You may not want to read this post. It defines TMI. But in the interest of continuing to chronicle the saga of my prostate cancer – for the benefit, I hope, of those who follow – the time has come to write about my penis. Specifically, what it doesn’t do.
Incontinence and impotence are two frightening words for a grown man but they are the side-effects of removing the prostate and its cancer with it. Worth the price, or at least that’s the calculation one makes beforehand: Cancer or erections? Cancer or dry underwear? Cancer loses.
I didn’t know quite what to expect of the incontinence and didn’t hear a clear description (maybe because I feared hearing it). I was dreading puddles on the floor. But it’s nothing like that. It’s a matter of dribs and drabs. I wish I understood the physical explanation of what’s happening but the end result is this: Sometimes, when you expect it (standing, coughing, lifting…) and sometimes when you don’t (that’s the tough part) you feel – in the excellent description of Howard Stern Show producer Gary Dell’Abate – something moving where it shouldn’t. Drib. Next time, you hope you remember to clench your muscles first.
When I left the doctor’s office after my hosectomy, I was outfitted in a gigantic Baby Huey diaper plus a pad – which only heightened my fear – but I quickly realized this wasn’t necessary and downgraded to pads. After much trial and, thank goodness, no error, I found my dream brand. I can’t believe I’ve become a connoisseur of such products but I recommend Poise Ultrathins. [Confidential to the FTC: That is not a paid commercial endorsement). I should also note that nighttime is not a problem at all; no latter-day bedwetting for me. So it’s inconvenient and distracting but as with every step of this process, I have seen that I’m luckier than I thought I’d be.
As for the penis’ other job, well, that’s not going so well. The nurse warned me not to expect anything yet (it has been four weeks since surgery) and so I suppose I shouldn’t be depressed. But it’s hard. Because it’s not.
We men have complicated relationships with our penises, of course. We follow them (that’s why they’re in front). They tell us what we like. They have minds of their own. We anthropomorphize them; some give them names (I don’t; it’s just it). So when I see mine looking like an emaciated, depressed, shrunken old man in a hospital bed, well, it’s hard not to empathize.
The doctor prescribed a quarter of a Viagra pill every night, to prime the pump, apparently. I have a page of standard instructions that suggest taking a whole little blue pill once a week and then to, well, have a go at it. Imagine being a teenager and being told that masturbation is a medical necessity. Doctor’s orders. Sounds like fun, but it’s not. Even when things start working (I hope) they’ll be weird, as a good friend warned me. Today, there’s sensation but there’s no growth and when and if there is liftoff, there’ll still be no semen (the seminal vesicles were taken out with the prostate). This is changed forever.
I’ll spare you further progress reports on these topics. As you can tell from my lame gags about my lame thing, this is about as much transparency as I can bear. I have found my limit.
(The rest of the saga is here.)
This could not have been an easy post to write. Very gutsy of you to talk about something that doesn’t get talked about nearly enough.
Jeff Harbert
My deepest sympathies. I had a friend (in his 60’s) back in the early 1990’s who went through the same thing. The chemotherapy he went though was that it first eliminated all his hair, including his eyelashes, which was all very strange. The upside was that his hair all came back in very dark. Took 20 years off his appearance. I remember giving him a copy of Gilda Radner’s book “It’s Always Something”. I hope your life plays out with happiness and the time to enjoy it.
Very gutsy, Jeff!
I know that women are often talking about TMI things, and that men usually don’t. Men are the ones who usually hold up the standard of “professionalism” which means no talking about anything below the waist unless it’s in very veiled and glowing terms–even then, some things are considered totally non-professiona.. But, you managed to talk about something deeply personal in a way that’s neither grandstanding to get attention nor unprofessional. It’s just something you’re going thru–and it happens to be going on with a part of your body that still makes people wink-wink-nudge-nudge. Very admirable, Jeff. And just remember….big illnesses take a long time to get overcome. But you will. trust me on that one :)
Thank you for writing this. i am a young man whose family has a history of prostate cancer (my dad, uncle, grandfather) and I am scared. I have seen my dad and the issues he has have made me question whether it was worth it. reading this has let me know that it is your attitude and how you handle the problem, not the problem itself. Thank You
Perhaps it’s considered TMI because no one does talk about it? I sympathize with your plight Jeff, and I’m glad you’re being open about it, for the sake of others who might be hesitant.
