Sex Following Prostate Cancer – The Real Truth from a Prostate Cancer Survivor!

October 4, 2008

Before reading this post…if you have been diagnosed with Prostate Cancer or are a Prostate Cancer survivor, I would appreciate your help.  I am writing a book, from a layman’s perspective, about Prostate Cancer and how to find solutions to improve our lives.  I am conducting interviews during the months of October 2008 through November 2008.  The interviews are confidential and your name will not be revealed.  If you are willing to discuss your experience…please contact me at chuck@chuckgallagher.com.  From there we can set up a time for a phone interview.  Likewise, this disease no only affects the man diagnosed but also his family, so I am interviewing spouses and/or significant others.  Thank you in advance for your help.  Now I hope this article is of some benefit to you.

First, if you are reading this you, like I, have had the unpleasant experience of being diagnosed with Prostate Cancer.  Just like a diagnosis of breast cancer to a woman, prostate cancer to a man is devastating to hear and begins a long physical and emotional road to a life changing phase of life.

Allow me to make certain assumptions:

(1) You are alive and have survived.  If you have just been diagnosed then this article, while informative, will be a bit premature.  Yes, I know the issue of sex following successful treatment for prostate cancer is on your mind, but your priorities must first be – what is the best treatment that will cure this cancer and eliminate the issue of mortality from my mind.

(2) The therapy you chose allowed for the physical nerves to be spared and hence allow for the potential resumption of sexual function.  All the research for years has shown that removing or substantially damaging the nerves eliminates the ability to achieve an erection and hence resume a “normal” sex life.

(3) Lastly, you recognize that you have undergone a substantial change in your body and accept that sexual function may never be quite the same.  That does not mean that sexual function can’t be quite good, approaching normal, but more than likely by the time you’re diagnosed and have gone through treatment, you are middle aged.  Face it, middle aged men aren’t quite as viral as they were when, say they were seventeen.

In an earlier blog entry I wrote about my experience with sexual function following a highly successful prostate cancer surgery.  The article is referenced here.  For clarity and convenience, allow me to restate a portion of that article here:

Sexual Function: Candidly, that returned much slower than I expected.

  • Within three weeks of the catheter being removed I wanted to test sexual function. To my pleasant surprise with physical and visual stimulation I was able to achieve a marginal erection and orgasm. I was elated. However, I soon found out that my first experience was not sustainable on a regular basis.
  • Like most men, I was given prescriptions for Viagra and informed about other alternatives.
  • Within three to six months, I found that achieving an erection was difficult and that any mental distraction would prove to be an impairment.
  • Viagra would provide some help, but the side effects were bothersome – especially the flushed feeling I felt in my chest and nasal cavity. Even with Viagra or the other alternatives, I did not feel that the result was successful.
  • By the seventh month I was concerned about the lack of consistence in sexual function. That took it’s toll emotionally. While women may not completely understand, men will get it. We are sexual beings and, while we don’t define ourselves by sex, we certainly understand the important role sexual function has in our lives. Inability to perform can have direct effects in other areas of ones life.
  • I was told there would be no ejaculate. That was true and false. There was no ejaculate as men generally know it. However, I did leak a fair amount of urine. I think the urine leakage surprises and disturbed me more than it did my partner She understood that urine is harmless. I soon learned that I should empty my bladder before sex otherwise, there would generally be urine leak when orgasm was reached.
  • By the ninth month I woke to a nocturnal erection. I must admit I was surprised and elated. However, the natural erection was still missing.
  • There had been no significant change from the sixth month through the tenth month, so I was becoming a bit concerned. I sought help in an unusual way, I sought Hypnotherapy as a possible solution. Wow…now that was worth it.

Hypnotherapy: Perhaps for the skeptics I had just healed enough to experience a change, but when I sought help I had the same results. Not knowing what to expect, I was open to anything that would provide some normalcy. I had come to know that things would never be the same. For one thing, I wasn’t 17 years old any more. I had to know that with age sexual performance will change. Likewise, I knew that without a prostate (the old plumbing if you will) I would never have an ejaculation – although an orgasm is quite normal without ejaculation. In any event, I elected this alternative form of therapy. What did I have to lose?

