Re: Curing PCa early?

[Guest guest]

TDR

I think some keep their sex life, eg nerve sparing surgery. Remember PCa is not the only thing to impact this. Diabetes can do too.

Curing PCa early?

After curing PCa -- no matter how early -- does it spell the end of a man's sex life, as he knew it? (without marital aids)

tdr

[Guest guest]

Simple answer, No. If you catch it early men can often return to a normal sex life after PCa. Catch it later and returning to a normal sex life with minor inconveniences is possible. In any case having a sex life is very possible, it may be a little different than before but certainly just as or more satisfying than before.

After curing PCa -- no matter how early -- does it spell the end of a man's sex life, as he knew it? (without marital aids)tdr

[Guest guest]

TD Roebling wrote:

>After curing PCa -- no matter how early -- does it spell the end

>of a man's sex life, as he knew it? (without marital aids)

I think a good answer to this question requires more than a

simple yes or no.

First let's look at the effects of treatment on male sexuality.

                      Effects of treatment

                      --------------------

SURGERY: Removal of the prostate by surgical means has several

effects on a man's sexual equipment:

1. It will likely reduce potency.

Most men cannot get an erection immediately after surgery.  In

some men, this ability comes back.  In others it does not.  The

ones who do recover the ability to have an erection may find it

less stiff and less long lasting than before.

2. There will be no ejaculate.

Orgasms are " dry " .  Men who become incontinent have additional

issues to deal with.  Their orgasms may spill urine.

3. There may be shortening of the penis.

This is due to removal of a section of the urethra that is

surrounded by the prostate and the rejoining of the ends, pulling

the penis in.

4. There may be some bending of the penis when erect - Peyronie's

Disease.

RADIATION: Radiation patients also suffer side effects.

1. Radiation will generally reduce potency.

Unlike surgery, this happens gradually rather than all at once.

Surgery patients lose potency all at once and then may gain a lot

back.  Radiation patients lose potency very gradually, taking up

to a couple of years after treatment to reach their final low

state.

Some studies claim that the end result is about the same for the

two treatment modalities.  Many men may become completely

impotent and many others may have a significant reduction in

potency.

2. There will be a reduction of ejaculate.

It may become completely dry, or it may become almost dry.

3. Peyronie's Disease is possible.

ADT: Men using androgen deprivation therapy (ADT) will have a

different set of sexual side effects.

1. Loss of libido.

Libido is desire for sex.  On ADT a man can look at a beautiful

naked woman and feel ... nothing.  A woman can touch and stroke

his penis and the sensation to him may be about the same as if

she were touching and stroking his finger, or even his hat.

2. Loss of potency.

There is said to be loss of potency on ADT.  I don't know if this

is true, or whether this is just a concomitant of loss of libido.

So a man takes some very significant hits.

What remains

------------

With surgery and radiation, most men still retains the ability to

have an orgasm.  For most men, libido (sexual desire) remains

after treatment, sex is still interesting to them, and orgasms

continue to be satisfying.

The story on ADT is more complicated.

How men can have sex

--------------------

Many men who become impotent can still achieve potency with

Viagra or similar drugs, or with stronger drugs that are injected

directly into the penis shortly before sex.  The injectable drugs

can often provide stiffer and longer lasting erections than the

man could achieve before treatment.  Many men find the notion of

an injection repugnant.  Others don't.

Some men who are impotent get prosthetic devices implanted in

their penis.  Again, many men find the notion of an implant

repugnant (I admit to being one of them), but some men swear by

it.

Other men switch from penetrative sex to oral and manual sex.

Speaking for myself, I would say that this can be very

satisfying.  I also believe that many, and perhaps most, women

would also find it very satisfying.  In fact there are many

women whose sex lives improve, sometimes dramatically, when their

husbands focus on oral sex rather than intercourse.

Sex on ADT

----------

Sex on ADT is a different story.  I believe that the great

majority of men on ADT give up sex and never have it as long as

they are on ADT, which may mean for the rest of their lives.  One

doctor told me that, on ADT, I would not be able to have sex and

I wouldn't care.

I think that's true for most men.  For myself, I found that

neither of those statements were true.  I didn't have any sexual

desire but in some nostalgic way, I missed it, and I also felt

that I was depriving my wife, and I didn't like that.

One day I decided that, even though I had no desire for sex,

there was no reason that I should deprive my wife.  I would at

least go through the motions, doing the things that she liked,

and bringing her to an orgasm.  So that's what I set about to do.

To my great surprise and delight, I found that as she became

aroused, so did I.  This was completely unexpected, but extremely

satisfying.  She was able to bring me to an orgasm too.

From then on we had regular sex.  It was not as often as before.

I had to start each session with a complete absence of desire.

But I was always able to get into it after 20-30 minutes of

foreplay.  We both always reached a climax.

Conclusions

-----------

Sex after treatment is different.  It's more difficult.  It

requires more effort, more commitment, lots of honest

communication between partners.  However, if both partners want

to make it work, they can succeed.

I am no longer on ADT, but radiation has left me relatively

impotent (I can still achieve penetration sometimes with the help

of Viagra, but not often) and with Peyronie's Disease.  However I

don't consider that my sex life is now worse than it was in the

essential ways, and I don't consider myself to be less able to

satisfy my wife or to be less of a man.  For me, the cup is way

more than half full.

Prostate cancer treatment damages one's sexual organs.  It

changes things.  But it doesn't affect physical and psychological

intimacy and it doesn't have to destroy sex.  If a man is willing

to adapt and persevere, and if he has a partner who loves him and

is also willing to adapt and persevere, sex can remain possible

and remain satisfying.

    Alan

[Guest guest]

TD Roebling wrote:

>After curing PCa -- no matter how early -- does it spell the end

>of a man's sex life, as he knew it? (without marital aids)

I think a good answer to this question requires more than a

simple yes or no.

First let's look at the effects of treatment on male sexuality.

                      Effects of treatment

                      --------------------

SURGERY: Removal of the prostate by surgical means has several

effects on a man's sexual equipment:

1. It will likely reduce potency.

Most men cannot get an erection immediately after surgery.  In

some men, this ability comes back.  In others it does not.  The

ones who do recover the ability to have an erection may find it

less stiff and less long lasting than before.

2. There will be no ejaculate.

Orgasms are " dry " .  Men who become incontinent have additional

issues to deal with.  Their orgasms may spill urine.

3. There may be shortening of the penis.

This is due to removal of a section of the urethra that is

surrounded by the prostate and the rejoining of the ends, pulling

the penis in.

4. There may be some bending of the penis when erect - Peyronie's

Disease.

RADIATION: Radiation patients also suffer side effects.

1. Radiation will generally reduce potency.

Unlike surgery, this happens gradually rather than all at once.

Surgery patients lose potency all at once and then may gain a lot

back.  Radiation patients lose potency very gradually, taking up

to a couple of years after treatment to reach their final low

state.