This, if I may be so bold, is the less important side of things. If you come out of this alive and healthy, but with limited sexual function, well then – you’re alive & healthy, right? When I think about men who have literally died because they were too embarrased or vain to discuss these issues with their doctors, it just seems so silly. It’s one thing to keep it off the internet. It’s another thing to avoid the necessary exams, medical procedures, and discussions with medical professionals.
Forgive the anonymous value judgement, but if you’re in danger of becoming one of those men, get over yourself. Your sensitivity/squeamishness is not worth your life…
Thanks again, Jeff, for starting the discussion…
Jeff,
Hats off to you Jeff – my dad went through the same thing 7 or 8 years ago and he’s come through well – it’ll get better.
I just finished your book and I loved it! It brought about a lot of late night thinking and pondereing (I’m a Realtor, you see). I do pride myself as a good Realtor with a modern approach but I need to evolve my practice to be more “value based” so that I can continue to provide the services that people will want in a relevant way. I’d love to hear any other ideas you may have heard about relevant Real Estate.
I’ve prayed for you this morning (take that for what it’s worth to you) and I’ll keep you in mind. I’m participating in the “Movember” event next month http://movember.com to raise money and awareness.
Yours truly,
Grant Wiebe
Kelowna, BC, Canada
http://GrantWiebe.com
http://Rutlanders.ca
…and I picked today to reference your site in my team blog.
Thanks for sharing with us Jeff. We are all pulling for you.
J
The following observations are premature in the course of your convalescence, Jeff, but I mention them now anyway as a contribution to the ongoing Google value of this discussion.
We men are so often teased by women for “thinking with our pricks” that it could be easy for someone reading your post about our penises — We follow them (that’s why they’re in front). They tell us what we like. They have minds of their own — to understand this as a glib jest rather than a profound insight.
Profound it is.
Prostate surgery damages the nerves that trigger the genital blood supply. Before surgery, our erections function as a physical symptom alerting us to our mental state. See a sexy person walking down the street…or daydream about an erotic encounter…or read a passage of salacious prose…or glance at raunchy pornography…or enjoy a flirtatious conversation — routinely the engorged penis tells us of our arousal even before we need to put our excitement into words.
After surgery, that feedback system fails. Even when your convalescence is complete and your erections return, they will not perform the same automatic function. Your penis will no longer tell you what you like, as you put it. Erection will be the consequence of arousal; it will no longer signify its initiation.
Before surgery, once one has an erection, sex follows. You masturbate to enjoy the excitement or, if you are lucky, make love with the person who aroused you or perhaps with a third party — or you wait for the arousal to dissipate and get on with your life. Whatever.
After surgery, the erection arrives much later in the process of arousal, often at the culmination of an erotic episode rather than at its initiation, often as the precursor to orgasm rather than as the beginning of a journey in that direction. This change is, obviously, demoralizing. We men take much pride in our mastery over our aroused penises. Finding that we can maintain our erections only as long as a prematurely ejaculating 14-year-old is an embarrassment, even a shame.
The change is also disconcerting, especially when masturbation is concerned. Now, when I want to masturbate, I no longer do so in response to an already-existing physical arousal. My penis no longer tells me when to do it. I have to explicitly think the thought. I have to invoke the object that is making me feel aroused. This literal summoning of fantasies and desires is initially utterly uncomfortable for someone, like I am, who is in a loving long term monogamous relationship. Doing the mental work of lusting consciously — rather than unthinkingly following the leadership of one’s erect penis — feels tantamount to adultery. It took years for me to give myself permission to feel honest, rather than a cheat, while having those erotic thoughts.
In addition, the phenomenon of the erection appearing at the culmination of arousal rather than at its initiation means that your penis will no longer be the dominant erogenous zone of your body. For me, I now become more aroused by fondling my nipples or the inside of my wrists or my stomach than my genitals directly; when I get aroused, my lips become engorged before my penis does.
All of these changes — no longer thinking with your genitals, invoking fantasies directly, losing mastery as a cocksman, collapsing the time between engorgement and orgasm, enjoying secondary erogenous zones — will only seem disconcerting to your male readers, I suspect, while your female readers see nothing to worry about. As a prostate cancer surgery patient advised me before I went under the knife: “After surgery, you will make love like a woman.”
Jeff, Thank you for the insights. I am from a family with a history of Prostate Cancer and approaching the time in my life when it becomes a greater concern. My anxiety is diminished reading stories like yours.
Jeff,
Thanks for bearing this much transparency. I am a cancer survivor myself (colon cancer 10 years ago, basal cell skin cancer four years ago). I lost my father in 1978 to prostate cancer that was not detected as early as yours. My brother had robotic surgery for prostate cancer earlier this year and appreciated your earlier posts (I will be sending him a link to this as well). And last month I lost a nephew to leukemia.