I went through the process feeling quite relaxed. The female hypnotherapist wasn’t sure that it would be comfortable for a man. Frankly, in my mind, if I got the result I didn’t care who provided the service. The process lasted and hour to and hour and one-half.

Within three days it was time to test the program. To my great surprise, I had an erection with less effort than it took over the prior 10 months and the orgasm was powerful. Since that point, there has been a marked difference in sexual function. Why? I’m not sure I know. I feel that two things converged at the same point. One – I had taken time to heal physically and with practice one can achieve a return to normalcy. Two, I feel the hypnotherapy allowed me to by pass my conscious emotional fears and empower my subconscious to know that I was fine and fully functional (within the physical confines of surgery). Either way…the process worked.

Three Years Later

There is a reality for us all.  For now all I can speak for is myself. (I am conducting research into this area – see the tab “Prostate Cancer” if you are willing to help). There are three areas that I feel need to be exposed as men and those who love them deal with the very real and significant issue of sexual function after prostate cancer.  There is no order to the issues listed below – each are important in their own way.

Issue One:  Psychological ramifications of sexual function after prostate cancer surgery. Following my earlier articles and blogs I received a number of e-mails and calls from men and women who appreciated the candid discussion and insight.  As time has moved on I have come to understand that sexual function, especially following prostate cancer, is as much (if not more) about the mind than it is about the body.

Women/Partners – I am not yet sure that you know just how much a man’s identity is tied up in his sexual function.  Now, I can hear two responses as this is being read: (1) you think I didn’t know that? and (2) it can’t be that important.  At the risk of sounding preachy – ladies – No you don’t really know that and, yes it is more important you’ll ever conceive.

While a man is far more than his sexual ability, the lizard brain in us all sends messages that we cannot control – to a man it is to procreate.  So to eliminate that possibility means that the subconscious mind diminishes the worth and value of the being.  On the outside he may seem invincible, but on the inside he is crumbling, but rarely will he be emotionally connected enough to show it or willing to show it.  Showing that pain (emotional pain) is a form of weakness to most men and revealing that would only slide him further into a downward spiral.

What to do? The less pressure there is to sexually perform the easier it is to perform.  Now, by that statement, I do not mean reduce the frequency of sexual attempts.  First, create an environment that will allow for play, fun and all the joy that comes from being sexually with your partner.

Secondly, be willing to become more active in order to help the recovery process.  I have been told by several physicians that muscles grow if they are used.  Basically they were telling me to use my penis (sexually of course) and do so whether through masterbation or with a partner.  I will be blunt here.  I have found that masterbation produces a more consistent result.  For a while I wondered why, then it hit me – I can take all the time I want to with myself.  There is no pressure and I can image that where ever my thoughts may take me, the person I imagine myself with is patient, willing and engaged.

Let me be clear, I am married and my wife has encouraged me to continue this writing knowing that others may, very well, be feeling the same thing or experiencing the same issues.  That said, while sex with my wife is very pleasing, I find that while I can gain an erection, often the sexual experience does not result in an orgasm.  As we have spent time discussing this, it has become clear that my inability to achieve a satisfactory sexual result was psychologically connected to my wife’s attitude and engagement in the process.  It takes more effort to achieve what used to be easy.  Hence, in order for the experience to be satisfying to me – my wife has to, bluntly put, work harder.  Not only is that a substantial change for her, but it puts pressure on me and the more pressure the less performance.

Issue Two:  Bodily Function. As I mentioned in the first article, it took me time to recognize that my body was different.  While sex was more difficult following surgery, it became clear that there was a greater than likely chance that urine would be released sometime during the act of sex.  Hence, I have discovered three things: (1) the less you drink before attempting sex the less chance of leakage; (2) urination immediately before sexual intercourse (or whatever method of sex is selected) reduces the chance for any substantial leakage; and (3) since urine is sterile and effectively harmless, allow it to be used as a form of lubricant or play.  I can hear many scoffing at the third suggestion, but going back to Issue One – if a man is concerned about what might happen (urine leak) during sex, he will be constrained physically (because of that mental state) and hence have a much more significant problem with achieving an erection or achieving a sexually satisfying experience.