Some studies claim that the end result is about the same for the

two treatment modalities.  Many men may become completely

impotent and many others may have a significant reduction in

potency.

2. There will be a reduction of ejaculate.

It may become completely dry, or it may become almost dry.

3. Peyronie's Disease is possible.

ADT: Men using androgen deprivation therapy (ADT) will have a

different set of sexual side effects.

1. Loss of libido.

Libido is desire for sex.  On ADT a man can look at a beautiful

naked woman and feel ... nothing.  A woman can touch and stroke

his penis and the sensation to him may be about the same as if

she were touching and stroking his finger, or even his hat.

2. Loss of potency.

There is said to be loss of potency on ADT.  I don't know if this

is true, or whether this is just a concomitant of loss of libido.

So a man takes some very significant hits.

What remains

------------

With surgery and radiation, most men still retains the ability to

have an orgasm.  For most men, libido (sexual desire) remains

after treatment, sex is still interesting to them, and orgasms

continue to be satisfying.

The story on ADT is more complicated.

How men can have sex

--------------------

Many men who become impotent can still achieve potency with

Viagra or similar drugs, or with stronger drugs that are injected

directly into the penis shortly before sex.  The injectable drugs

can often provide stiffer and longer lasting erections than the

man could achieve before treatment.  Many men find the notion of

an injection repugnant.  Others don't.

Some men who are impotent get prosthetic devices implanted in

their penis.  Again, many men find the notion of an implant

repugnant (I admit to being one of them), but some men swear by

it.

Other men switch from penetrative sex to oral and manual sex.

Speaking for myself, I would say that this can be very

satisfying.  I also believe that many, and perhaps most, women

would also find it very satisfying.  In fact there are many

women whose sex lives improve, sometimes dramatically, when their

husbands focus on oral sex rather than intercourse.

Sex on ADT

----------

Sex on ADT is a different story.  I believe that the great

majority of men on ADT give up sex and never have it as long as

they are on ADT, which may mean for the rest of their lives.  One

doctor told me that, on ADT, I would not be able to have sex and

I wouldn't care.

I think that's true for most men.  For myself, I found that

neither of those statements were true.  I didn't have any sexual

desire but in some nostalgic way, I missed it, and I also felt

that I was depriving my wife, and I didn't like that.

One day I decided that, even though I had no desire for sex,

there was no reason that I should deprive my wife.  I would at

least go through the motions, doing the things that she liked,

and bringing her to an orgasm.  So that's what I set about to do.

To my great surprise and delight, I found that as she became

aroused, so did I.  This was completely unexpected, but extremely

satisfying.  She was able to bring me to an orgasm too.

From then on we had regular sex.  It was not as often as before.

I had to start each session with a complete absence of desire.

But I was always able to get into it after 20-30 minutes of

foreplay.  We both always reached a climax.

Conclusions

-----------

Sex after treatment is different.  It's more difficult.  It

requires more effort, more commitment, lots of honest

communication between partners.  However, if both partners want

to make it work, they can succeed.

I am no longer on ADT, but radiation has left me relatively

impotent (I can still achieve penetration sometimes with the help

of Viagra, but not often) and with Peyronie's Disease.  However I

don't consider that my sex life is now worse than it was in the

essential ways, and I don't consider myself to be less able to

satisfy my wife or to be less of a man.  For me, the cup is way

more than half full.

Prostate cancer treatment damages one's sexual organs.  It

changes things.  But it doesn't affect physical and psychological

intimacy and it doesn't have to destroy sex.  If a man is willing

to adapt and persevere, and if he has a partner who loves him and

is also willing to adapt and persevere, sex can remain possible

and remain satisfying.

    Alan

[Guest guest]

Thanks for taking the pains and your candor, AlanYou mention it's possible to climax. Is orgasm very different?tdr

>After curing PCa -- no matter how early -- does it spell the end

>of a man's sex life, as he knew it? (without marital aids)

I think a good answer to this question requires more than a

simple yes or no.

First let's look at the effects of treatment on male sexuality.

Effects of treatment

--------------------

SURGERY: Removal of the prostate by surgical means has several

effects on a man's sexual equipment:

1. It will likely reduce potency.

Most men cannot get an erection immediately after surgery. In

some men, this ability comes back. In others it does not. The

ones who do recover the ability to have an erection may find it

less stiff and less long lasting than before.

2. There will be no ejaculate.

Orgasms are "dry". Men who become incontinent have additional

issues to deal with. Their orgasms may spill urine.

3. There may be shortening of the penis.

This is due to removal of a section of the urethra that is

surrounded by the prostate and the rejoining of the ends, pulling

the penis in.

4. There may be some bending of the penis when erect - Peyronie's

Disease.

RADIATION: Radiation patients also suffer side effects.

1. Radiation will generally reduce potency.

Unlike surgery, this happens gradually rather than all at once.

Surgery patients lose potency all at once and then may gain a lot

back. Radiation patients lose potency very gradually, taking up

to a couple of years after treatment to reach their final low

state.

Some studies claim that the end result is about the same for the

two treatment modalities. Many men may become completely

impotent and many others may have a significant reduction in

potency.

2. There will be a reduction of ejaculate.

It may become completely dry, or it may become almost dry.

3. Peyronie's Disease is possible.

ADT: Men using androgen deprivation therapy (ADT) will have a

different set of sexual side effects.

1. Loss of libido.

Libido is desire for sex. On ADT a man can look at a beautiful

naked woman and feel ... nothing. A woman can touch and stroke

his penis and the sensation to him may be about the same as if

she were touching and stroking his finger, or even his hat.

2. Loss of potency.

There is said to be loss of potency on ADT. I don't know if this

is true, or whether this is just a concomitant of loss of libido.

So a man takes some very significant hits.

What remains

------------

With surgery and radiation, most men still retains the ability to

have an orgasm. For most men, libido (sexual desire) remains

after treatment, sex is still interesting to them, and orgasms

continue to be satisfying.

The story on ADT is more complicated.

How men can have sex

--------------------

Many men who become impotent can still achieve potency with

Viagra or similar drugs, or with stronger drugs that are injected

directly into the penis shortly before sex. The injectable drugs

can often provide stiffer and longer lasting erections than the

man could achieve before treatment. Many men find the notion of

an injection repugnant. Others don't.

Some men who are impotent get prosthetic devices implanted in

their penis. Again, many men find the notion of an implant

repugnant (I admit to being one of them), but some men swear by

it.

Other men switch from penetrative sex to oral and manual sex.

Speaking for myself, I would say that this can be very

satisfying. I also believe that many, and perhaps most, women

would also find it very satisfying. In fact there are many

women whose sex lives improve, sometimes dramatically, when their

husbands focus on oral sex rather than intercourse.

