maybe you could think about that one.

    However, you are right. … He really needs to talk to someone about all this. … It’s just so very hard for some men to get up the self-honesty and courage to do that, because it comes with all these silly ideas about “not showing weakness”.


  198. Amy, I’m struck that most of what I’m reading here is about communication problems as opposed to the symptoms couples suffer with the added burden of prostate cancer and ED. I’m no exception.

    I’m 58 and my fiancé is 72. I think there is love, but not much in shared values. As a result, I think we lack the warmth and security that comes with being in love with a soul mate. Perhaps lack of intimacy is why our sex life has taken on more prominence than perhaps it should in people who are contemplating marriage in these circumstances.

    I met my fiancé 8 years ago when he was ending a prior marriage (his third). At the time, he already had ED (he believed it was an emotional reaction to guilt at being with me sexually when his wife didn’t want a divorce). We are both sexually sophisticated and because he could 50% of the time have an erection over the past several years, it didn’t bother me so much to be satisfied with oral sex the other 50%. After all, some people aren’t getting any at all.

    Enter prostate cancer 3 years ago. He was perceived as very healthy, and though his urologist wanted him to have surgery, I encouraged him to explore other options. I already had serious concerns about hypogonadism, and believe the only reason he has never been formally diagnosed is because he minimizes the symptoms and hasn’t told his doctors what they need to know. He has little body hair — his skin is softer than a baby’s behind; he has little upper body mass though he exercises regularly, has gynecomastia, central obesity, and hot flashes. Those aren’t a symptom here and there. He says he has always been this way. So even though he chose radiation, which hasn’t affected continence, his ED has gotten worse. I know some doctors might consider TRT if his testosterone is really as low as I suspect, but I wouldn’t encourage that because I wouldn’t want to be responsible for a cancer recurrence.

    He goes for his bi-yearly post-cancer checkups, and tells his doctor that our sex life is just fine. We live a distance from each other right now, and we see each other once weekly. He wants to be intimate, but when he knows I’m coming to visit, he gets up at the crack of dawn, and works to physical exhaustion. (He’s retired but cannot not be doing something useful.) Then he forgets to take his ED meds, starts with drinking wine with a heavy dinner and by the time we get to bed, he wants to “get it over with” (i.e., get me off orally). Goes directly to the goodie box and doesn’t even pretend to be interested in foreplay (other than oral sex, but that has a specific purpose). This is just not intimate. And I suspect he is desensitizing himself with porn.

    Now, I don’t expect him to be able to perform much with low testosterone, prior ED, and radiation therapy. But I’ve become very resentful because though he seems to be able to get hard with very aggressive and long sessions of fellatio, if I stop for a second, he goes limp immediately. Which seems to give him pleasure, but is exhausting for me with no “payoff”. (I know that sounds bad.) He’s recently started making comments like, “You are too loose, too tight or too wet” to excuse ED. When he can penetrate for a few minutes, he will blame my orgasm for making him lose his erection. With all of his true clinical issues, I am actually surprised that he has erections at all.

    I guess I told this tale because it’s clear that this is not really about cancer and ED. It’s about two people who aren’t communicating well, probably weren’t compatible in the first place, and who have resentment. I certainly resent being blamed for ED for 8 years. I convinced myself that sex wasn’t that important because I thought we had other things. Except that now that I know we don’t have all those other things that mean true intimacy, sex seems to matter to me more. I’m feeling less and less attracted to him for refusing to deal with this problem. While I know he is insecure, he’s an intelligent man, but his lack of interest and making this “my problem” have made me want out. And while I’m sure I will feel bad about leaving, it sure feels like the right thing to do. While a strong relationship will likely survive ED and prostate cancer, a weak one will only get worse. He’s refusing to explore treatment options (“There’s nothing wrong with me other than your unreasonable expectations”) and I suspect it’s because he doesn’t want to pay for treatment though he can well afford it..

    It’s a very hard decision that I had no idea so many women were dealing with. Life is indeed complicated.