I don’t believe we can have TMI when it comes to cancer (though I suppose my tweeps are glad I wasn’t Twittering when I celebrated my first post-surgical fart and bowel movement). When I posted a link to one of your earlier posts about your surgery, I heard from a Facebook friend that he was going to schedule the physical exam he had been postponing. Your transparency, candor and wit have been inspiring. I hope your mood is, er, elevated by continuing progress in your recovery, even if you don’t decide to share that progress with us.
You’re a valuable voice in some important discussions. I am sorry you have experienced this illness but glad that you have continued your graceful and insightful writing.
All the best.
Sir I find your courage and honesty very humbling. Thank You.
Thanks for this post. I’m a young guy with a different story (see the website I linked if you want to know the limit of my transparency) but am especially glad for this line: “I don’t believe we can have TMI when it comes to cancer (though I suppose my tweeps are glad I wasn’t Twittering when I celebrated my first post-surgical fart and bowel movement).”
Props.
Roughly 7 year testicular cancer survivor. In the grand scheme, I was lucky. Early detection and after fighting with insurance for my “elective” surgery early removal. Only 18 radiation treatments and 1 less testicle. I can’t imagine what you are going through, as I have never been there. Thank you for writing a post like this, it needs to be talked about more.
Jeff… Bless you. I was in a huge argument with three friends in the ’70s in Berkeley when we were all young. If an operation could save your life, but leave you impotent, would you have it? Three people said no. I thought they were nuts. There are many ways to make love to a woman that don’t include It.
Great post on a subject too few are willing to talk about openly. One of the things I took away from a prostate support group I joined — after my surgery — is that a doctor’s track record on limiting ED and incontinence is as important as his success rate in curing cancer. Some docs pay attention to this, but others don’t.
I think all men considering prostate cancer treatment should ask their doctors how their patients are faring 6 months, 1 year, or 5 years after treatment.
Thanks, Jeff. I was about to ask about the after-effects, since they are an important part of any decision about what option is chosen to treat prostate cancer. You beat me to it. I think we all respect whatever limits you decide to impose on how much you reveal, but every bit helps.
Extraordinary post, I’m sure you will manage All this. I ever get cancer your story will be an important inspiration
lost my dad to this and a boss that inspired me.
ditch the v – lifes better than that.
as for dribbles – forget it – at some pt we all dribble (some more than most).
Thanks, Jeff, for your courage and your honesty. This post will help people.
You made a tradeoff. It was worth it, but you did lose something in the trade.
Best post yet. Thanks Jeff.
heh.
Great Jeff. Congratulations for publishing here the whole saga. People come to read about media and technology, and may be puzzled, but end up by learning that there are more important issues than whether newspapers will survive.
chapeau!
Jeff, Have heard you a time or two on Leo Laporte’s TWIG and today caught your reference to this post..
You have my respect for a writing both a thoughtful and humorous piece on a difficult subject.. very well done.
Hang in there and you have my best wishes for a full recovery and on to more of life’s better things.
Best wishes on your continuing recovery, Jeff.
Recuerde que hay terapias estupendas puestas en marcha por el Dr. Hammer que le pueden ayudar. Busque información sobre ello: orinoterapia, agua de mar, ayurveda y un medicamento parecido al Biobac.
Busque información del Dr. Moriano.
Muy valiente contando esta historia y muy sobrecogedor para mi por ver que un hombre habla de incontinencia cuando normalmente son las mujeres la que la padecen llegadas a una edad o en el embarazo.
Un saludo y suerte, seguir luchando siempre con el pensamiento positivo.
brave. hoping for your recovery. Godbless.
Jeff – best wishes for a speedy recovery to where you want to be. As a fellow penis owner I appreciate your openness in sharing with us. Definitely not TMI.
You are really a brave man. Hope you recover quickly. And keep producing insightful books like WWGD.
Get well, Jeff. The good news is the cancer’s gone, and as additional good news my brother-in-law went through this same thing a few years ago and everything’s working again as desired. It just takes time.
Husband and brother-in-law both had PC within a year of each other — 10 years ago now. (Safe guess tht it runs in the famiy?) Successful sx treatment in both cases, cancer free.
Best book back then – Man to Man by Michael Korda. (Korda is a terrifically funny writer about other more mundane things as well as a military history writer.)
Good of you to write. More men need to be aware of need to be checked.