Sex on ADT

----------

Sex on ADT is a different story. I believe that the great

majority of men on ADT give up sex and never have it as long as

they are on ADT, which may mean for the rest of their lives. One

doctor told me that, on ADT, I would not be able to have sex and

I wouldn't care.

I think that's true for most men. For myself, I found that

neither of those statements were true. I didn't have any sexual

desire but in some nostalgic way, I missed it, and I also felt

that I was depriving my wife, and I didn't like that.

One day I decided that, even though I had no desire for sex,

there was no reason that I should deprive my wife. I would at

least go through the motions, doing the things that she liked,

and bringing her to an orgasm. So that's what I set about to do.

To my great surprise and delight, I found that as she became

aroused, so did I. This was completely unexpected, but extremely

satisfying. She was able to bring me to an orgasm too.

From then on we had regular sex. It was not as often as before.

I had to start each session with a complete absence of desire.

But I was always able to get into it after 20-30 minutes of

foreplay. We both always reached a climax.

Conclusions

-----------

Sex after treatment is different. It's more difficult. It

requires more effort, more commitment, lots of honest

communication between partners. However, if both partners want

to make it work, they can succeed.

I am no longer on ADT, but radiation has left me relatively

impotent (I can still achieve penetration sometimes with the help

of Viagra, but not often) and with Peyronie's Disease. However I

don't consider that my sex life is now worse than it was in the

essential ways, and I don't consider myself to be less able to

satisfy my wife or to be less of a man. For me, the cup is way

more than half full.

Prostate cancer treatment damages one's sexual organs. It

changes things. But it doesn't affect physical and psychological

intimacy and it doesn't have to destroy sex. If a man is willing

to adapt and persevere, and if he has a partner who loves him and

is also willing to adapt and persevere, sex can remain possible

and remain satisfying.

Alan

[Guest guest]

Thanks for taking the pains and your candor, AlanYou mention it's possible to climax. Is orgasm very different?tdr

>After curing PCa -- no matter how early -- does it spell the end

>of a man's sex life, as he knew it? (without marital aids)

I think a good answer to this question requires more than a

simple yes or no.

First let's look at the effects of treatment on male sexuality.

Effects of treatment

--------------------

SURGERY: Removal of the prostate by surgical means has several

effects on a man's sexual equipment:

1. It will likely reduce potency.

Most men cannot get an erection immediately after surgery. In

some men, this ability comes back. In others it does not. The

ones who do recover the ability to have an erection may find it

less stiff and less long lasting than before.

2. There will be no ejaculate.

Orgasms are "dry". Men who become incontinent have additional

issues to deal with. Their orgasms may spill urine.

3. There may be shortening of the penis.

This is due to removal of a section of the urethra that is

surrounded by the prostate and the rejoining of the ends, pulling

the penis in.

4. There may be some bending of the penis when erect - Peyronie's

Disease.

RADIATION: Radiation patients also suffer side effects.

1. Radiation will generally reduce potency.

Unlike surgery, this happens gradually rather than all at once.

Surgery patients lose potency all at once and then may gain a lot

back. Radiation patients lose potency very gradually, taking up

to a couple of years after treatment to reach their final low

state.

Some studies claim that the end result is about the same for the

two treatment modalities. Many men may become completely

impotent and many others may have a significant reduction in

potency.

2. There will be a reduction of ejaculate.

It may become completely dry, or it may become almost dry.

3. Peyronie's Disease is possible.

ADT: Men using androgen deprivation therapy (ADT) will have a

different set of sexual side effects.

1. Loss of libido.

Libido is desire for sex. On ADT a man can look at a beautiful

naked woman and feel ... nothing. A woman can touch and stroke

his penis and the sensation to him may be about the same as if

she were touching and stroking his finger, or even his hat.

2. Loss of potency.

There is said to be loss of potency on ADT. I don't know if this

is true, or whether this is just a concomitant of loss of libido.

So a man takes some very significant hits.

What remains

------------

With surgery and radiation, most men still retains the ability to

have an orgasm. For most men, libido (sexual desire) remains

after treatment, sex is still interesting to them, and orgasms

continue to be satisfying.

The story on ADT is more complicated.

How men can have sex

--------------------

Many men who become impotent can still achieve potency with

Viagra or similar drugs, or with stronger drugs that are injected

directly into the penis shortly before sex. The injectable drugs

can often provide stiffer and longer lasting erections than the

man could achieve before treatment. Many men find the notion of

an injection repugnant. Others don't.

Some men who are impotent get prosthetic devices implanted in

their penis. Again, many men find the notion of an implant

repugnant (I admit to being one of them), but some men swear by

it.

Other men switch from penetrative sex to oral and manual sex.

Speaking for myself, I would say that this can be very

satisfying. I also believe that many, and perhaps most, women

would also find it very satisfying. In fact there are many

women whose sex lives improve, sometimes dramatically, when their

husbands focus on oral sex rather than intercourse.

Sex on ADT

----------

Sex on ADT is a different story. I believe that the great

majority of men on ADT give up sex and never have it as long as

they are on ADT, which may mean for the rest of their lives. One

doctor told me that, on ADT, I would not be able to have sex and

I wouldn't care.

I think that's true for most men. For myself, I found that

neither of those statements were true. I didn't have any sexual

desire but in some nostalgic way, I missed it, and I also felt

that I was depriving my wife, and I didn't like that.

One day I decided that, even though I had no desire for sex,

there was no reason that I should deprive my wife. I would at

least go through the motions, doing the things that she liked,

and bringing her to an orgasm. So that's what I set about to do.

To my great surprise and delight, I found that as she became

aroused, so did I. This was completely unexpected, but extremely

satisfying. She was able to bring me to an orgasm too.

From then on we had regular sex. It was not as often as before.

I had to start each session with a complete absence of desire.

But I was always able to get into it after 20-30 minutes of

foreplay. We both always reached a climax.

Conclusions

-----------

Sex after treatment is different. It's more difficult. It

requires more effort, more commitment, lots of honest

communication between partners. However, if both partners want

to make it work, they can succeed.

I am no longer on ADT, but radiation has left me relatively

impotent (I can still achieve penetration sometimes with the help

of Viagra, but not often) and with Peyronie's Disease. However I

don't consider that my sex life is now worse than it was in the

essential ways, and I don't consider myself to be less able to

satisfy my wife or to be less of a man. For me, the cup is way

more than half full.

Prostate cancer treatment damages one's sexual organs. It

changes things. But it doesn't affect physical and psychological

intimacy and it doesn't have to destroy sex. If a man is willing

to adapt and persevere, and if he has a partner who loves him and

is also willing to adapt and persevere, sex can remain possible

and remain satisfying.

Alan

[Guest guest]

TD Roebling wrote:

>You mention it's possible to climax. Is orgasm very different?