    Amy replied:

    Dear Peggy:

    I don’t think there’s much that I can say in response to this tale. … But I also don’t think you are expecting me to.

    Far too many of us are still living in a world in which all too many men expect to “be pleased” by the behaviors of others and all too many women believe that it is their responsibility to do that “pleasing”. There’s nothing at all wrong with the giving and the receipt of pleasure … but it’s not a “responsibility” of either party … the giving of pleasure to others needs to be a pleasure in and of itself, otherwise it just becomes another chore.

  199. Dear Amy,

    I am the wife, of 36 years, of a prostate cancer husband. In researching the topic of psychological help for our loved ones following this horrible disease and treatment, it is obviously apparent that there is no help or guidance in the storm that follows this diagnosis and treatment. I am interested in opening up a dialog of how we may help the men we love, and how we can de-mystify this disease and the aftermath we encounter with them. I am feeling directed to make a difference, to help other women, in helping our beloved men.

    Amy replied:

    Dear Debb:

    So there is a whole spectrum of ways in which motivated wives and partners of men with prostate cancer can help patients themselves and other wives/partners. I have given you a short list below. Some require a greater commitment than others, and I shall leave that up to you, but I suggest you start with some of the easier things before trying to take on the harder ones:

    — Join one or more “social networks” and become a regular and committed contributor on the issues that you have learned about and how you and your husband have dealt with these over time. Three possible networks you might want to consider are: The “New” Prostate Cancer InfoLink Social Network; the Prostate Problems Mailing List; and the UsTOO-sponsored prostate cancer network on

    — I have no idea where you live, but if you click here you can find out whether there is an Us TOO prostate cancer support group near you. If there is, contact the support group leader and ask if there is any interest in forming an associated local support group for wives and partners.

    — If you live near a major cancer center, go and talk to someone there about how you could help to provide and build a group of volunteers who could help them to provide psychological support for patients and family members after a diagnosis of prostate cancer. If you want to do this let me know because I might be able to help you work out who to talk to at specific facilities.

    — If you are a good writer, write about these issues on a regular basis. You don’t have to start your own blog to do this. I can talk to the sitemaster here about whether you could contribute to the InfoLink blog on this subject. The sitemaster is very interested in building a greater understanding of the need for “care” (as compared to just diagnosis and treatment) in the management of prostate cancer.

    — If you let me know it is OK I can give your name and e-mail address to Jan Manarite (the EVP of Prostate Cancer International). She has been helping patients and their family members for about 15+ years now, and I am sure she will be able to give you more ideas about things that you could do.


  200. Do you think a 70-year-old man who had open-heart surgery 2 years ago and now possible prostate cancer is able to stay at night with his 94-year-old mother?


    His wife, Dee


    Amy replied:

    Dear Dee:

    I don’t think I have a good answer to that question beyond, “It depends …”.

    It depends on how well he has recovered from the open-heart surgery. It depends on the nature of the prostate cancer diagnosis and what he is doing (or needs to do) about it. It depends on whether his mother needs someone to stay with her 24/7 and who else is going to do that if your husband can’t or shouldn’t. It depends on whether your husband is going to pay the slightest bit of attention to what you are worried about here (let alone what I might think).

    Unfortunately it is very hard to answer questions like this in the abstract.


  201. My husband had his prostate removed in February 2017. He doesn’t seem to be interested in trying to satisfy me sexually. Does he not love me anymore? That is how I feel.


    Amy replied:

    Dear Shelia:

    Have you talked to your husband at all about his prostate cancer and how it has been treated? Did you ever go with him to the doctor when he was diagnosed and talked with the doctor about getting treatment?

    You need to understand that surgery for prostate cancer almost always leaves a man with short-term erectile dysfunction (the inability to get an erection), and it is not at all unusual for this to be a permanent consequence of the surgery.