Issue Three:  Practice…Practice…Practice. Now, as I write those words, it occurs to me that some may interpret this as applying pressure and increasing the sexual anxiety associated with prostate cancer.  I don’t mean “practice” in that sense.  Rather, it means either love yourself or love your partner (that will depend on who is reading this – you or your partner) enough to provide any and all outlets necessary to heal.  I would suggest that you consider spicing up your sex life so that the stimulation (whether visual, auditory or by feeling) is enhanced.  Having talked with others I know that sexual healing can take place, but it does come with a cost – and in most cases that cost is increased effort.

Question: If your dog broke his or her leg in an accident and the vet told you that he had to walk at least two mile each day and do other physical activities in order to heal – would you do what was necessary to help your dog heal?  If you answer no – “I’d put him to sleep,” please quit reading this article – it’s hopeless.  But, I think most would agree that we’d all say, “I love my pet and would do what ever.”  Strange example, but we need to do whatever is necessary to heal, both physically and emotionally.  No one said it would be easy – physical therapy is hard.

Simply put, sexual healing from prostate cancer is physical therapy that heals on both a physical and emotional plain.  If sex is still a struggle…hang on and keep trying.  It may never be what it was, but in most cases you can sexually recover from prostate cancer.  I did and so have countless others.


Sex after Prostate Cancer Surgery – What Can You Expect? Comments by Motivational Speaker and Cancer Survivor Chuck Gallagher

February 23, 2008

Before reading this post…if you have been diagnosed with Prostate Cancer or are a Prostate Cancer survivor, I would appreciate your help.  I am writing a book, from a layman’s perspective, about Prostate Cancer and how to find solutions to improve our lives.  I am conducting interviews during the months of October 2008 through November 2008.  The interviews are confidential and your name will not be revealed.  If you are willing to discuss your experience…please contact me at chuck@chuckgallagher.com.  From there we can set up a time for a phone interview.  Likewise, this disease no only affects the man diagnosed but also his family, so I am interviewing spouses and/or significant others.  Thank you in advance for your help.  Now I hope this article is of some benefit to you.

Let me begin by saying, this is written with the intent to help those men who have dealt with or are dealing with the issues surrounding prostate cancer. I am not a physician. My perspective is my own and born from my personal experience with prostate cancer at a “relatively” young age.

Background: I was diagnosed with prostate cancer at age 47. There were no warning signs. To all around me I was the picture of health and as far as I was concerned they were right. I had no symptoms. In fact, I felt great.

I went to my family doctor in order to get a prescription for Propecia (a pill to keep your hair from falling out). My hair line was beginning to recede and I wanted to stop its progress. My physician (who in retrospect saved my life) required that I have a blood test before she would prescribe the hair loss drug. As I recall, she said that the drug would artificially lower my PSA and I needed to have it checked first.

Honestly, at the time I didn’t know what a PSA was – the only thing I did know was – I hated needles and the thoughts of giving blood repulsed me. But vanity won and I had the test. Frankly, the rest was history, as the tests revealed an elevated PSA which ultimately lead to the prostate cancer diagnosis.

Treatment Method: While considering many methods, ultimate I selected surgery using the da Vinci method. I could not have been more pleased. The skill of the surgeon from Johns Hopkins and the method used were both outstanding. I highly recommend that men considering surgery consider this method. The recovery time following surgery was substantially reduced and the side effects were non-existent.

Following surgery there were several issues that were of immediate concern:

  1. What was in the pathology report (if that was good then the other issues were important)?
  2. Were the nerve bundles saved around the prostate (if not, no erection)?
  3. How difficult would it be to recover – move, walk, have a bowel movement, etc.?
  4. How long would the catheter stay in and would it cause problems?
  5. What would the reported incontinence be like (really) and would it last a long time?
  6. When could I expect some normalcy in sexual performance?

#1 = great pathology report (whew…that was a relief!)