For me, I'd have to say it's not very different.  I produce hardly

any ejaculate but the sensation is surprisingly unchanged.  It

feels like I'm squirting a lot.  It's still very intense.

I've heard other men say the same thing.

    Alan

[Guest guest]

Very encouraging, Alan. What stage were you when you were DX'd?tdr

>You mention it's possible to climax. Is orgasm very different?

For me, I'd have to say it's not very different. I produce hardly

any ejaculate but the sensation is surprisingly unchanged. It

feels like I'm squirting a lot. It's still very intense.

I've heard other men say the same thing.

Alan

[Guest guest]

TD Roebling wrote:

> Very encouraging, Alan.  What stage were you when you were DX'd?

My initial diagnosis by my HMO urologist was Gleason 6, T2a, PSA 6.3.

I wound up in a clinical trial at the National Cancer Institute where

they said I was Gleason 7 (4+3), T2c, and their PSA readings were

higher (the highest before treatment was around 10.2 IIRC.)

They also did an endorectal MRI and saw a fair amount of cancer in

the prostate and a fairly large extraprostatic extension of the tumor.

At any rate, it looked big to my wide eyes when they showed it to me.

I was treated with a combination of Lupron, followed by HDR

brachytherapy, then 25 3DCRT external beam treatments, then

another HDR brachytherapy session.

    Alan

[Guest guest]

Alan,Very good piece you wrote, certainly the part before ADT should be handed out to everyone diagnosed when diagnosed. My experience was that I was left to " discover " the ultimate effects using internet searches and follow up questions. I for one was shocked when it became clear that I was going to be shooting blanks in the most literal sense.

While I greatly value all the resources (this group, Yana etc.) it is easy to get panicked and depressed looking through some of the cases. Despite that there is a certain minimum level of information all of us diagnosed need to be given and your summary certainly covered the ED/sexual aspects in an accurate, sensitive and necessary manner.

Steve

[Guest guest]

tdr,

I would only add to Alan's excellent discussion that penile injections, while the concept may be offputting, are really no big deal, and in my case, after experimenting with the tri-mix dosage, have produced wonderfully satisfying orgasms. My wife and I enjoy a sex life at least equal to what we enjoyed before my RALP surgery in Jan. 2010. When I now see the syringes in the cabinet I consider them my friends. I went to tri mix when Viagra did not produce the desired effect. I still take 50mg of Viagra four times a week to help nerve repair, and I think I am seeing slow improvement.

Mike >You mention it's possible to climax. Is orgasm very different?For me, I'd have to say it's not very different. I produce hardlyany ejaculate but the sensation is surprisingly unchanged. Itfeels like I'm squirting a lot. It's still very intense.I've heard other men say the same thing. Alan

[Guest guest]

Also encouraging info, MikeHad your PCa metastasized when you were DX'd?tdr>You mention it's possible to climax. Is orgasm very different?For me, I'd have to say it's not very different. I produce hardlyany ejaculate but the sensation is surprisingly unchanged. Itfeels like I'm squirting a lot. It's still very intense.I've heard other men say the same thing. Alan

[Guest guest]

Also encouraging info, MikeHad your PCa metastasized when you were DX'd?tdr>You mention it's possible to climax. Is orgasm very different?For me, I'd have to say it's not very different. I produce hardlyany ejaculate but the sensation is surprisingly unchanged. Itfeels like I'm squirting a lot. It's still very intense.I've heard other men say the same thing. Alan

[Guest guest]

My DH supposedly had nerve sparing surgery. Sex life continues, but not without the help of Viagra.

TDR

I think some keep their sex life, eg nerve sparing surgery. Remember PCa is not the only thing to impact this. Diabetes can do too.

Curing PCa early?

After curing PCa -- no matter how early -- does it spell the end of a man's sex life, as he knew it? (without marital aids)

tdr

[Guest guest]

It's a simple question, with a very complicated answer:

.. . . . Maybe.

You have to be very careful about defining " curing " , " sex life " , and " marital

aids " .

For the best full answer I know, get:

" Saving Your Sex Life: A Guide to Men with Prostate Cancer "

by Dr. J. Mulhall:

http://www.amazon.com/Saving-Your-Sex-Life-Prostate/dp/0980064961/ref=sr_1_1?ie=\

UTF8 & qid=1310922149 & sr=8-1

or

http://tinyurl.com/3qcrsmj

>

> After curing PCa -- no matter how early -- does it spell the end of a man's

sex life, as he knew it? (without marital aids)

> tdr

>

[Guest guest]

It's a simple question, with a very complicated answer:

.. . . . Maybe.

You have to be very careful about defining " curing " , " sex life " , and " marital

aids " .

For the best full answer I know, get:

" Saving Your Sex Life: A Guide to Men with Prostate Cancer "

by Dr. J. Mulhall:

http://www.amazon.com/Saving-Your-Sex-Life-Prostate/dp/0980064961/ref=sr_1_1?ie=\

UTF8 & qid=1310922149 & sr=8-1

or

http://tinyurl.com/3qcrsmj

>

> After curing PCa -- no matter how early -- does it spell the end of a man's

sex life, as he knew it? (without marital aids)

> tdr

>

[Guest guest]

Alan's answer was much more enlightening than mine. I shouldn't ever reply to

such a query when rushed.

There's a good piece on the USTOO website:

http://www.ustoo.org/post_treatment_issues.asp

which talks about what can happen, and what can be done about it.

The first thing to get your head around is that these three things are

different:

.. . . libido (the wish to have sex)

.. . . erectile function (having a penis that responds to

.. sexual stimuli by getting hard)

.. . . orgasmic capability (the ability to have, and enjoy, an orgasm).

Different PCa treatments affect _each of those aspect of sexuality differently_,

and over different time periods.

And the intensity of side-effects of treatments varies _a lot_ from one man to

another.

I read " Invasion of the Prostate Snatchers " , and got really angry. The picture

it paints is:

.. . . After treatment for early-stage prostate cancer, your

.. . . sex life is over.

The correct picture (according to my experience, and that of many other men [and

women]) is:

.. . . After treatment for early-stage PCa, your sex life will _change_.

The details of those changes are discussed, at length, in the USTOO documents

and Mulhall's book.

If you have a PCa diagnosis, and are trying to figure out what to do, we will

all be happy to share our own experience -- good and bad.

> >

> > After curing PCa -- no matter how early -- does it spell the end of a man's

sex life, as he knew it? (without marital aids)

> > tdr

> >

>

[Guest guest]

thanks alan good reply Iam thinking of saving it. I had my prostate taken out. I masturbate alot becassue my wife has no real sexul desire or maby Iam just to lazy to pursue seducing her (did you ever try to seduce a robot)I find the orgasms ,in my opinion bring me to my knees .they blow you away. No ejaculation of course. Iam probably doing myself an injustice not pursuing sex. My PSA went up in the past 6 months and my uro recommended radiation..IMRT . This is a good system . Still good orgasms time will tell though.