    It is probable that: (a) your husband currently has at least a significant loss of his ability to get an erection; (b) he is upset and distressed by this; (c) he is embarrassed and doesn’t know how to talk to you or anyone else about this; (d) he is scared that he may never recover good erectile function again. Many men who choose to have surgery as a treatment for prostate cancer either just don’t hear what the doctor tells them about risks for this side effect of their surgery, or they just tell themselves that “that won’t happen to me.”

    My strong suggestion is that you should start to educate yourself about this possible problem (click here for some introductory information) and find a way to talk to your husband about what is going on. But you need to understand that this may make him feel very uncomfortable, and so it may be hard for him to “open up” to you about what is really going on.

    I suspect that he still loves you just as much as he always has … but he doesn’t know how to tell you about what has happened, and he is worried that you will stop loving him!


  202. Dear Amy,

    Started dating a man Jan 2016. In April 2016 I underwent bilateral mastectomy and immediate reconstruction (no chemo, radiation, hormone therapy) and he knew of my diagnosis when we had first met in late 2015. He was 5+ years throat cancer free by April 2016.

    In May 2016 he was diagnosed with prostate cancer. In Aug 2016 he underwent robot-assisted surgery. Prior to and after my recovery up until the day before his surgery we had a great intimate relationship along with a loving one. It’s been 16 months since his surgery … and he has had radiation and is on hormone therapy and states it has reduced his libido. Yes he can have an orgasm without erection with oral stimulate. But then there is me …

    Let me add, he is 68 years old and I am 55. He doesn’t and never has offered or wanted to orally stimulate me. (His throat cancer was associated with HPV, so I will assume that’s why). He has tried digital and makes it very painful and I have expressed gently that the way he is doing what he is doing hurts. Have gently tried to show him different approaches with no luck. So … there has been no intimate touch between us except the greeting kiss when we see each other. We enjoy spending time together … movies, dinners, outings on motorcycle, snowmobiling … but I’m missing the other part.

    Any suggestions?

    Thank you.



    Amy replied:

    Dear Ellen:

    First and foremost, I am sorry to hear that you and your husband have had to go through three separate bouts of cancer.

    Second, and I do mean this kindly, but your husband must be “all thumbs” if he can’t work out how to give you digital stimulation without it hurting! But I do realize that some men are distinctly lacking in the finer arts of “touch”. Maybe there are two possible things that you could do here:

    (1) Introduce your husband to the possible value of hand cream to make his fingers less rough-feeling (particularly if he has always done a good deal of heavy manual work that would lead to having rough skin on his hands).

    (2) Persuade him to let you be the person controlling his fingers so that you can manipulate his fingers in ways that please you until he can “get the idea” on his own

    It is also very possible that he is in too much of a hurry for you because — for many men — it is all about the orgasm whereas fore many women it is all about the sense of intimacy and the orgasm is only achievable if the sense of intimacy can be achieved first.

    And then, of course, there is a whole other idea, which is the possibility of him getting a penile implant, which, for many men, can help them to recover their sense of masculinity despite the effects that hormone therapy has on their libido. And of course this would have obvious benefits for you too — always assuming that he can learn how to use the implant with good technique so that that isn’t painful either. Medicare will often cover the costs of an implant for men like your husband, but this is a surgical procedure that does need to be done by someone with a lot of experience of this type of surgery — as opposed to just any old urologic surgeon.

    Hope this helps a little.


  203. Dear Amy,

    My husband is 15 years older than me. When we first got together he had issues with his prostate. Thirteen years later it started up again, out of blue. My question, I guess, is whether sleeping with someone else other than me could make his prostate act up.

    Just trying to make sense

    Thank u


    Amy replied:

    Dear C.:

    So a lot would depend on what you mean when you say that your husband’s prostate is “acting up”.

    To be blunt, if your husband had some sort of sexually transmitted infection when you first got together and it was being treated and “went away” and then he started sleeping with someone other than you 13 years later and got a new infection, then yes, sleeping with someone else could have been part of the problem.

