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Page 1 of 2  One of the critical things we consider after doctors tell we have prostate cancer is how will the various treatments affect our quality of life, especially our sexual function.
Various degrees of impotency are side effects of virtually any kind of treatment for prostate cancer, but like my mother—God rest her soul—said, “Impotency can’t kill you, prostate cancer can.” Her father, by the way, died of prostate cancer. Here’s the problem: the prostate rests in a bed of nerves that control urinary and sexual functions, so the surgeon must navigate gingerly around those critical spots to pluck out the prostate. As in the words of the Wicked Witch of the West, these things must be done delicately.
Some years ago, surgeons cut those nerves, but now use “nerve-sparing surgery” that attempts to preserve as much of a man’s sexual prowess as possible. Still, thank God for Viagra and its competitors, and other treatments for erectile dysfunction. As for external or internal radiation, the radiologist must aim the beams or place the radioactive seeds in the exact spots of the cancer and avoid those nerves. Still, it doesn’t take a rocket scientist to realize that those nerves very easily could get zapped. Going under the knife The thought of facing a life of impotency, especially if you’ve enjoyed a good sex life, sends shutters up the spines of men who face prostate cancer. That’s all my friend, Joe, could ask about when he faced a potential battle with prostate cancer and called me frantically asking for advice. “Can you still do it?” Joe asked, haltingly, referring to . . . well, you know. I’ll only divulge what I told him after a few beers. But sexual function after surgery—called a radical prostatectomy—had little effect on men's feelings about choosing to go under the knife, researchers at the University of British Columbia say. According to Joyce Davison’s findings, 77 percent of the men in her study reported having moderate to severe erectile dysfunction one year after surgery. Although their sex drive didn’t decrease, they did feel less masculine, were less sexually active, didn’t enjoy sex as much, and were more uncomfortable being sexually intimate, among other problems. However, only 4 percent of them regretted their decision to pick surgery over other treatments. I wonder if any of them thought the same thing that went through my mind five years ago when I picked surgery: Any treatment other than surgery would leave the organ that went cancerous in my body—and could I live with that knowledge? Now that is a dilly of a question.
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