The Definition of "Quality of Life"

[dmt1121]

I see over and over again that we are being faced with the choice of selecting a treatment plan that is less invasive and leads to a "higher quality of life" (i.e. you can maintain an erection and have sexual intercourse with your partner) versus one that may be more likely to cure the cancer.. Memorial Sloan Kettering is now even supplementing their treatment plans with ED meds from the outset.

It is obviously very individual, as to what constitutes "higher quality of life" for each person. However, I see that it has become virtually synonymous with maintaining one's sex life. When I was faced with the choice (age 57), I began thinking about all aspects of my life, things I had and had not done. Spending more time with my wife, grandchildren and traveling to places I have never been and always wanted to visit,as well as maintaining my sex life. In my case I decided that sex was a part of who I am but certainly did not define me or my manhood and that I was at a point where I was okay with letting that go for the other benefits I would receive.

I encourage every man facing the various treatment options for prostate cancer to really research the clinical outcomes, survival rates and duration and types of treatments. Weigh the side effects and efficacy of treatment protocols against what you would have to endure undergoing that treatment down the road to continue battling the disease.

Life is wonderful and it offers us so much to experience, no matter how old we are. Take that extra time to consider what is truly the most important to you. May we all make the right choices for what we most cherish.

[JoelT]

Bravo

Joel

[Dr_WHO]

I was diagnosed at 58 with Stage 4 D1 Ductal. I went for surgery in April of this year ( had arguments with the surgeon) as my primary treatment even though it reduced my ability to preform. Since then I have been close with my wife, if not physical, then mental.

[AlanMeyer Moderator]

I think it's a big mistake to believe that sex is impossible without an erection and vaginal penetration. As I understand it, the majority of women do not experience orgasms during intercourse. They experience them via oral or manual stimulation - best done before intercourse. Vibrators might be appreciated and, for the woman who needs vaginal penetration, there are sex toys, even vibrating ones, that can oblige. You can even find strap-ons for a more conventional experience.

As for the men, impotence generally does not imply loss of response to stimulation or inability to reach orgasm. It only means the partner has to be more creative.

I firmly believe that, in spite of the damage done by prostate cancer, sex is possible and highly satisfying.

On Lupron I had zero interest in sex and thought I couldn't possibly be aroused. However, after some weeks of no sex I thought that this was cruel to my wife and I decided to satisfy her. She seemed to enjoy it immensely and, to my great surprise, I found myself aroused by her arousal and even reached an orgasm. We committed to continuing the practice.

So, I believe that your most important sexual organ is your brain - which is not damaged at all by prostate cancer treatment.

Alan

[joetxn43 in reply to AlanMeyer]

I agree, Alan. There's other means for sure.

[dmt1121]

That's a great story and one worth everyone considering.

[joetxn43]

I agree with your assessment for "quality of life". I too miss the sex aspect but there's other benefits that offset that. In my case feeling that I'll be around for my spouse and progeny is worth more than having an erection. Alas, there are choices that every man must make and some are more pleasant than others. And the beat goes on!

[David1958]

dmt1121 your letter looks a lot like what I would have written. I agree wholeheartedly. I was 52 when diagnosed and had surgery right away (2011). I am happily undetectable in the PSA department. Guys are notorious liars when it comes to sex. Everybody claims to be insatiable sex fiends in their 50's and 60's. I have to laugh at that. I will admit that I thought old mr. reliable would be so up until the day I died. Ha! A little thing called "doubt" started entering my head as I eased into my 50's. He stopped being the reliable partner I was used to. Of course PC came along a really torpedoed the whole erection thing. You are certainly correct that sex is a brain thing. That was why doubt became such a problem. Every man who has PC has to come to grips with this. Only some get to keep doing the bump and grind. Then there is the rest of us.