    On the other hand, there are some prostate problems that can “come and go” without any third party being involved. For example, there is a form of prostate inflammation called chronic prostatitis that is not inherently infectious, and the symptoms can be more or less severe over time, but it has nothing to do with who a man has been sleeping with (that I am aware of).

    I think what you really need is a “heart to heart” with your husband about what has been going on and whether he has seen a doctor about the prostate problem and if so what the doctor has told him. Of course I also understand that your husband may (a) not want to see the doctor at all and (b) not want to talk about it at all either.

    Sometimes living with a man can be a real pain in the you know what!



  204. Dear Amy,

    Husband had prostate surgery almost 3 years ago. He has finished chemo and is on the cancer pills, they told him it would be 3 years before he stops taking the pills but they say they got it all but in all this time my husband will not think about anything intimate. We have been married 39 years and I understand totally but I read that many men can and that they will do things to wake up their nerves and sensations. He will not allow us to do anything, no rubbing, touching in that area, nothing. My husband won’t let me try to wake up anything. We get along great; I love him but I don’t understand why we can’t do anything and resent a little why he doesn’t want to do anything for me at all. I’m willing to do anything for him including wait, but thishas been been going on for 3 years and I am getting a little frustrated. We went to counseling the second year and nothing changed. I’ve talked to him and he just doesn’t want anything to do with sex. I’m not leaving him or going outside the marriage ever, but what can I do? Thank you.


    Amy replied:

    Dear Waiting Patiently:

    Ummm … I’m not sure what one does with a man who isn’t even prepared to discuss the possible!

    It sounds to me as though your husband is terrified by the idea that sex will never be the same as it was for him in the past. That is inherently a huge problem because he apparently can’t imagine that sex can still be fun even if it is “different” and (potentially even more problematically) he simply can’t see this from your perspective at all.

    Several years ago, I remember suggesting to one relatively young woman with a similar problem that what she needed to do was find a way to strip her husband naked, tie him to the bed, take her own clothes off, climb on the the bed, and they say — with a BIG grin: “So honey … It’s time for us to discover some new ways to enjoy this one way or another. You may be scared to death by performance anxiety. But I am just sexually frustrated. So what do you want to try first!”

    Of course there are certain implicit problems and risks associated with this approach that I probably don’t need to go into!

    The bottom line here is that your husband is being selfish, and either (a) he doesn’t understand just how selfish he is being and he has a remarkable lack of imagination or (b) he really is paralyzed by terror of the potentially unconventional.

    He needs serious help … but I suspect he is so fraught by the whole idea that sex will never be the same again that he can’t even begin to think about asking for that help. He needs to be able to talk to someone … but the problem will be getting him to understand that.


  205. Thank you Amy

  206. Hi Amy.

    Well, my husband is still with us — sort of. His latest diagnosis (as if Stage IV metastatic prostate cancer isn’t enough) is Lewy body dementia. Wow — adding insult to injury in some respects.

    However, that being said — maybe it’s a blessing because he doesn’t really know / remember what is happening to his body. He had the last chemo in March of 2017 and he will never have it again, according to the doctors. There is nothing out there that can be tried on him at this point and, since he now has been diagnosed with Lewy body dementia — it merely complicates the possibility of any trial studies that might have been effective.

    We have Home Health / Hospice / Social Worker coming in now — to see if we can now get palliative care for him and to make sure I am doing OK.

    I had to retire in August due to his not wanting me to leave him to go to work. My sister had moved in with us — he would not have been alone, but he didn’t want me to leave him — I cried all the way to work and called in retired after my shift was over. Praise God!

    I told him that I retired when I got home and that I still had paperwork to do to process out, but that after that — all was good and I would be with him 24/7/365. Seemed to make him happy.

    The doctors are not ordering scans any more because there is not much they can do at this point — no matter where it’s spread or how much more it’s spread. His PSA has risen another 10 points in a month — kind of sad — and he’s starting to have some pain in his left upper thigh down to his foot — sad there as well. He doesn’t want to take pain medication so I give him Aleve or Tylenol (not at the same time or even on the same day). Eases the pain somewhat and Physical Therapy is coming in to help with that as well.

