Tuesday, August 21, 2012

Sex and the not-so-single prostate cancer patient

At a meeting no one wanted to attend about a subject no one wanted to comfortably listen to, psychiatrist Stephen Levine spoke frankly anyway.

And that was a good thing. At least for roughly 20 men, most of whom were accompanied by their wives.

A psychiatrist who has long specialized in sexual issues, Levine candidly laid out to the assembled group the long and short of sexuality following treatment for prostate cancer.

He made his remarks during a recent Thursday evening prostate support group meeting held at Lake Health/University Hospital’s Seidman Cancer Center in Mentor.

Not only was the meeting free but so were the sweet treats and coffee. Reason enough, I figured, to sit in on the topic and even chip in my two cents worth since I’m due for treatment for prostate cancer Sept. 24.

Frank to the point of being blunt, Lavine’s also manage to treat a rather grim subject as humanely as possible.

Which makes sense. That is because to men the matter of prostate cancer, its treatment and subsequent impact on their sexuality weighs heavily on the mind.

Sometimes even to the point of obsession. And frequently enough that  some men don’t seek either medical treatment early on, let alone mental health assistance once treatment has arrested the cancer.

“Until about 1992, the issue was referred to as ‘impotence,’ but that’s not a very nice term and is demeaning to men,’” Lavine said at the program’s jump start. “Now it’s called ‘erectile dysfunction, or ED,’ though you have the same term problem.”

Instead, suggests Lavine, the medical profession ought to use the term “penile unreliability.”

“It’s a big deal to lose your potency,” Lavine said.

Oh, yeah it is, as the heads of most every attendee nodded in agreement.

Not in so much a literal way, of course, but in such a manner where the wife can feel she’s being denied her own sexuality by either the fear, the anger, the frustration, the disappointment on the part of a non- or low-performing husband.

A big part of the bigger mental health picture, says Lavine, is that men are much less inclined to seek professional help following prostate cancer treatment and its sexual aftermath than are women following breast cancer reconstruction.

Fully 90 percent of the women who’ve undergone breast cancer treatment seek mental health support within one year. For men, it’s much, much less, Lavine says.

“Prostate cancer is a physiological problem,” Lavine says. “‘Cancer has come and found me.’”

Lavine then laid out the various alternatives that men can employ to assist them in having at least a modest level of sexual pleasure via a maintained erection following some form of prostate cancer treatment.

That’s true, says Lavine, regardless of whether the chosen course of treatment means surgery to remove the cancer-stricken gland, external radiation treatment, insertion of radioactive pellets called “seeds” into the prostate organ, hormone therapy, watch-and-wait therapy, or some other treatment form.

After all, we men have an image to protect, and Lavine was doing his darnedest to break down that irrational barrier.

Thing is, however, says Lavine, a man can no longer “depend on his sexual organs.”

“It’s the cure itself that causes the problem,” Lavine said.

Overcoming the problem can take one of several current forms. There is the so-called “Osborne Pump;” a device that pretty explains itself though Lavine had no qualms about addressing the ins and outs of this tool; pun intended.

And no one attending the meeting was even close to putting their hands over their ears and shouting “Enough, enough!”

Nope, we all listened attentively, maybe squirming inside some but not overtly showing any display of discomfort.

Neither did we openly blush when Lavine spoke about using a vacuum pump, let alone employing a syringe to inject medicinal fluid directly into the penis to cause an erection.

There is also a prosthesis which requires an operation to implant, and for the men who have gone all ready experienced some form of prostate surgery they are inclined to say that they don’t want to “ever do that again,” Lavine said.

Of course, there is the magical little blue pill or its counterpart, Lavine says.

Such drugs as Viagra, Levitra, Cialis and their siblings can do wonders.

That being said, as often as not, many men who swallow such pill are probably downing as much advertising bling as they are a potent product, Lavine insisted.

“In medicine we have a lot of treatments that aren’t very effective,” Lavine who added later that “advertising is an acceptable way of lying.”

Yet perhaps most importantly of all, stresses Lavine, is that the matter of prostate cancer treatment/sexual activity is a two-lane highway and not just a single track for a horse-drawn carriage ride for a man only.

“Psychiatrists understand that when a man gets prostate cancer so does his sexual partner,” Lavine said.
“That’s why the real patient is the couple and not just the individual.”

To which, a husband and a wife “can still have romance,” Lavine says.

So while a prostate cancer-surviving man may not have the wherewithal to enjoy the same sexual pleasure he once did, that need/urge can be mitigated at least in part by working to satisfy one’s spouse, says Lavine.

“If she knows that you want to please her, you can help overcome the blow that Nature gave you,” Lavine said.

It was at this juncture in Lavine’s hour-long presentation that drew the most attention; from the women as much as from the men.

To hike this path of mutual satisfaction, Lavine says, a couple can engage their hands as well as their tongues.

And while such talk rarely - if ever - surfaces within the confines of the Baby Boom Generation, let alone that of the Greatest Generation, the up-and-coming ones representing our children and even grandchildren have no such qualms, says Lavine.

“There are many different ways of having sex,” Lavine says. “But it is seldom an issue until a couple confronts something like prostate cancer.”

And that remains a hill whereby the best journey to the top is not undertaken alone.

- Jeffrey L. Frischkorn
Twitter: @Fieldkorn

1 comment:

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