Note from a wife’s side — there are ways ;-)
May your recovery be quick and forgettable.
RE: leaking
It will most likely never completely cease. It’s been 5 years since my prostate surgery and that’s the way it is.
As it was explained to me. Men start out life with three valves in their urinary tract. The biggest is in the prostate gland and is a three-way, high pressure valve. It shuts off urine flow when you get an erection and lets sperm and seminal fluid mix just prior to ejaculation, and directs the mix toward your penis. Naturally, that valve is removed during PC surgery. Almost as big is the valve (sphincter) at the base of the bladder. It can hold a full bladder (pint?) while you run, climb stairs, pick up a sack of cement, etc. The problem is that it is adjacent to the prostate gland and (unlike anatomy drawings) organs tend to grow into each other so the bladder wall and the prostate wall share cells. To get all the prostate cells, it is usually (97%) necessary to take this valve out as well. So the two big valves are gone.
What’s left? The tiny valve in your pubococcygeus (pelvic floor) muscle (a muscle that both sexes have). In a man, it is right at the base of your penis. The primary problem is that it’s probably not been in action as a flow stopper for 50 years while the bigger valves did the job. That’s why you have to “house break” yourself after surgery. This muscle takes training and strengthening (Kegel exercises are used by men and women) in order to bring it into service.
Furthermore, it will never work as well as the much bigger valves removed during surgery. Get used to it. I can go several days without a leak, then there’s a drop or two. Or I’ll have a bad day and the drops come repeatedly. In five years, I’ve not been able to detect a pattern in what sets off the leaking. Straining (such as lifting a heavy box of books) will do it. But so will nothing. So I’ll be wearing a half pad forever. Just in case.
There’s another problem with the pubococcygeus muscle. For 50 years, it has been programmed to pop open when you ejaculate so as not to impede the flow. After surgery, there’s no more ejaculation but there is still sexual arousal. And what happens when the PC survivor is excited, … the valve pops open and you leak urine (usually several drops). It’s messy but it is an unfakeable, unmistakable sign that you “like” your partner. This you can’t stop but you can reduce the mess by keeping the tank (bladder) empty and using towels. Oh goody, stop sex, run to toilet, empty tank, run back. Now you can pee with an erection! It’s worth a shared giggle. Fortunately, women are very forgiving and generally they’ll accept what you can do now, not pine for what you could do at 18. Remember that you still have ten fingers, two lips, and a tongue. You can figure that out yourself.
Best of luck with your recovery.
I too have prostate cancer. I have recently finished the diagnostic with with my urologist and will meet with my oncologist soon. I plan to have the radioactive seed implant therapy.
I don’t know why I posted the previous post anonymously. I’m generally happy to talk about the disease. If Jeff can talk about this in public, so can I. More of us should. If men were as open about PC as women are about BC, we’d be a lot further along on the way to curing the disease and eliminating the need for surgery (no matter how well done).
My name is not “Big Boy.” I’m Joseph Olson and I’m a prostate cancer survivor. And damn happy to be one.
If you’ve got PC and want to talk, send me an e-mail to jolson@hamline.edu.
And thanks for your great post, Joseph.
It takes balls to publicly blog about such a personal issue like penile problems and I heartily commend you.
I have not one but two males in my family who have been diagnosed with Prostate cancer and it’s been a rough road for both of them.
They are both just traveling down this road now and neither of them know what to expect in the future. I’ll be sure to forward them the link to your blog and these posts because they can read all the medical information they want, but I think it will help to hear it from a survivor’s point of view.
So a big thank you for being brave enough to put a face on the broken penis.
Now that General Petraeus is widely known to have prostate cancer, it will bring more needed attention to this form of cancer.
You’re brave! my father had his operation today, they wont remove it, but they will sort of chip off pieces of it… Going to call home soon and check with my parents.
i am praying for you. sir, i take my hat(s) off to you. you my friend are a hero. the others here above me have said it far better than i can.
You are loved,
brother frankie
a biker for christ
Joseph Olson —
Fortunately, women are very forgiving and generally they’ll accept what you can do now, not pine for what you could do at 18. Remember that you still have ten fingers, two lips, and a tongue. You can figure that out yourself.
Your point is well taken but let’s be brutally honest nonetheless…
— we do not have sex merely to please women but to please ourselves too. Thank goodness that she may be forgiving and accepting; self-acceptance can be the harder task.