    Good news is that he is still able to walk a little — slowly — but since I had him taken off one medication his walk is getting a little better and he is able to be awake more, but his memory is messed up still. Some days — most days — he has no idea that I am his wife and that makes me sad as well. Still, I figure I can do the remembering for him along with our children and the grand-loves. We talk to him and show him pictures and talk about old times with him and it seems to bring him back to reality for a little while anyway.

    Guys: Please — do get your check ups. Prostate Cancer is totally curable if found early enough –

    Wives / Partners: Encourage and drag your man in for a yearly check up. A lot of the frustration I have read about in some of the posts could be avoided with a little prevention. Perhaps “prevention” isn’t the correct word. There is no “preventing” cancer — but if caught early enough, most of the things I’ve read, don’t have to happen. If caught early enough, prostate cancer is curable.

    I’m not trying to make anyone feel guilty — my husband had no symptoms or such vague symptoms that we were not really aware of — nothing that would lead anyone to think anything was amiss — until October 26, 2012 when he could not urinate at all. That’s when my husband’s journey began with this mean disease.

    My goal of posting now is just to ask you men to get your check-ups! (Wives / partners — you may have to drag them to a doctor to get this done.)

    While there is little that can be done to help my precious husband — if even one person is spared all he has gone through and what he will go through without a miracle — this post will be worth it.

    As my husband continues through this journey, I will be right here with him through every appointment — through the good and the bad, till death do we part. (BTW: My husband is what everyone would call a model patient. He’s calm, collected, and has not allowed this to drag him down. Praise God – I give all the glory to God for that.)

    God bless each and everyone of you. Ladies — my thoughts and prayers are with you all — caretakers of the world unite. Toughest job we have to deal with, but all I can really add is, “All it takes is for my husband to smile at me and say thank you for me to know that he is appreciative and just makes me want to help him even more”. I will love him forever … 39 years of marriage and counting. …


    Amy replied:

    Hi Ellen.

    I don’t think there is anything that I can usefully add to that!


  207. My husband has had his prostate removed. It’s been 3 years now. He has no sex drive and cannot get an erection. He has for the past 22 years secretly (until caught) looked at porn. I recently found evidence that he still looks at porn. I’m hurt by this. We have not had sex in 3 years. He’s not interested in trying to please me by oral sex or toys. He has the injections he could use but doesn’t seem interested. My question is, if he can’t get a hard on, what is he getting from still looking at porn? I just don’t understand. We are just now in our 50s.


    Amy replied:

    Dear Sherri:

    For many men, the idea of being able to procreate is the absolutely driving and dominant force in their lives, and it is something they have limited control over. We are, after all, “just another animal”. Look at the way stags behave during the rutting season. They have just one thing on their minds, and anything that gets in the way is taking his/its life in his/its hands!

    Many human males live in a constant state of confusion between this biological priority and the (comparatively recent) social priority of monogamy. Some can deal with this easily. Others can’t. Arguably, male use of pornography is a way to help some men balance the two conflicting priorities. Many women — unsurprisingly — have a hard time understanding this.

    Your husband has had a third problem added to this mix. He can no longer “function appropriately” as a male. He has lost his ability to get and maintain an erection, and this means he not only feels emasculated. He also feels as though he has no status as a male among other males (let alone among women). For some men, this is devastating.

    Now your husband’s failure to “please” you is probably a consequence of the issues just described in combination with a lack of imagination and a profound degree of embarrassment. Being able to look at pornography may — in his mind — be his only way to pretend to himself that he is “still a man”. His imagination can still work in this area even if his body can’t.

    Please understand that I am not trying to absolve him of what I would like to think he would see as his responsibility to find ways to change how he thinks and behaves and to recognize that he isn’t the only one who is in need of missing sexual gratification. What I know is that, unfortunately, there are a lot of men who just don’t seem to be able to make this transition. They just don’t seem to “have the necessary wiring” in their brains.