 

TD Roebling wrote:

>After curing PCa -- no matter how early -- does it spell the end>of a man's sex life, as he knew it? (without marital aids)I think a good answer to this question requires more than a

simple yes or no.First let's look at the effects of treatment on male sexuality.                      Effects of treatment                      --------------------SURGERY: Removal of the prostate by surgical means has several

effects on a man's sexual equipment:1. It will likely reduce potency.Most men cannot get an erection immediately after surgery.  Insome men, this ability comes back.  In others it does not.  The

ones who do recover the ability to have an erection may find itless stiff and less long lasting than before.2. There will be no ejaculate.Orgasms are " dry " .  Men who become incontinent have additional

issues to deal with.  Their orgasms may spill urine.3. There may be shortening of the penis.This is due to removal of a section of the urethra that issurrounded by the prostate and the rejoining of the ends, pulling

the penis in.4. There may be some bending of the penis when erect - Peyronie'sDisease.RADIATION: Radiation patients also suffer side effects.1. Radiation will generally reduce potency.

Unlike surgery, this happens gradually rather than all at once.Surgery patients lose potency all at once and then may gain a lotback.  Radiation patients lose potency very gradually, taking upto a couple of years after treatment to reach their final low

state.Some studies claim that the end result is about the same for thetwo treatment modalities.  Many men may become completelyimpotent and many others may have a significant reduction inpotency.

2. There will be a reduction of ejaculate.It may become completely dry, or it may become almost dry.3. Peyronie's Disease is possible.ADT: Men using androgen deprivation therapy (ADT) will have a

different set of sexual side effects.1. Loss of libido.Libido is desire for sex.  On ADT a man can look at a beautifulnaked woman and feel ... nothing.  A woman can touch and strokehis penis and the sensation to him may be about the same as if

she were touching and stroking his finger, or even his hat.2. Loss of potency.There is said to be loss of potency on ADT.  I don't know if thisis true, or whether this is just a concomitant of loss of libido.

So a man takes some very significant hits.What remains------------With surgery and radiation, most men still retains the ability tohave an orgasm.  For most men, libido (sexual desire) remains

after treatment, sex is still interesting to them, and orgasmscontinue to be satisfying.The story on ADT is more complicated.How men can have sex--------------------Many men who become impotent can still achieve potency with

Viagra or similar drugs, or with stronger drugs that are injecteddirectly into the penis shortly before sex.  The injectable drugscan often provide stiffer and longer lasting erections than theman could achieve before treatment.  Many men find the notion of

an injection repugnant.  Others don't.Some men who are impotent get prosthetic devices implanted intheir penis.  Again, many men find the notion of an implantrepugnant (I admit to being one of them), but some men swear by

it.Other men switch from penetrative sex to oral and manual sex.Speaking for myself, I would say that this can be verysatisfying.  I also believe that many, and perhaps most, womenwould also find it very satisfying.  In fact there are many

women whose sex lives improve, sometimes dramatically, when theirhusbands focus on oral sex rather than intercourse.Sex on ADT----------Sex on ADT is a different story.  I believe that the great

majority of men on ADT give up sex and never have it as long asthey are on ADT, which may mean for the rest of their lives.  Onedoctor told me that, on ADT, I would not be able to have sex andI wouldn't care.

I think that's true for most men.  For myself, I found thatneither of those statements were true.  I didn't have any sexualdesire but in some nostalgic way, I missed it, and I also feltthat I was depriving my wife, and I didn't like that.

One day I decided that, even though I had no desire for sex,there was no reason that I should deprive my wife.  I would atleast go through the motions, doing the things that she liked,and bringing her to an orgasm.  So that's what I set about to do.

To my great surprise and delight, I found that as she becamearoused, so did I.  This was completely unexpected, but extremelysatisfying.  She was able to bring me to an orgasm too.From then on we had regular sex.  It was not as often as before.

I had to start each session with a complete absence of desire.But I was always able to get into it after 20-30 minutes offoreplay.  We both always reached a climax.Conclusions-----------Sex after treatment is different.  It's more difficult.  It

requires more effort, more commitment, lots of honestcommunication between partners.  However, if both partners wantto make it work, they can succeed.I am no longer on ADT, but radiation has left me relatively

impotent (I can still achieve penetration sometimes with the helpof Viagra, but not often) and with Peyronie's Disease.  However Idon't consider that my sex life is now worse than it was in theessential ways, and I don't consider myself to be less able to

satisfy my wife or to be less of a man.  For me, the cup is waymore than half full.Prostate cancer treatment damages one's sexual organs.  Itchanges things.  But it doesn't affect physical and psychological

intimacy and it doesn't have to destroy sex.  If a man is willingto adapt and persevere, and if he has a partner who loves him andis also willing to adapt and persevere, sex can remain possibleand remain satisfying.

    Alan

[Guest guest]

Quinn wrote:

> ... my wife has no real sexual desire or maybe I am just too

> lazy to pursue seducing her (did you ever try to seduce a

> robot) ...

When two people reach our ages they can be pretty set in their

ways, adhering to ways of life that they fell into decades ago.

Even if one wants to change things, the other may be unwilling or

afraid, and each one knows very well exactly how to push the

right buttons to drive the other one away and end any unwanted

discussion.

Nevertheless, if you want to make a change, there may be some

hope.

There are counselors who understand these things and have worked

with many people with marriages like yours (and unfortunately

there are a _lot_ of marriages like yours.)  They can help both

of you to understand why your wife is frigid and rejects you.

She might be able to say something about what she dislikes about

sex and help you to understand how to develop intimacy without

offending her.

I've been married 43 years and I swear I keep learning more about

how to please my wife.  The male and female biology are just

different.  The sexual response is different.  The psychology is

different.  It requires that each person really devote themselves

to learning about this and pleasing the other person.  You may

need to read a sex book on how to please a woman.  You may need

to move very slowly, over a period of weeks and months, making

small progress each time and not pushing her too far beyond her

comfort zone.  But if you succeed, you'll find yourself getting a

terrific sense of gratification from that.  Stimulating her to an

orgasm can be even more exciting and satisfying than having your

own orgasm!

It's not easy to find good counselors.  A lot of them aren't very

good, or are only good at some things and not others.  But there

are counselors out there who are very good and specialize in

couples counseling that really might be able to help the two of

you.

Best of luck.

    Alan

[Guest guest]

read how Quinn is getting along.

Rody Here       

I was operated on in 2008 and I have yet to see an erection. Dr said

The numbness will go away. Like hell it will. My two friends are

like , zero problems; however I keep hearing everyone is

different. I think the "Robot" was left inside me  As Dr. Meyers

knows, and Chuck Maack, My psa is 3.7 after surgery. It wasn't but

4.2 when I had my first of two biops. The Arithmetic was  7+3. I am

devastated with the out come of my surgery. He was the director of

Urology at UAB and I think he should have had an office directing

medical records to file 13.