— we already “figured out” how to use ten fingers, two lips and a tongue long before surgery — even when we still had the potency of an 18-year-old — and highly pleasurable they are too. To “pine” over the damage done to one’s penile prowess does not imply that cunnilingus or mutual masturbation are not first rate sexual experiences. Of course they are. But so is fucking and ejaculating.
Yours in solidarity — Andrew
A very brave post, Jeff. Thank you for being willing to share. Sometimes TMI is exactly the right amount.
Thank you for lifting the veil on such an uncomfortable topic. Hopefully, this will spur more conversation about a potentially life-saving topic.
Stay strong, Jeff!
Wow, I wrote a post last week on my otherwise business-oriented blog about my recent double hernia surgery… I thought that was pushing it a bit. You have definitely taken the candor to a new level with this post. Congratulations, and best of luck with your recovery.
I’ve seen a couple of references in the comments here about the unavoidability of both impotence to some degree and incontinence after prostate surgery and that is not true anymore. As both an MD and someone who had his prostate removed in 2008, I can reassure you, professionally and personally, that a growing number of patients have no erectile problems and no incontinence problems some months after surgery. The nerves can often be saved on one or both sides during the procedure, so sex works just as before (one of the two nerves is enough to keep the machine working). Except nothing comes out, but during “normal” sex, nobody would know the difference.
So, rest assured, things are looking up. Pun intended.
For the record, responding to J Martin…
…I hope no prospective prostate surgery patient reads my posts and concludes that some degree of impotence is unavoidable. I am one of those lucky patients who has “no erectile problems,” in Dr Martin’s words, if by that he means that, for me, sexual arousal routinely leads to penile engorgement.
Yet having no problems is not the same as saying “sex works just as before.” Speaking personally, I would give no one such a reassurance. Sex is not the same as before.
This is an excellent and moving post. You are indeed very brave to write about this. I have been following the saga, and I am glad you have. This is the kind of thing that more men need to be reading. Thank you.
Best, and keep on blogging.
I used to hitchhike back in the day, on my way from Miami to Burlington I got picked up by a totally hot guy in a Camaro. He was just supposed to give me a ride part of the way, by the time we got to the agreed drop-off point we were both mesmerized, he was a parapalegic using hand controls but somehow we ended up at his place and I stayed with him for two weeks. It was the best sex I’ve ever had, thirty years later I wish I knew his name so I could google him and go find him. He couldn’t achieve an erection or ejaculation but could orgasm, it was all fingers and eyes and tongues and mouths and lust and amazingness.
I can’t tell from your post if you have a woman in your life, I hope so, but just know there are some of us out there who couldn’t care less about all those “limitations”, who are moved (to multiple orgasms!!) when we find lust in your eyes, courage in your heart, and beauty in your soul.
Andrew,
“Yet having no problems is not the same as saying “sex works just as before.” Speaking personally, I would give no one such a reassurance. Sex is not the same as before.”
To me it is, and I’m not alone. That’s what I’m saying. There is certainly no assurance it will be the same, but there is equally no guarantee it won’t be. Not anymore.
I am the widow of a doctor who died of prostate cancer twelve years ago. He was so scared about becoming incontinent and impotent that he waited too long to have the surgery; the tumor had already escaped the prostate He was living the high life of a divorcee and didn’t want it compromised.
. I was not married to him until after he found out he had cancer, but I was the one urging him to have surgery. I swore to him that it wouldn’t matter, but he didn’t believe me. In fact, he made me get married before he woud have the surgery, so I wouldn’t leave. This is a complicated relationship to your penis, all right. Believe, me, I wasn’t going anywhere. I loved him.
After the surgery he was incontinent in just the way you both describe, and also impotent. No matter what I said (I loved him and I was glad he was alive!), he was determined to get an erection. So he went and had apenile implant. It made him semi hard all the time. To me, it was silly and a needless surgery.
I swear to you, it made absolutely no difference to me, but it did to him. He was happy until he died.
You do what you have to. But it’s for you, not for the woman who loves you. That woman loves you anyway. And trust me, after middle age, no one’s without flaws. THat’s what wisdom is for — to guide you to acceptance.
Believe me Jeff, when I listen to you on TWIG, I know a bit about what you are going through inside, and my heart goes out to you. You are so lucky to be so loved by the online community, and so supported. Stay healthy and keep your sense of humor. We still have to get all these books digitized:-)
Francine,
Thank you. Your message is at once heartbreaking and helpful and generous. Thank you.
jeff
Of all your writing, and I include your life changing experiences on 9/11, I find this to be your most profoundly moving. The Javis Fanboys (and girls) who have been with you since the start are never worried about TMI. You’re a teacher, and you teach us. It’s touching and it’s an important lesson to the guys about what it really means to be a man. You’re a man, Jeff. And a hell of a one at that.