    The only way real I know of that can help men like this to overcome their problem is through professional counseling. And sadly all too many such men absolutely reject the idea that they need such help — because it requires them to admit that they need the help in the first place. Catch 22!

    I have laughingly (and laughably) told people in the past that if I could find a way to resolve this particular problem I would be a deserving candidate for a Nobel Prize (for Marital Peace). But the problem is not funny at all. Overcoming it is all about communication between the couple. And that communication means you putting aside the anger about him looking at porn and him putting aside his sense that he is “no longer a man” and deciding to do something about it.

    One thing that I do know has worked for some couples is when the man gets a penile implant. It can give him back his sense of confidence in being able to “perform” as a male, and (I hear) it can give the woman back her sense of physical pleasure. However, it probably doesn’t work for everyone, and any man who wants to consider getting an implant would be wise to have this done by someone who specializes in this particular forms of surgery.


  208. My husband had prostate cancer 5 years ago. He had the surgery and radiation. He has not touched me since. He got me to get stuff from the compounding pharmacy, but he won’t use it. He asked how I would feel if I had to put a needle in my privates. I am thinking of leaving. Please help.


    Amy replied:

    Dear Karen:

    I’m sorry to hear about your and your husband’s problems.

    The impact of diagnosis of and treatment for prostate cancer is well understood to be completely traumatic for many men. I addressed many of the reasons for this a few days ago in answer to a question about another, similar, situation. You might want to look at that question and my answer.

    I am assuming that the product you got for your husband from the compounding pharmacy was what is known as Trimix. It is administered by injection into the penis prior to sex, and it can work very well for some men. However, I can also tell you that for other men the whole idea is simply impossible to deal with, and the only thing I could possible compare it to would be you having to give yourself an injection of something into your clitoris each and every time prior to having sex. In all honesty, I’m not sure how well I could deal with that, so I do understand your husband’s question.

    Now don’t get me wrong, I also absolutely do understand your anger and frustration. But the only solutions that I know of for this problem are communication between you and your husband and (perhaps) a penile implant (as described in the prior answer above).

    If you and your husband have reached the point at which you can barely talk to each other at all about all this, then I suggest you both need some professional counseling … but I also have to tell you that there are no “easy fixes” for this particular problem.

    I don’t know if this will help, but you do need to be able to see this from your husband’s perspective … even if he appears to be being unsympathetic to you. He has been devastated by his inability to “perform” normally as a man.


  209. Amy,

    My question is I have met a guy I really care about and have a great deal of feelings for. He is going through a divorce, and I just found out not long ago that he has had prostate cancer and is afraid to get involved with me. His words are, “You wouldn’t understand.”

    I’ve assured him I’m not going anywhere and that it’s not all about sex. He also has a bad tendency of shutting down. He will get really depressed and angry. Is there anything I can do to help him? I really care a lot about this guy and I enjoy what time we spend together. I also don’t want to scare him off with texting and calling him all the time to make sure he is OK, because when he gets depressed and angry I worry a lot about him.


    Amy replied:

    Dear Amy:

    I think that the first thing you need to appreciate is that he really almost certainly is depressed and angry. And he may be depressed and angry for a long time.

    He has been traumatized. He has lost a key physiological capability that was a big part of what made him a man. And to some extent he is right. No woman will ever really understand what that means to some men, just as no man will ever understand the emotional response that most women have to giving birth. So …

    If you really feel strongly about the gentleman in question, you are going to need to be very, very patient, and very, very gentle. Don’t bring up his issues at all. Only call him when you have something very specific that you’d like him to do for you, e.g., when you are going to a dinner or a party and you want someone as an “escort” or when you’d just like a companion to go with you to a movie or similar. Treat him as a friend and let him “make the running” when he is ready to do so.

    But equally you need to be aware that some men never get over this problem.

