I was standing in line at Publix the other day when my phone rang. It was Lou, one of my prostate cancer buddies. It seems that when you are diagnosed with prostate cancer, as I was recently, you form an informal support group of friends, friends of friends and complete strangers who are all going through the same experience.
Lou wanted to know how I was doing. I was at the three weeks past the surgery point, very much up and around, but still, not quite there yet. A million things were still a little off, and I explained them to Lou. My belly was still swollen—with robotic surgery they go in through the abdomen and blow it up with air so the little robot arms have more room to move around—and there was still a little “leakage” which explained the carton of adult diapers in my shopping cart, discreetly tucked under a bag of dog food.
“There’s just one real problem,” I told Lou.
“What?” he asked.
I held the phone a little closer to my mouth and lowered my voice. “I can’t get an erection.”
One of the problems with men in your prostate cancer support group is that they don’t have the best hearing in the world.
“No, no,” I whispered. “Erection.”
“Erection!” I screamed in a tone that rang through Publix. “I can’t get an erection!”
So it’s come to this. I’m so frustrated with my sex life that I’m yelling about it in the grocery checkout line. Imagine, me a victim of erectile dysfunction. I never dreamed it would happen, so accustomed I had become to erectile function. I had been enjoying it in one form or another since I was 12. Now, nothing.
I can’t say I wasn’t warned. I read all about the aftereffects on the internet. But I didn’t delve too deeply. Psyching yourself up for cancer surgery is tough enough. You can’t let yourself obsess about whether it has spread, or did you pay your supplemental insurance, or will you get a crazy anesthetist like Michael Jackson’s doctor—the one who gave the injection and then left the room to get a drink and call his girlfriend.
But somehow you manage to survive the operation and the outcome seems to be good and you are slowly recuperating. That’s when you start to wonder. The incontinence is just a little dribble now and then, not a real problem. For me, anyway. Though I must say the prostate cancer grapevine is crowded with diaper-clad old men who are not happy about it.
But what about sex? At first it is not on your mind, the way it vanishes when you’re sick or traveling by air. But sure enough, it comes creeping back, just little flutters at first, until it builds and builds and an attempt is made. And believe me, attempt is the word. You soon realize that absolutely nothing is going to happen and that you might as well get back to answering that email from your sister.
Was this it? Would it be like this forever?
The research I did wasn’t good. The statistics vary, but they all agree that erectile dysfunction happens with every prostate cancer surgery and every radiation treatment. Sometimes it comes back, sometimes it doesn’t. It can take years and you have to work at it. And often, what comes back is a different kind of sex, not actual intercourse but a touchy feely “intimacy” with a saintly partner.
I reviewed my other options. There were a lot of them. The pills, of course—the Viagra and Cialis, with the famous erection lasting more than four hours. But it turns out that they could mess with my heart medication. And the last time I tried Viagra I ended up on the bathroom floor with a headache so bad that I put ice cubes in my socks and held them to my eyes.
Each option seems to have a major drawback. Testosterone replacement is never prescribed after prostate surgery; it would “feed” any cancer cells left. In fact, many of the guys have to take estrogen and find themselves developing “man boobs.” I wasn’t worried about this, as I already have my own.
That brings us to vacuum pumps. No again, for two reasons. I am very sensitive and abhor any type of yanking. And I’m afraid that a pump might pull loose all those rearranged arteries and nerves. As far as penile implants go, they just aren’t “me.” I couldn’t imagine acupuncture doing much good (though it did help my mother with her hearing). And “talk therapy”—who would want to talk about something so personal and embarrassing? I certainly can’t see myself eating the bark of the yohimbe tree from west Africa or getting something called “horny goat weed,” which the Chinese swear by.
I had a brief moment of hope when I came across something called Alprostadil. It was an injection and seemed to work quite well. As I already inject myself with insulin I knew what it entailed. I can give myself shots. No problem. Then I got to the sentence that explained Alprostadil is injected directly into the shaft of the male organ.
If your choice in life has narrowed down to injecting yourself in the shaft of the male organ or watching Rachel Maddow, well, it’s a close call but I say, turn on the TV.
Which leads us somehow to the subject of your partner. Whoever it is. Your long-suffering wife, or your new girlfriend from down at the senior Friendship Center or that retired florist you met at the gay dining club. These are the poor people who really bear the brunt. You get the drama and self-involvement and pity. They get no sex. And even worse, they have to step up to the plate and try to figure how to get you aroused. It used to be so easy and now it’s virtually impossible. It takes a spiritually pure and virtuous type of person who will attempt an erotic dance at age 70—these are the real heroes of prostate cancer.
My own particular partner, I get the feeling, heaved a sigh of relief and thought, at last—we can give it a rest. And I agree, for the time being.
Who knows what the future holds? Maybe these silly millennial start-up groups will stop trying to perfect farm-to-table food delivery and concentrate on something really important: cures for ED, improved strap-ons (I’m referring to catheter bags, of course) and easier access to horny goat weed. There’s money to be made. In the meantime, for me, sex has morphed into lying in bed watching Netflix with a bottle of wine and a little grabby-grabby under the covers. And for now, at least, I guess that’s just fine.