Jeff
You make things human and the book is great.Get to Cardiff!!
Thanks, Steve
I’m a twenty-year survivor of advanced ovarian cancer–yes, we do exist. A surgeon told me something I had cause to remember many times: until your scar turns white, some place in your body is healing. It takes many more months than you realize.
Good luck.
I just wanted to tell you how much I sympathize with what you are going through. My husband had a prostatectomy using the da Vinci robot in March of 2008. He was 48 years old at the time. He was impatient for everything to return back to normal like you. He did not need to wear pads very long because he stopped leaking within a couple of weeks of the surgery. With his doctor’s encouragement, we started having sex again 6 weeks after surgery, and about 6 months after that, he no longer needed the help of viagra. My husband did have his age on his side, as it is much harder the older you are to regain the ability to obtain and keep an erection after a prostatectomy. We always maintained the attitude though that if he need the help of viagra for the rest of his life, that was a minor price to pay for being cancer free.
Hang in there. It will get better!
I also want to second J. Martin. All of my husband’s plumbing works the same as before. They have made wonderful advances in prostate surgery.
Thanks, Jeff, for writing and posting this. It’s not TMI if it saves lives-and I think it will.
Sorry to be so late to the thread but I only found it when Instapundit linked. I had prostate cancer when I was 53 and decided that I enjoyed life too much to risk it. That was nearly 20 years ago and many tools didn’t exist then.
One reason I’m posting is because I currently have a good friend who chose the radium pellet option and he now has had cancer return and cannot have an operation. It’s now just a matter of time for him and he’s enjoying life as much as possible.
I used the smallest infant diaper inside briefs and it worked well for as long as it was needed. After a while with the regular exercises described next, the leakage became very manageable. The exercise consisted of stopping the urine flow several times each time I needed to relieve myself. Apparently you’re exercising some muscles to work better even when it is not a conscious act.
After a while, I no longer needed a pad IF I was content to buy new briefs two or three times a year whenever the yellow residue became too offensive to me since no one else sees it. It’s really just a personal choice since the underwear are really clean after washing but there is color stain quicker than it was before the operation.
Back then the degree of impotence depended on the skill of the surgeon and the extent to cancer. A few maintained potency but most did not. I happened to be one who became impotent but retained the feeling of climax without an erection. No semen but an occasional thrill if one gets bored.
Neither I nor my wife has any regrets about our decision. I call it our decision because I felt the need to have my wife participate in the decision but we both knew that it was ultimately my decision. I hope this might be helpful to those facing this decision.
I was diagnosed in 2003, and went the radiation route. Radiation patients have the same ‘arid love life’ fallout, since the prostate is essentially a large chunk of scar tissue after that. We have the opposite structure from surgical folks, in that our side-effects tend to come years after the procedure, rather than beginning the same day the stitches go in.
My oncologist has a motto that reads, “there’s a reason we call them PATIENts”, and that certainly applies to RP’s. You’re early in the healing process, and the fact that you’re having relative minor complications is a pretty positive sign. Give it a few months, get past the occasional drip stage, then you’ll qualify for the T-shirt I designed for the “dry-orgasm’ fraternity that reads, “surviving prostate cancer can leave you with a dry… sense of humor”. It was only later that I came up with the some what better slogan, “So Long Mister Wet Spot”.
Moe,
I’m a pathologist, and, like you, the son and grandson of men with prostate cancer. You and I have about a 50% chance of getting prostate cancer. Being fortunate enough to live in the US, I have almost an 80% chance of surviving it. This compares to about a 40% chance in the UK. My granddad’s cancer reflected what is approximately state of the art in the UK at present. His prostate cancer was detected at an advanced stage, and his death from it was protracted, difficult, and painful. This is the future here, too, if those who wish for it are successful in imposing it on the rest of us.
My dad’s cancer was detected through PSA screening. It was low stage, and cured by prostatectomy. He was impotent, but not incontinent. He lived for another 11 years and was quite healthy until he developed acute leukemia and died from that. That, of course, is the argument therapeutic nihilists use against the screening and treatment for cure of prostate cancer. Basically, old men get the disease and they often die of something else within a decade or two anyway. I can tell you, those 11 years with my dad meant a lot to everyone involved. He didn’t live long enough, really, to become an old man. He was healthy and vigorous right up to the time he came down with his acute leukemia. But in any case, is old age really a morally defensible reason for denying someone medical treatment?