#2 = nerves were saved; however, the doctor cautioned about expecting too much too soon.

#3 = no great surprise, the hospital got me moving quickly. It was not comfortable, but in the end they were right. Suck it up and get on with it they told me. You’ll appreciate how quickly you’ll recover when you get out of bed and get on with life. They were right. Within three days, I was prepared (moving a bit slowly I might add) to get on a plane and fly back home from Baltimore to North Carolina.

#4 = That was (at the outset) the biggest challenge. While most catheters stay in a week or maybe two, mine was in for three weeks. The physician stated that he wanted to make sure due to my psychology that it healed well, so I got the pleasure (NOT) of an extra week. Frankly, that was annoying and one of the happiest days of my life was when it was removed. Frankly, it was somewhat painful, unpleasant, difficult to keep comfortable, and all around a real pain (both figuratively and literally).

#5 = Considering I took a good six months from diagnosis to surgery, I had time to work with Kegel exercises. Kegel exercises may be beneficial in treating urinary incontinence in both men and women. Having received wise advice from the folks at Johns Hopkins, I was told that men would be wise to exercise those pubococcygenus muscles in advance of surgery so that they have “muscle memory” after surgery. I was told issues with incontinence would be dramatically reduced and they were right. Within 5 – 6 weeks I was 99% continent.

#6 Sexual Function: Candidly, that returned much slower than I expected.

  • Within three weeks of the catheter being removed I wanted to test sexual function. To my pleasant surprise with physical and visual stimulation I was able to achieve a marginal erection and orgasm. I was elated. However, I soon found out that my first experience was not sustainable on a regular basis.
  • Like most men, I was given prescriptions for Viagra and informed about other alternatives.
  • Within three to six months, I found that achieving an erection was difficult and that any mental distraction would prove to be an impairment.
  • Viagra would provide some help, but the side effects were bothersome – especially the flushed feeling I felt in my chest and nasal cavity. Even with Viagra or the other alternatives, I did not feel that the result was successful.
  • By the seventh month I was concerned about the lack of consistence in sexual function. That took it’s toll emotionally. While women may not completely understand, men will get it. We are sexual beings and, while we don’t define ourselves by sex, we certainly understand the important role sexual function has in our lives. Inability to perform can have direct effects in other areas of ones life.
  • I was told there would be no ejaculate. That was true and false. There was no ejaculate as men generally know it. However, I did leak a fair amount of urine. I think the urine leakage surprises and disturbed me more than it did my partner She understood that urine is harmless. I soon learned that I should empty my bladder before sex otherwise, there would generally be urine leak when orgasm was reached.
  • By the ninth month I woke to a nocturnal erection. I must admit I was surprised and elated. However, the natural erection was still missing.
  • There had been no significant change from the sixth month through the tenth month, so I was becoming a bit concerned. I sought help in an unusual way, I sought Hypnotherapy as a possible solution. Wow…now that was worth it.

Hypnotherapy: Perhaps for the skeptics I had just healed enough to experience a change, but when I sought help I had the same results. Not knowing what to expect, I was open to anything that would provide some normalcy. I had come to know that things would never be the same. For one thing, I wasn’t 17 years old any more. I had to know that with age sexual performance will change. Likewise, I knew that without a prostate (the old plumbing if you will) I would never have an ejaculation – although an orgasm is quite normal without ejaculation. In any event, I elected this alternative form of therapy. What did I have to lose?

I went through the process feeling quite relaxed. The female hypnotherapist wasn’t sure that it would be comfortable for a man. Frankly, in my mind, if I got the result I didn’t care who provided the service. The process lasted and hour to and hour and one-half.

Within three days it was time to test the program. To my great surprise, I had an erection with less effort than it took over the prior 10 months and the orgasm was powerful. Since that point, there has been a marked difference in sexual function. Why? I’m not sure I know. I feel that two things converged at the same point. One – I had taken time to heal physically and with practice one can achieve a return to normalcy. Two, I feel the hypnotherapy allowed me to by pass my conscious emotional fears and empower my subconscious to know that I was fine and fully functional (within the physical confines of surgery). Either way…the process worked.

