Throw us a bone

by Donna Canada, RN, CURN

Psychological and sexual side effects from prostate cancer treatment can be daunting. Making the transition back to a new normal following prostate cancer treatment can be challenging for the whole family. Seek support from family, friends, and especially from other men who have been on this journey. Everyone grieves, adjusts, copes, and accepts in his own way.

Coping with Decreased Sexual Desire After Treatment for Prostate Cancer

• Physical factors
  Various physical factors can impact sexual desire—absent or low testosterone, low energy or nausea. Men treated for prostate cancer will sometimes be taking certain medications such as opioid painkillers, antidepressants or anti-anxiety drugs, any of which may have an impact on desire.
  
  
• Psychological factors
  The way you and your partner react to your treatments—your communication, attitudes, frame of mind, and emotions—can significantly affect sexual desire.

Desire begins from a variety of sources, some of which can be positively affected with conscious effort. Open communication and a commitment to remain sexually active are powerful tools. Men who use these tools are often also proactive in approaching their health care team about methods available to effectively deal with their side effects.²⁷

Coping with Orgasm and Ejaculation Problems After Treatment for Prostate Cancer

Orgasm refers to the moment of most intense pleasure during sex; ejaculation is the release of semen during orgasm. Changes in a man's ability to feel the pleasure of orgasm and ejaculate semen can occur after treatment for prostate cancer and include difficulty reaching orgasm, loss of the intensity of orgasmic pleasure, or dry orgasm. Premature ejaculation may also be one of the side effects from treatment.²⁷

• Dry Orgasm
  Radical prostatectomy involves removal of the prostate and often the seminal vesicles, which produce most of the seminal fluid. Radiation therapy to the prostate also destroys much of the tissue in the prostate and seminal vesicles, and reduces semen production radically. Hormonal therapy decreases semen production because testosterone controls how much semen is made by the glands.²⁷
  
• Orgasm changes and premature orgasm
  Varying degrees of change in orgasm follow prostate cancer treatments. Each orgasm is different and this can be difficult for men to accept. Partners need to be patient, understanding and supportive during this time. Some men experience weaker orgasm or premature orgasm where others experience heightened, increased sensitivity to stimulation that is so intense it requires some adjustment. Do not despair when going through this process. It is possible to improve the orgasm experience with time and practice. Here's one survivor's take on his experience: "The band still plays, it's just not the whole orchestra anymore." This is a time to realize that many aspects of intimacy are about much more than having sex. Open communication and turning to an expert for sexual counseling, if needed, are so important.²⁷
  

Resources for Ongoing Support After Treatment for Prostate Cancer

When a diagnosis of prostate cancer strikes, the journey can be difficult. We have to stop and realize that great strides have been made in treatments over the past 10-20 years. Try to maintain a calmness and presence of mind during the difficulties and learn to communicate well with your health care providers.

Resources, support groups, books and well trained professionals are available just about everywhere. My husband, a survivor of prostate cancer himself, and I relied heavily on our urologist and friends at ustoo.org during that first difficult year. We now share a deeper level of intimacy and mutual respect. The Prostate Pointers mailing list and Wiki Resources can be accessed at ustoo.org—both of which helped us a great deal. We are blessed with a daughter, son, and daughter-in-law along with three very fine grandsons. We enjoy life to the fullest every day now. It's clear that the future for prostate cancer diagnosis, treatments and recovery will continue to improve over time as will the quality of lives for prostate cancer survivors.

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This article has been reviewed by a member of the Wellness Partners Editorial Board.

Posted June 2011