Given the even odds you and I face regarding getting prostate cancer, I’m sure you’ve thought a lot about therapy over the years. There are many options, as you’ve probably researched for yourself. Nerve-sparing surgery (which often spares potency and continence) is great for those with low stage, low PSA, low Gleason score tumors (6 or less on needle biopsy). Prostatectomy can also work well for those with higher Gleason scores and higher PSAs, though the chances of being able to do a nerve sparing surgery go down sharply as PSA rises. Two good reasons for early detection: continence and potency. External beam radiation, implant therapy, cryoablation…the data continues to come in. I’ve been following this literature both out of personal and professional interest for more than 20 years, and it has been a great comfort to me to know that when and if the time came, it would be up to me to choose which road to go down. This freedom has been up until now one of the privileges of living in this country. The fact that there are many options to pursue is owed to our medical system too. Virtually every advance in the diagnosis and treatment of prostate cancer was made in the US, as physicians here took the disease seriously, considered treatment worthwhile, and both patients and physicians were free to pursue the course they thought best. Their choices were not circumscribed by a panel of “experts” defining “best practices” that just happen to reflect the political priorities of those who chose those who sat on that panel. Had we “progressed” to the point of having one therapeutic pathway for all chosen by a panel, the best practice would consist of waiting until someone started having symptoms from their prostate cancer, and then giving them a testicle ablating drug. Actually, the pharmacological anti-testosterone therapy would not have been developed. We’d still be cutting off testicles.
Dan,
Great information. Thank you. Yes, I didn’t just want to roll the dice. I wanted to be the casino.
Interesting comments. I a took the surgery option, with the understanding that I could be impotent and incontinent. With excercise and focus the incontinence can be managed. The impotency is another matter. Immediately after my surgery I felt a lot of sensation in that area and thought I have lucked out. After I healed to a degree we tried viagra which of course didn’t work. I then tried the penile implant.
I didn’t realize that the surgery would reduce your length, and that the organ would never get firm enough for use , even after furious pumping.
After all of that it occured to me that the best part of the act is the ejaculation. And then I realized that there’s a whole world of sexual pleasure that doesn’t require an erection. And, after you realize that research the huge sex toy market.
Good Luck
Jeff, I had prostate cancer surgery in 2007 and blew through my share of Depends. But I was basically back in about a year in both, um, areas. I guess the free Viagra my doctor insisted on giving me at every follow-up visit helped a bit. In both, um, areas. :-)
Jeff,
Your honesty is ever more valuable, as are the real life experiences of your equally courageous commenters.
However, everybody should remember, Viagra helps the blood stay there after arrival, does nothing to get it there.
My prosectomy nine years ago (un-needed but lying Kaiser Dr.’s told me it was, biopsy of removed organ was Pre-cancerous) was not eligible for nerve sparing so erection was impossible. However, orgasm still possible & my partner at the time & I worked out a mutually satisfying sexual relationship (I was 58 at the time and she was 53). I think that it is a kind of a male ego thing to believe women need penetration sex to be satisfied.
That said, G-d speed your recovery of all functions.
Mike Daley
BTW, disgraced financier Mike Milken has put a lot of time and money into PC awareness. However, I put no credence in his miracle holistic cure of late stage PC. His Dr.’s were lying SOB’s just like mine. Yeah, I remain bitter!
http://www.businessweek.com/1999/99_19/b3628001.htm
I was diagnosed with PC almost two years ago; 23 core samples, one was positive. Doc was classic knife wheedling– wanting to take the gland. I said “second opinion,” he groaned. Samples sent to John Hopkins came back with better Gleason score (3+3) than was first done by local hospital.
Read and studied selective material, 1) John Hopkins Medical white papers on prostate, enabled me to discuss with Dr. Slice&DIce other options, and 2) Mark W. McClure’s “Smart Medicine for a Healthy Prostate.” Both gave me perspective to seek out second opinion and not panic.
Second opinion came from Dr. McClure himself, looked at evidence, “Eight years for your PSA to double, 23 core samples and one was 5% positive . . . your cancer is latent.”
Have been on Avodart and Flowmax for a year and a half, PSA done every six months, readings are lower, followup biopsy six months ago was negative.
In my case, Slice&DIce had to put his knife back in the sheath.
Wish you well in recovery.
I had Protons for my Prostate Cancer. Doing well, almost zero side effects. PSA now down to 1.2 from a high of 4.3
A woman’s perspective here:
I know many women, myself included, who would take someone like a General Petraeus with PC and all that can result from that than a so-called “healthy” man who does not have his act together.