Three Years Later: Sexual function is normal – for a 50 year old prostate cancer survivor.

  1. I understand that sex will never be the same as before. I accept that knowing that I am living as a result of early detection and appropriate treatment.
  2. With the prostate gone, there will not be normal ejaculate during sex. Strange, but as a man I miss that – but I must say, my wife doesn’t.
  3. As time goes on natural erections (unassisted) are possible. They are not as frequent as they used to be, but from time to time I will have a nocturnal erection.
  4. Orgasm is quite natural, with or without ejaculate. However, expect some urine leakage during sex. Especially early on one might want to keep a towel handy.
  5. Libido did not change even right after surgery.

As a motivational speaker, I have become accustom to sharing personal experiences in order to share more universal truths. This entry, however unusual, is not about personal sexual performance, but rather written in order to help other men understand from a first hand perspective what to expect and perhaps to provide hope that sexual performance, so important to most men, can return after experiencing surgery.

If this posting helps or you have comments…PLEASE SHARE!


Prostate Cancer – Tragic Deaths Of Famous Men

January 10, 2008

As a prostate cancer survivor, I often use this blog (my ethics speaker blog) to discuss issues of prostate cancer and what can be done to cure this disease – dreaded by men worldwide. When I arrived home today there was a wonderful magazine on our kitchen counter – LifeExtension – that my wife brought home. She purchased it for other reasons, but what caught my attention was an outstanding article entitled: Merv Griffin’s Tragic Death from Prostate Cancer.

merv-griffin.jpg

In the magazine they publish what they refer to as a short list of Famous Men who died from prostate cancer. While I won’t list them all, here’s some for us to remember and think about:

  • Merv Griffin
  • Dan Fogelberg
  • Bill Bixby
  • Telly Savalas
  • Frank Zappa
  • Earl Woods (Tiger Woods Dad)
  • Bobby Riggs
  • Thomas Witter (Dean-Witter-Reynolds)
  • Johnny Ramone
  • Steve Ross (CEO Time-Warner)

This is truly a short list that I selected – they’re are far to many more to list in this short blog

Portions of the article appear as follows:

Prostate cancer kills 300,000 Americans each year. With proven means of prevention and early detection, death from prostate cancer should be a rarity and not so common.

Merv Griffin was initially treated for prostate cancer back in 1996, but the disease returned with a vengeance to claim his life in 2007. News accounts described Merv’s final days living on feeding tubes and morphine drops, as metastasized prostate cancer cells ravaged his bones, liver and lungs.

It often takes a celebrity death for the public to pay proper attention to a curable disease. If there is any consolation to the ordeal Merv Griffin suffered, it will be that more men will be screened and follow proven preventive strategies to reduce their risk of developing this insidious disease. For example, a recent study published by the National Cancer Institute showed that men slash their risk of prostate cancer by up to 52% by regularly consuming cruciferous vegetables (such as broccoli and cauliflower).

The article is excellent. Is the content a magic bullet? No. But from a vast amount of research I have conducted (for personal benefit), I know that their findings are well documented and simple “life style” changes can have a huge effect on your risk of contracting prostate or breast cancer.

Having been diagnosed (quite by accident) at 47 with prostate cancer, I know what it feels like to be told – when you think you’re healthy as a horse – that you have cancer. After getting over the shock – I began extensive research as to the treatment that would allow me to avoid what Merv Griffin faced.

Today, based on my routine tests, I am cancer free. However, let me caution my readers – much as I was cautioned not long ago – surgical removal or any other treatment does not mean that cancer can not return. Merv Griffin is a perfect example of what can happen. Hence, for those of us who have been diagnosed and successfully treated for prostate cancer, we cannot reduce or ignore methods for reducing risk or maintaining health.

A copy of the LifeExtension article can be found at this link: http://www.lef.org/magazine/mag2008/jan2008_awsi_01.htm

Here’s to your health! Comments welcome oh and drop by my web site if your business or association is ever in need of a keynote or motivational speaker http://www.chuckgallagher.com