    Arthur and I (that’s the Arthur who also answers questions on this web site) have discussed this whole issue many times over the years. Arthur never got depressed about the biological changes that happened in his case, but he has always told me that he can easily see why it happens to a lot of men, but explaining it is almost impossible. The impact is so deeply embedded in what it means, biologically, to “be a male”. He tells me that there is really nothing rational or logical about it. It’s just something that happens to some men, and — for such men — recovering their sense of self worth and masculinity can just take time.

    Hope this helps a little.


  210. Hi I’ve been going with my partner for 1 year. He has metastatic prostate cancer. He acts like everything is fine, which is good because he is getting on with his life. This includes relationship arguments which I’m sure is elevated because of his illness and stress from both of us.

    My issue is he demands my time constantly and I have been tugged between my daughter and him for my time. I have asked for time to myself but he doesn’t understand and gets upset. How do I deal with this or do I just try and keep my self as healthy as possible and try not to stress. It is sometimes hard to tell if he is jealous or just scared to be in his own. Any suggestions?


    Amy replied:

    Dear Therese:

    It really doesn’t matter whether he is being jealous or is scared to be on his own. If you don’t get “down time” to do the other things that you want and need to do, his constant demands for attention will just wear you out.

    This sounds like one of those situations when, if he was a 9-year-old, you would simply say that, “Mommy has to go out for an hour and you will need to be a big boy and look after yourself for a little while. There’s a peanut butter sandwich in the fridge if you get hungry.”

    Your partner “understands” just fine. He is simply being unrealistic, and you need to be polite and firm. A healthy relationship is one in which both parties agree to cooperate about some things and give the other party space and time to do other things on their own or with other parties (e.g., your daughter). Every time that you give in to his demands for constant attention is one more time that you reinforce his sense of entitlement.

    I understand that it can be difficult to negotiate these issues, but it is a necessary aspect of a healthy relationship. He needs to value your needs as much as he seems value his own.

    This probably isn’t particularly helpful. Unfortunately, however, it is a fact of life! :O)


  211. Hi Amy, when I married my second husband he was 45 and I was 47. He had gone through chemotherapy for prostate precancerous cells and was given a clean bill of health. This was a few years before I had met him and we had no problem at all with intimacy.

    After 2 years he completely lost interest in intimacy, blaming it on his prostate. It has now been 9 years and he has not even wanted to try all the different meds there are for men. I just do not understand that for 2 years, with a clean bill of health, he was fine. I hate to admit this but I have found evidence contrary to what he has told me. It’s not another woman that I’m worried about; it’s if it’s a man, which makes me feel even worse. I honestly don’t know if I can live the rest of my life with not having intimacy or constantly wondering if he’s bi, gay, or whatever. I’ve asked him but he totally denies it and says he loves me. Now his best friend who is 10 years younger and his boss has been governing him real trendy clothes and they talk on the phone all the time. So, if you do gain back everything can it go away like he says or am I basically being a total fool?


    Amy replied:

    Dear Demi:

    I don’t think this is a situation that I am going to be able to give you much help with.

    However, for what little it is worth … I don’t think you are “being a total fool.” If anyone is doing that, it would seem to be your husband, because apparently he is unable or unwilling to explain to you what is going on in his head (quite apart from whatever may be going on in/with his genitalia).

    It doen’t sound to me as though your husband has a biological problem at all, but he may well have a psychological one if he is unable to give you a meaningful explanation for what is going on. If there is really a problem with his prostate, then why hasn’t he seen a physician about it? And if he has been seeing a physician about it, why hasn’t he been taking you with him to see that physician?

    Now I will also tell you that I don’t understand what you (or he) mean when you say that before he was married to you he had “gone through chemotherapy for prostate precancerous cells”. There is no such chemotherapy that I am aware of (or that Arthur is aware of either; I asked him). A man can have treatment for what is known as “benign prostatic hyperplasia” or BPH, but that isn’t precancerous or cancerous at all. So I have no idea what your husband was being treated for, and I have no reason to believe that whatever he had was actually any form of risk for prostate cancer.