There’s no comparison.
Also, as a RN, I want to assure you that you can have cancer and / or other health problems and still be HEALTHY. I wouldn’t have said this before becoming a nurse but it’s true. I see it all the time – people with health burdens who are, in my view, healthy. It’s HOW they live that makes the difference. So put on the pad and do what you need to do to feel good. Please understand that I’m not belittling your experience at all – it’s just that you DESERVE to be as ok as you can be right now. Don’t settle for less.
Blessings to you!
Hi Jeff, very ballsy of you to be so forthcoming. I wish you a speedy recovery, and hope your battle station becomes fully operational again.
Best of luck with this. It takes a strong man to post about something like this. And then to go This Week in Google and talk about it further.
I think things like this would be less scary if more people were willing to speak candidly about it.
I think you should be complimented. Therefore, I send you my complements!
Hi I just wanted to add thank you for making this something we can talk about.My husband had his prostate removed last september 2008.I can tell you it was a hard decision for him to make to have it removed but my begging him helped him as it runs in his family of men.we decited on the robotic surgery.We went thru the pad stage which went away after about two months that was hard on him.I can tell you that every stage is different he goes thru emotions due to his man hood.yes he has become unable to get erections we tried the pills nothing started to give him head aches so I said it wasn’t worth it for us to try something else less dangerous so we tried the injections but he only did it once he can’t handle the needle thing so now we are doing nothing I am happy with that because I can’t be without him my life would just never be the same if I couldn’t see him,touch him, smell him.I am a stronge woman because of him I have never been happier in my life but I feel that going thru this is very hard on him.I wish the doctors would offer us therapy for men who go thru this because I feel they need to be able to talk about it .I feel he feels that a part of him has died because he has changed.I just want to tell everyone out there that yes it’s not something easy to go thru but don’t wait because it’s not something you want to play with.We are very happy and taking baby steps and see improvements as time goes on.I just wanted to share the moments and emotions we all go thru but in the end it’s worth seeing him and holding him and be able to smell him everyday that makes it all worth it!Thank you again.
Thanks for your comment and good luck with it all. I’ll bet it will get better.
I’m thinking of pursuing the radioactive seed implant therapy as recommended by my urologist.. Would like to hear from you as to your experience and results.
CWiliams:
I’m doing well. It’s nice to know that the cancer is out of me — fingers always crossed — and that the side effects I’m going to have I already have. For me, the choices was somewhat psychological: I wanted the stuff out of me and I didn’t want to worry about the lingering chance of side effects emerging later.
Good luck with yours!
To read more about my sage, click on the “prostate” link under “tags” at the bottom of the post.
jeff
Well, i have a friend who suffer prostate and he does not want to share and tell about his illness and he is getting worse now.
what suggestion for him?
As some other commentators already said: Respect for you, Jeff! Not many men, who think they have a lot of guts, would be as gutsy as you were when writing about this topic.
Jeff,
Bravo (belated) for sharing. I’ve followed your comments for months about “publicy” (opposite of privacy?) but reading this post is the first time I’ve seen any good reason for the openness. Not everyone can force it, it seems to me to be like nudity. Thanks for sharing this, I’m sure many thousands would benefit from what you say so clearly. Before it, I saw you as someone like Prok from the Inner Circle. Maybe the Kinsey report did a lot of good, but not everyone could do what those guys did and talk about it :)
Jeff:
Thank you for going boldly where few men want to go… your blog is an important contribution to raising awareness and acceptance of this disease that affects 1 in every 6 American men.
We are making progress, one step, one open discussion at a time!
Best regards,
Dan
Orgasm is perceived from the mind. Which is to say that you can still have an orgasm in your situation. Look up information on mind-based orgasms if you are interested. Good luck.
Jeff Thank you for writing this. As with everything you write it was well written. It was informative, some parts had me laughing then the next line I was like a deer in the headlights with an “Oh that’s what happens” moment.
Good luck with everything. I hope the positives continue to outweigh the negatives.
Nathaniel
Thank you for the good writeup. It in truth was a leisure account it. Glance complicated to more delivered agreeable from you! By the way, how can we keep in touch?
Thanks Jeff and thanks everyone for all the helpful comments. My husband was diagnosed with rectal cancer, but due to the size of the tumor, he may face the same side effects. I’m more hopeful after reading everything you’ve all had to say. I know it’ll be hard on him but maybe if I send him here he’ll feel better about it all.
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