Depression

[Skip66]

I am 55 my ex and I separated before I was diagnosed with prostate cancer. I moved back to Phoenix and started my life here...I was diagnosed with prostate cancer in December of 2020 and had the RP in August of 2021. I've been dealing with the incontinence issue for now and haven't really addressed the ED. I've been taking the 5mg cialis my Dr prescribed daily at night...As I start to navigate this new uncharted waters I've been dealing with alot of emotions as is this my new life and is there a sex life after this...Has anyone else dealt with this?

[Tall_Allen]

The prospect of losing my prostate (I decided to have SBRT) and my partner at the same time is what sent me into psychotherapy - maybe the only thing I'm grateful to him for. I learned to practice Mindfulness, which continues to hold me on an even keel.

The Cialis may be interfering with your continence. Some urologists are now only advocating its use "on demand" until continence is recovered. Maybe email this link to your urologist:

ncbi.nlm.nih.gov/pmc/articl...

You should be doing a lot more than just Cialis to recover erectile function. Penile rehab can also reduce size loss. I recommend this book:

amazon.com/Saving-Your-Sex-...

[Skip66 in reply to Tall_Allen]

Thank you Sir, I am going to check out the book. I ordered it on my kindle and will start reading it. Looks like it has some good reviews on it...I figure it will be good insight on my new journey.

[anon71 in reply to Tall_Allen]

TA,Hope you are well and thank you for sharing your knowledge and experiences of PCa. Forgive me if I have not reached you directly but inserted myself in someone else's email chain. I didn't know how to contact you other than "reply to Tall_Allen"

I would appreciate your guidance/advice. About a year ago (72 y/o) I had PSA 4.99 and a biopsy revealed a small cancer in one core and indeterminable results in 4 cores but "likely cancerous". Reported as GL 6 (3+3). Urologist recommended SBRT which I did not pursue because the biopsy results did not seem definitive.

Subsequently I went to another urologic oncologist who told me the cancer in the biopsy was not an aggressive type and he believed AS was appropriate. 6 months later my PSA was 5.50 and after one year it was PSA 6.2 Last week I had an MRI guided biopsy that showed another "tiny" cancer spot (GL 3) along side the one found a year ago (GL 1). Reported as

GL 7 (4+3), Stage 1.

The doctor said I should consider treatment: surgery, radiation (SBRT), focal therapy (what is that? Is this enough information that you could make a recommendation? Please let me know your thoughts how I should proceed.

Thanks again.

With kindest and best regards,

[dadzone43]

Nearly all of us, I would guess. Not all of us have the courage to raise the questions, though. There are a lot of videos, lectures, etc. on this topic and on what you can do to regain sex drive and sex pleasure. Also a frequent topic in my support group. Skip don't struggle alone; join a group.

[EdinBmore]

My docs were next to worthless when it came to sexual issues. In this day and age, I was rather surprised. Be that as it may, I was lucky enough to find a study - which was advertised here - that dealt with sexual issues relating to gay men with prostate cancer. The study was conducted by U of MN. I don't know if they have published their results yet but you may be able to google it and avail yourself of some of its contents. The name of the study was Restore. It provided all kinds of info related to sex - from trying to bottom again, to maintaining an erection, to dealing with dribbling/leakage during sex...and all of the emotional and psychological components.

The study provided sildenifil (their recommended dosage was 3 times a wk, 60mg each dose. I have no idea if this is supported by any research data but I "went with it") and a penis pump (which my docs seemed uncomfortable talking about). It takes getting use to but it works - helps to keep the blood flowing to your penis and helps with combating genital shrinkage, common side effect of RP and ADT. The study provided a pump manufactured by NuPath. You may want to check it out.

Good luck to you. I think you'll find great support and info here. Tall Allan is a treasure of up to date information in layman's terms.

EdinBaltimore

[jimreilly]

Yes, many of us have, and suppose there are almost as many ways of dealing with it as there are of us. I had significant incontinence issues after RP and eventually had to have male sling surgery (other strategies didn't bring enough relief). As far as ED, recovery of what functioning I have took a while including a setback for the male sling surgery. Always having been "versatile" I no longer am in any really useful way, but Viagra helps me more than Cialis (worth trying them both to see which works better for you). I too was depressed by this all (and had several other surgeries besides--kidney cancer, macular holes in each yes, and more since). And I too had broken up with my partner a while before. Eventually, like others, I had some therapy, which helped, but it took me a few years to have the "breathing space" to take on therapy, too. For each of us these kind of health issues can exacerbate previously existing emotional issues we may have, but even if we"re "perfect" emotionally before (lol) this can be hard enough to warrant help. For several years I had no sexual relations with anyone and finally (the therapy helped) I started getting out there again. I also started a low dose of an anti-depressant (bupropion, which does not interfere with sexual functioning--there's been enough interference!). I was about ten years older than you when it all started, and now, at 77, not too many people are interested, but I do lead a rich life --not retired--love my work, with good friends, including new friends (when your old ones are dying and going into nursing homes you'd better make some new ones, travel (until Covid--damn Covid, anyway), a few boyfriends--living on memories alone is not satisfactory, at least at this point). I wouldn't wish all this on anyone but yes, emotional health and sexual life are possible afterwards.

[SpenceNYC]

Yes, and I am glad that you are talking about this. Before and after my RD I attended a few information groups for gay men with prostate cancer and found some of the strident, macho "I am handling this" talk false, intimidating, and certainly avoidant. I eventually stopped going and am still seeing a therapist. Wishing you all the best. It can be difficult.

[Survivor2310]

Hi I am 55 from France

My English is perhaps not as good as I would like but I guess I could make you understand me.

I had surgery last July after one year of active surveillance.

I wish I could keep on that « treatment » but unfortunately my cancer became more agressive.

So we both with my surgeon decided to make RP.

I just would like to testimony that things can be really positive after surgery.

I don’t know if I am only very lucky or I had a good doctor but I dit not have any incontinence issue nor erecting problems.

I already recovered dry orgasms and they sound very similar to the late ones.

And after 7 weeks I found again a lot of pleasure bottoming with my partner.

Probably being bottom helps me and moreover the understanding and the love of my boyfriend make the things easier.

I use cialis once a day and my dick size remains the same.

I would like to encourage you not to give up and to just realize that we all have been ill.

For sure not seeing any difference (except cuming of course) between before and after helps me so much but as I always said between dying or having sex it’s obvious that we have to choose life.