  212. I am sorry if this offends you but I need an answer.

    My husband had a biopsy. Looks like cancer. We are married 38 years. We have experienced lots of playtime and techniques as we have gotten older that help us to continue our happiness intimately. But now I am reading about throat cancer and blow jobs. … Can I get cancer from him?

    I am not foolish I understand you cannot give me a definite yes or no. We have not been with anyone else other than each other. Sometimes he gets a burning feeling since the biopsy from blow job ejaculation but not from vaginal ejaculation. Thus us why I am concerned. Please advise.


    Amy replied:

    Dear Any:

    Don’t worry. I’m not offended. You are far from the first spouse or partner or prostate cancer patient to ask about this.

    As far as anyone knows, it would be biologically impossible for you to “catch” prostate cancer from your husband as a consequence of oral sex. Similarly, it would be biologically impossible for your husband to catch vaginal or ovarian cancer from you if you had one of those forms of cancer and he was practicing oral sex on you.

    Female biology and male biology are very different and most cancers aren’t “communicable” in the first place. The only exceptions (as far as anyone knows) are the forms of cancer that are clearly known to be associated with viral disorders such as the HPV virus that can and does cause cervical cancer.

    I don’t think the burning sensation your husband is currently feeling after ejaculation when you have oral sex has anything to do with the cancer itself. It may have more to do with the strength of the ejaculation and some small — and probably temporary — changes to his prostate as a consequence of the relatively recent biopsy.

    Hope that helps


  213. Amy:

    My husband just had an inflatable penile implant done three and a half weeks ago and my question is this: his penis and scrotum is very different in that you can feel the implant. … It doesn’t feel like his penis but like a penis with tubes and same with the scrotum. … Is this normal? He’s going to see his urologist on Thursday (4 days) but I wanted to see if this weird feeling is always going to feel like that or what?

    We’ve been married almost 48 years and he’s tried everything before this so it was both of our decisions. … I hope it was the right one. … We haven’t been able to have regular intercourse for many years. … I would appreciate your input and thoughts on this matter. … Thank you.


    Amy replied:

    Dear Kathy:

    I have no personal experience to go on with this question … and this isn’t exactly a cocktail party conversation one has with people. However, …

    I do think that his penis and his testicles are going to feel different. After all, they do indeed now have various bits of technical stuff implanted in them. Also, based on the “use it or lose it” paradigm, his penis probably became smaller over the past few years, and it may take time for his body to adapt to the implants. So, …

    I think the really important thing is for you both to take all of this slowly. You are both “out of practice” so to speak. I suspect that you are going to be able to adapt to the changes if you take it slowly and don’t expect everything to be exactly the same as it was 5 or 10 years ago (let alone when you were both in your 20s!).

    You are going to both need to be able to laugh about “re-learning” to have sex in a new way. If you take it too seriously and make it too important, then you may not be able to take advantage of the opportunity you have both been looking for. You are both going to need to find ways to believe that you really have taken the right decision, but that it’s rather like learning to be a snowboarder after years of being a skier. Some tings are the same … but some things are going to be distinctly different.

    Be patient with each other … be willing to experiment … the fact that there are different feelings for you (and for him) as a consequence of the implant may turn out to have benefits once you have adapted to the idea, after all!


  214. Is it safe to give a man oral sex after he’s had prostate surgery? And it’s been removed! He’s in remission now.


    Amy replied:

    So long as that’s the only problem he has, then — as far as I know — yes. Prostate cancer isn’t a sexually transmissible disease. (See also my answer to this related question.)


  215. I’m in a long-term relationship with someone who has been diagnosed. Can I continue to give him oral sex. TY.


    Amy replied:

    Dear Jane:

    Sure you can. If you want to and if he wants you to! Prostate cancer is not a communicable disease, and your biology wouldn’t allow you to have prostate cancer anyway.


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