When I "flip over" to the other side my attorney will retrieve all

records from my Dr.  seventy miles east of my location, plus the

three Urologist that practiced on me. Like the sign states in their

office "License To Practice".

 

thanks alan good reply Iam thinking of saving it. I had

my prostate taken out. I masturbate alot becassue my wife

has no real sexul desire or maby Iam just to lazy to

pursue seducing her (did you ever try to seduce a robot)I

find the orgasms ,in my opinion bring me to my knees .they

blow you away. No ejaculation of course. Iam probably

doing myself an injustice not pursuing sex. My PSA went up

in the past 6 months and my uro recommended

radiation..IMRT . This is a good system . Still good

orgasms time will tell though.

On Sat, Jul 16, 2011 at 6:06 PM,

Alan Meyer

wrote:

 

TD Roebling

wrote:

>After curing PCa -- no

matter how early -- does it spell the end

>of a man's sex life, as he knew it?

(without marital aids)

I think a good answer to this question requires

more than a

simple yes or no.

First let's look at the effects of treatment on

male sexuality.

                      Effects of treatment

                      --------------------

SURGERY: Removal of the prostate by surgical

means has several

effects on a man's sexual equipment:

1. It will likely reduce potency.

Most men cannot get an erection immediately

after surgery.  In

some men, this ability comes back.  In others it

does not.  The

ones who do recover the ability to have an

erection may find it

less stiff and less long lasting than before.

2. There will be no ejaculate.

Orgasms are "dry".  Men who become incontinent

have additional

issues to deal with.  Their orgasms may spill

urine.

3. There may be shortening of the penis.

This is due to removal of a section of the

urethra that is

surrounded by the prostate and the rejoining of

the ends, pulling

the penis in.

4. There may be some bending of the penis when

erect - Peyronie's

Disease.

RADIATION: Radiation patients also suffer side

effects.

1. Radiation will generally reduce potency.

Unlike surgery, this happens gradually rather

than all at once.

Surgery patients lose potency all at once and

then may gain a lot

back.  Radiation patients lose potency very

gradually, taking up

to a couple of years after treatment to reach

their final low

state.

Some studies claim that the end result is about

the same for the

two treatment modalities.  Many men may become

completely

impotent and many others may have a significant

reduction in

potency.

2. There will be a reduction of ejaculate.

It may become completely dry, or it may become

almost dry.

3. Peyronie's Disease is possible.

ADT: Men using androgen deprivation therapy

(ADT) will have a

different set of sexual side effects.

1. Loss of libido.

Libido is desire for sex.  On ADT a man can look

at a beautiful

naked woman and feel ... nothing.  A woman can

touch and stroke

his penis and the sensation to him may be about

the same as if

she were touching and stroking his finger, or

even his hat.

2. Loss of potency.

There is said to be loss of potency on ADT.  I

don't know if this

is true, or whether this is just a concomitant

of loss of libido.

So a man takes some very significant hits.

What remains

------------

With surgery and radiation, most men still

retains the ability to

have an orgasm.  For most men, libido (sexual

desire) remains

after treatment, sex is still interesting to

them, and orgasms

continue to be satisfying.

The story on ADT is more complicated.

How men can have sex

--------------------

Many men who become impotent can still achieve

potency with

Viagra or similar drugs, or with stronger drugs

that are injected

directly into the penis shortly before sex.  The

injectable drugs

can often provide stiffer and longer lasting

erections than the

man could achieve before treatment.  Many men

find the notion of

an injection repugnant.  Others don't.

Some men who are impotent get prosthetic devices

implanted in

their penis.  Again, many men find the notion of

an implant

repugnant (I admit to being one of them), but

some men swear by

it.

Other men switch from penetrative sex to oral

and manual sex.

Speaking for myself, I would say that this can

be very

satisfying.  I also believe that many, and

perhaps most, women

would also find it very satisfying.  In fact

there are many

women whose sex lives improve, sometimes

dramatically, when their

husbands focus on oral sex rather than

intercourse.

Sex on ADT

----------

Sex on ADT is a different story.  I believe that

the great

majority of men on ADT give up sex and never

have it as long as

they are on ADT, which may mean for the rest of

their lives.  One

doctor told me that, on ADT, I would not be able

to have sex and

I wouldn't care.

I think that's true for most men.  For myself, I

found that

neither of those statements were true.  I didn't

have any sexual

desire but in some nostalgic way, I missed it,

and I also felt

that I was depriving my wife, and I didn't like

that.

One day I decided that, even though I had no

desire for sex,

there was no reason that I should deprive my

wife.  I would at

least go through the motions, doing the things

that she liked,

and bringing her to an orgasm.  So that's what I

set about to do.

To my great surprise and delight, I found that

as she became

aroused, so did I.  This was completely

unexpected, but extremely

satisfying.  She was able to bring me to an

orgasm too.

From then on we had regular sex.  It was not as

often as before.

I had to start each session with a complete

absence of desire.

But I was always able to get into it after 20-30

minutes of

foreplay.  We both always reached a climax.

Conclusions

-----------

Sex after treatment is different.  It's more

difficult.  It

requires more effort, more commitment, lots of

honest

communication between partners.  However, if

both partners want

to make it work, they can succeed.

I am no longer on ADT, but radiation has left me

relatively

impotent (I can still achieve penetration

sometimes with the help

of Viagra, but not often) and with Peyronie's

Disease.  However I

don't consider that my sex life is now worse

than it was in the

essential ways, and I don't consider myself to

be less able to

satisfy my wife or to be less of a man.  For me,

the cup is way

more than half full.

Prostate cancer treatment damages one's sexual

organs.  It

changes things.  But it doesn't affect physical

and psychological

intimacy and it doesn't have to destroy sex.  If

a man is willing

to adapt and persevere, and if he has a partner

who loves him and

is also willing to adapt and persevere, sex can

remain possible

and remain satisfying.

    Alan

[Guest guest]

wrote:

> I was operated on in 2008 and I have yet to see an erection. Dr

> said The numbness will go away. Like hell it will. My two

> friends are like , zero problems; however I keep hearing

> everyone is different.

I know that this is no consolation, but I read somewhere that

very few men have " zero problems " .  Most of the men who recover

functionality don't recover as much as they had before their

operations.  Many of them need Viagra.  Some take injections.

Some find that they can achieve penetration sometimes but not all

the time.  Some find they can achieve penetration but can't

sustain it to a conclusion.

I lot of men are worried that other people, both men and women,

will pity them or think worse of them if they can't get an

erection like a young man can.  They don't want to be pitied and

they don't want to be looked down upon so, when someone asks

them, they say " zero problems " .

