Personal lives take a hit
“We knew it was the last time we would be able to have intercourse, so we went away for a holiday before the surgery. When you’ve been married a long time, you know there are many different ways to make love and you appreciate that. Still, it was kind of sad.”
Debbie Davis*, 49, is composed when she explains the details of how she and her husband have coped with his prostate cancer. “The surgery was quite an ordeal — the recovery gruelling. I was able to take care of my husband, but it was an agonizing two weeks.” It’s when she pauses for a moment to reflect on the future that tears well up in her blue eyes and she sobs quietly into a tissue.
Prostate cancer is the most common form of cancer in men. The Canadian Cancer Society estimates that in 2007, more than 22,300 men in Canada were diagnosed with prostate cancer and 4,300 died from it. In the past, the disease wasn’t diagnosed until men were in their sixties or seventies, because it was rarely detected until the advanced stages. But with the advent of prostate-specific antigen (PSA) screening in 1989, an increasing number of men are diagnosed at a younger age. “Now it’s common to find the disease in men in their early fifties, which was unusual before,” says Laurence Klotz, a urological oncologist at Toronto’s Sunnybrook Health Sciences Centre. Furthermore, men in high-risk groups — of African descent or with a family history of prostate cancer — are now being urged to get tested at age 40, and all men 50 and over are advised to insist their doctors check for signs of prostate cancer either with a digital rectal exam (DRE) or PSA test.
As a result, the partners of men diagnosed with prostate cancer are watching their personal lives detonate. After the chaos surrounding diagnosis, treatment, recovery and follow-up testing, reality sets in: Sooner or later, all treatments frequently cause erectile dysfunction. A once confident husband may now be wracked with insecurities; a bedroom that was a playground is now anything but.
“I’m not a man anymore”
James Talcott of the Massachusetts General Hospital Cancer Center, and co-author of a 2001 study on prostate cancer, discovered that “men who before diagnosis might have considered sexual intimacy a possibility when they were around a woman now figured it was out of the question. They felt like they weren’t full participants in society any longer.” In other words, most men fantasize about having sex with a woman they find attractive. However, once they are impotent it is difficult for many to have even a fantasy life because they know that, in reality, sex is out of the question. The whole idea of sex depresses them and makes them feel as though they are no longer complete men.
Ralph Alterowitz, co-author (with his wife Barbara) of Intimacy with Impotence: The Couple’s Guide to Better Sex after Prostate Disease, says the disease hits at the very essence of manhood. “Men have said to me, ‘I’m not a man anymore. I can’t get an erection. What good am I?’”
In a tiny boardroom in north Toronto, about a dozen women have gathered. Several of them clutch tissues, and one bursts into tears as she starts talking about her husband’s recent diagnosis. All are married to men with prostate cancer. They’ve gathered at the Canadian Cancer Society’s offices for the monthly meeting of the female-only support group, Side By Side. All feel they have just two tasks: help their husbands beat the disease, and help each other. “You just want your husband alive. The sex doesn’t matter,” is heard over and over again. That and the phrase, “You can’t get an erection in a coffin.”
Privately, though, they are more candid about intimacy issues. Ronnie Bacher, who started attending Side By Side support group meetings after her husband, Aaron, was diagnosed when she was 56, says it’s a big concern for women who have strong libidos. “They’re frustrated because they can’t get their partners to talk about it. Some men aren’t interested in correcting it. Others feel if they can’t complete what they’re doing, they don’t want to start.”
