A Couple's Cancer

If you or your partner has had prostate cancer, you're probably aware that it's not only a man's problem; it also has an impact on spouses. And in some cases, one side effect of treatment may take both the patient and the partner to overcome it.

Men’s prostate problems often become the concern of women, as they tend to be the family’s caregivers and gatekeepers. A recent survey suggests that women are the ones to push their husbands and other men in their lives to go to the doctor. This may be particularly true for prostate cancer exams or treatment.

My wife, Yvonne, was incredibly affected by my prostate cancer after it was confirmed in January 2007. I had a biopsy Gleason score of 6—a moderately aggressive cancer. As with 80 percent of the nearly 200,000 men diagnosed in 2009 with prostate cancers in the U.S., my cancer was localized and did not go beyond the prostate itself. Still, we realized this was a life-altering event for both of us.

I was a bit surprised, but not startled, when I learned I had prostate cancer. If anything, I felt a bit relieved that now I knew the reason for the discomfort I had experienced during previous months. Yvonne, though, was shocked.

That night, we hugged as she cried on my shoulder. Like many other cancer patients, I found myself consoling her, although I felt I was the one in trouble. Sobbing, she recalled the 30 years of our married life when I, as a congregational rabbi, had visited and counseled many people with cancer. “But, in all those years I never even contemplated that ‘the big C’ would invade our own household,” she said.

After my robotic surgery to remove my cancerous prostate in April 2007, I was fortunate that the nerve bundles adjacent to the prostate were spared. This allowed for the possibility of renewed sexual functioning and renewed continence reinforced by the sphincter muscles. The likelihood of erectile dysfunction is lowered if doctors avoid cutting these nerves. However, age also plays a role. Men under 50 have a good chance of having their function fully restored, but for men above 70, there’s a greater chance it may not return to 100 percent.

Even so, erectile dysfunction—defined as the incapacity to have a spontaneous erection sufficient for penetration—is one of several adverse treatment after-effects for most surgery patients and those undergoing radiation. I was no exception. In my case, my erectile dysfunction was complicated by diabetes, neuropathy, and certain medications which “put a lid on my damper.” Yet like most men, I successfully offset my erectile dysfunction with medications like Viagra or by using a vacuum erection device. Others have successfully taken Cialis (tadalafil) or Levitra (vardenafil) pills to become firm, or used non-oral medications, such as Caverject (alprostadil) or MUSE pellets (both are drugs that widen blood vessels in the penis, allowing for a stronger erection). However, like other medications, they do cause side effects. Penile implant surgery has also been an option for many men.

Whether or not erectile dysfunction can be offset by such means, it can become a permanently frustrating reality not only for men, but their wives and partners. Using the approaches I’ve mentioned can help, but can also take the spontaneity out of intercourse. This, too, is a source of frustration for both men and women, but spontaneity can be preserved when practicing “whole body sex,” with an emphasis on the entire body. All in all, more extensive foreplay is one major way to reduce the frustration of erectile dysfunction.

All too often erectile dysfunction causes men to feel they’ve lost their manhood. The net result is he may withdraw from any intimacy with the woman he loves, adversely affecting both the patient and his partner.

It has taken my wife and me considerable time to learn how to be open with each other again. By now both of us have readily managed to communicate our frustrations and desires. As a result, we have immersed ourselves in rebuilding the intimacy that characterized us for most of nearly 37 years of marriage.

To avoid disappointment, spell out your needs to your partner rather than asking them to second-guess what’s important to you. Be clear but gentle, and maintain the give-and-take relationship that can endear you to each other—the way my wife and I have … most of the time!

Above all, men and women should avoid self-recrimination or mutual blame. We should not put ourselves down for our inability to function as the “studs” or “babes” we once were. Acknowledging this will help prostate cancer survivors and their wives alike. Together we can attain the physical, emotional, and spiritual intimacy we desire and deserve.

Rabbi Ed Weinsberg, EdD, DD, is a prostate cancer survivor, gerontologist, public speaker, and health care educator. He is the author of Conquer Prostate Cancer: How Medicine, Faith, Love and Sex Can Renew Your Life. For other tips on coping with prostate cancer, treatment options and after-effects, visit www.ConquerProstateCancer.com.