If by " numbness " you mean no feeling at all in the penis, for

example if you touch it you can't feel the touch, I haven't heard

that before and it has to be very depressing.  On the other hand,

if you mean that you can feel the touch but don't get any

erectile response, that's common.  You might consider the

injections that some men use to get erections.  A lot of men

swear by them.  Alternatively, you may find that oral and manual

sex are still possible and satisfying.

Best of luck with it.

    Alan

[Guest guest]

Hi, I had erection problems after surgery and nothing worked. So I had an implant and it works great with all of the feeling. I have enjoyed sex since. Good Luck, Tom WFrom:

To: ProstateCancerSupport Cc: Quinn Sent: Saturday, July 23, 2011 8:24 PMSubject: Re: Curing PCa early?

read how Quinn is getting along.

Rody Here

I was operated on in 2008 and I have yet to see an erection. Dr said

The numbness will go away. Like hell it will. My two friends are

like , zero problems; however I keep hearing everyone is

different. I think the "Robot" was left inside me As Dr. Meyers

knows, and Chuck Maack, My psa is 3.7 after surgery. It wasn't but

4.2 when I had my first of two biops. The Arithmetic was 7+3. I am

devastated with the out come of my surgery. He was the director of

Urology at UAB and I think he should have had an office directing

medical records to file 13.

When I "flip over" to the other side my attorney will retrieve all

records from my Dr. seventy miles east of my location, plus the

three Urologist that practiced on me. Like the sign states in their

office "License To Practice".

thanks alan good reply Iam thinking of saving it. I had

my prostate taken out. I masturbate alot becassue my wife

has no real sexul desire or maby Iam just to lazy to

pursue seducing her (did you ever try to seduce a robot)I

find the orgasms ,in my opinion bring me to my knees .they

blow you away. No ejaculation of course. Iam probably

doing myself an injustice not pursuing sex. My PSA went up

in the past 6 months and my uro recommended

radiation..IMRT . This is a good system . Still good

orgasms time will tell though.

On Sat, Jul 16, 2011 at 6:06 PM,

Alan Meyer

wrote:

TD Roebling

wrote:

>After curing PCa -- no

matter how early -- does it spell the end

>of a man's sex life, as he knew it?

(without marital aids)

I think a good answer to this question requires

more than a

simple yes or no.

First let's look at the effects of treatment on

male sexuality.

Effects of treatment

--------------------

SURGERY: Removal of the prostate by surgical

means has several

effects on a man's sexual equipment:

1. It will likely reduce potency.

Most men cannot get an erection immediately

after surgery. In

some men, this ability comes back. In others it

does not. The

ones who do recover the ability to have an

erection may find it

less stiff and less long lasting than before.

2. There will be no ejaculate.

Orgasms are "dry". Men who become incontinent

have additional

issues to deal with. Their orgasms may spill

urine.

3. There may be shortening of the penis.

This is due to removal of a section of the

urethra that is

surrounded by the prostate and the rejoining of

the ends, pulling

the penis in.

4. There may be some bending of the penis when

erect - Peyronie's

Disease.

RADIATION: Radiation patients also suffer side

effects.

1. Radiation will generally reduce potency.

Unlike surgery, this happens gradually rather

than all at once.

Surgery patients lose potency all at once and

then may gain a lot

back. Radiation patients lose potency very

gradually, taking up

to a couple of years after treatment to reach

their final low

state.

Some studies claim that the end result is about

the same for the

two treatment modalities. Many men may become

completely

impotent and many others may have a significant

reduction in

potency.

2. There will be a reduction of ejaculate.

It may become completely dry, or it may become

almost dry.

3. Peyronie's Disease is possible.

ADT: Men using androgen deprivation therapy

(ADT) will have a

different set of sexual side effects.

1. Loss of libido.

Libido is desire for sex. On ADT a man can look

at a beautiful

naked woman and feel ... nothing. A woman can

touch and stroke

his penis and the sensation to him may be about

the same as if

she were touching and stroking his finger, or

even his hat.

2. Loss of potency.

There is said to be loss of potency on ADT. I

don't know if this

is true, or whether this is just a concomitant

of loss of libido.

So a man takes some very significant hits.

What remains

------------

With surgery and radiation, most men still

retains the ability to

have an orgasm. For most men, libido (sexual

desire) remains

after treatment, sex is still interesting to

them, and orgasms

continue to be satisfying.

The story on ADT is more complicated.

How men can have sex

--------------------

Many men who become impotent can still achieve

potency with

Viagra or similar drugs, or with stronger drugs

that are injected

directly into the penis shortly before sex. The

injectable drugs

can often provide stiffer and longer lasting

erections than the

man could achieve before treatment. Many men

find the notion of

an injection repugnant. Others don't.

Some men who are impotent get prosthetic devices

implanted in

their penis. Again, many men find the notion of

an implant

repugnant (I admit to being one of them), but

some men swear by

it.

Other men switch from penetrative sex to oral

and manual sex.

Speaking for myself, I would say that this can

be very

satisfying. I also believe that many, and

perhaps most, women

would also find it very satisfying. In fact

there are many

women whose sex lives improve, sometimes

dramatically, when their

husbands focus on oral sex rather than

intercourse.

Sex on ADT

----------

Sex on ADT is a different story. I believe that

the great

majority of men on ADT give up sex and never

have it as long as

they are on ADT, which may mean for the rest of

their lives. One

doctor told me that, on ADT, I would not be able

to have sex and

I wouldn't care.

I think that's true for most men. For myself, I

found that

neither of those statements were true. I didn't

have any sexual

desire but in some nostalgic way, I missed it,

and I also felt

that I was depriving my wife, and I didn't like

that.

One day I decided that, even though I had no

desire for sex,

there was no reason that I should deprive my

wife. I would at

least go through the motions, doing the things

that she liked,

and bringing her to an orgasm. So that's what I

set about to do.

To my great surprise and delight, I found that

as she became

aroused, so did I. This was completely

unexpected, but extremely

satisfying. She was able to bring me to an

orgasm too.

From then on we had regular sex. It was not as

often as before.

I had to start each session with a complete

absence of desire.

But I was always able to get into it after 20-30

minutes of

foreplay. We both always reached a climax.

Conclusions

-----------

Sex after treatment is different. It's more

difficult. It

requires more effort, more commitment, lots of

honest

communication between partners. However, if

both partners want

to make it work, they can succeed.

I am no longer on ADT, but radiation has left me

relatively

impotent (I can still achieve penetration

sometimes with the help

of Viagra, but not often) and with Peyronie's

Disease. However I

don't consider that my sex life is now worse

than it was in the

essential ways, and I don't consider myself to

be less able to

satisfy my wife or to be less of a man. For me,

the cup is way

more than half full.

Prostate cancer treatment damages one's sexual

organs. It

changes things. But it doesn't affect physical

and psychological

intimacy and it doesn't have to destroy sex. If

a man is willing

to adapt and persevere, and if he has a partner

who loves him and

is also willing to adapt and persevere, sex can

remain possible

and remain satisfying.

Alan

[Guest guest]

Hi, I had erection problems after surgery and nothing worked. So I had an implant and it works great with all of the feeling. I have enjoyed sex since. Good Luck, Tom WFrom:

To: ProstateCancerSupport Cc: Quinn Sent: Saturday, July 23, 2011 8:24 PMSubject: Re: Curing PCa early?

read how Quinn is getting along.

Rody Here

I was operated on in 2008 and I have yet to see an erection. Dr said

The numbness will go away. Like hell it will. My two friends are

like , zero problems; however I keep hearing everyone is

different. I think the "Robot" was left inside me As Dr. Meyers

knows, and Chuck Maack, My psa is 3.7 after surgery. It wasn't but

4.2 when I had my first of two biops. The Arithmetic was 7+3. I am

devastated with the out come of my surgery. He was the director of

Urology at UAB and I think he should have had an office directing

medical records to file 13.

When I "flip over" to the other side my attorney will retrieve all

records from my Dr. seventy miles east of my location, plus the

three Urologist that practiced on me. Like the sign states in their

office "License To Practice".

thanks alan good reply Iam thinking of saving it. I had

my prostate taken out. I masturbate alot becassue my wife

has no real sexul desire or maby Iam just to lazy to

pursue seducing her (did you ever try to seduce a robot)I

find the orgasms ,in my opinion bring me to my knees .they

blow you away. No ejaculation of course. Iam probably

doing myself an injustice not pursuing sex. My PSA went up

in the past 6 months and my uro recommended

radiation..IMRT . This is a good system . Still good

orgasms time will tell though.

On Sat, Jul 16, 2011 at 6:06 PM,

Alan Meyer

wrote:

TD Roebling

wrote:

>After curing PCa -- no

matter how early -- does it spell the end

>of a man's sex life, as he knew it?

(without marital aids)

I think a good answer to this question requires

more than a

simple yes or no.

First let's look at the effects of treatment on

male sexuality.

Effects of treatment

--------------------

SURGERY: Removal of the prostate by surgical

means has several

effects on a man's sexual equipment:

1. It will likely reduce potency.

Most men cannot get an erection immediately

after surgery. In

some men, this ability comes back. In others it

does not. The

ones who do recover the ability to have an

erection may find it

less stiff and less long lasting than before.

2. There will be no ejaculate.

Orgasms are "dry". Men who become incontinent

have additional

issues to deal with. Their orgasms may spill

urine.

3. There may be shortening of the penis.

This is due to removal of a section of the

urethra that is

surrounded by the prostate and the rejoining of

the ends, pulling

the penis in.

4. There may be some bending of the penis when

erect - Peyronie's

Disease.

RADIATION: Radiation patients also suffer side

effects.

1. Radiation will generally reduce potency.

Unlike surgery, this happens gradually rather

than all at once.

Surgery patients lose potency all at once and

then may gain a lot

back. Radiation patients lose potency very

gradually, taking up

to a couple of years after treatment to reach

their final low

state.

Some studies claim that the end result is about

the same for the

two treatment modalities. Many men may become

completely

impotent and many others may have a significant

reduction in

potency.

2. There will be a reduction of ejaculate.

It may become completely dry, or it may become

almost dry.

3. Peyronie's Disease is possible.

ADT: Men using androgen deprivation therapy

(ADT) will have a

different set of sexual side effects.

1. Loss of libido.

Libido is desire for sex. On ADT a man can look

at a beautiful

naked woman and feel ... nothing. A woman can

touch and stroke

his penis and the sensation to him may be about

the same as if

she were touching and stroking his finger, or

even his hat.

2. Loss of potency.

There is said to be loss of potency on ADT. I

don't know if this

is true, or whether this is just a concomitant

of loss of libido.

So a man takes some very significant hits.

What remains

------------

With surgery and radiation, most men still

retains the ability to

have an orgasm. For most men, libido (sexual

desire) remains

after treatment, sex is still interesting to

them, and orgasms

continue to be satisfying.

The story on ADT is more complicated.

How men can have sex

--------------------

Many men who become impotent can still achieve

potency with

Viagra or similar drugs, or with stronger drugs

that are injected

directly into the penis shortly before sex. The

injectable drugs

can often provide stiffer and longer lasting

erections than the

man could achieve before treatment. Many men

find the notion of

an injection repugnant. Others don't.

Some men who are impotent get prosthetic devices

implanted in

their penis. Again, many men find the notion of

an implant

repugnant (I admit to being one of them), but

some men swear by

it.

Other men switch from penetrative sex to oral

and manual sex.

Speaking for myself, I would say that this can

be very

satisfying. I also believe that many, and

perhaps most, women

would also find it very satisfying. In fact

there are many

women whose sex lives improve, sometimes

dramatically, when their

husbands focus on oral sex rather than

intercourse.

Sex on ADT

----------

Sex on ADT is a different story. I believe that

the great

majority of men on ADT give up sex and never

have it as long as

they are on ADT, which may mean for the rest of

their lives. One

doctor told me that, on ADT, I would not be able

to have sex and

I wouldn't care.

I think that's true for most men. For myself, I

found that

neither of those statements were true. I didn't

have any sexual

desire but in some nostalgic way, I missed it,

and I also felt

that I was depriving my wife, and I didn't like

that.

One day I decided that, even though I had no

desire for sex,

there was no reason that I should deprive my

wife. I would at

least go through the motions, doing the things

that she liked,

and bringing her to an orgasm. So that's what I

set about to do.

To my great surprise and delight, I found that

as she became

aroused, so did I. This was completely

unexpected, but extremely

satisfying. She was able to bring me to an

orgasm too.

From then on we had regular sex. It was not as

often as before.

I had to start each session with a complete

absence of desire.

But I was always able to get into it after 20-30

minutes of

foreplay. We both always reached a climax.

Conclusions

-----------

Sex after treatment is different. It's more

difficult. It

requires more effort, more commitment, lots of

honest

communication between partners. However, if

both partners want

to make it work, they can succeed.

I am no longer on ADT, but radiation has left me

relatively

impotent (I can still achieve penetration

sometimes with the help

of Viagra, but not often) and with Peyronie's

Disease. However I

don't consider that my sex life is now worse

than it was in the

essential ways, and I don't consider myself to

be less able to

satisfy my wife or to be less of a man. For me,

the cup is way

more than half full.

Prostate cancer treatment damages one's sexual

organs. It

changes things. But it doesn't affect physical

and psychological

intimacy and it doesn't have to destroy sex. If

a man is willing

to adapt and persevere, and if he has a partner

who loves him and

is also willing to adapt and persevere, sex can

remain possible

and remain satisfying.

Alan