Shock diagnosis of prostate cancer

It's every couple's nightmare: your loved one has finally got over it and is tortured into going to the doctor - and is diagnosed with prostate cancer. With 64,000 new cases every year, it is the most common cancer in men in Germany. However, in its early stages, this cancer does not even cause symptoms that a man could ignore. For this reason, and because cancer is best cured the earlier it is detected, doctors recommend regular annual examinations. And as long as the cancer is limited to the prostate gland, as the prostate is also known, the chances of survival are very good. However, the problem tends to affect older men with an average age of 69. Average means that some are affected earlier and others later. But sexuality also plays a major role in people's lives at an older age and so the question probably arises quite quickly as to whether a love life is still possible at all even in the worst case scenario of radical prostate removal. Yes, it is, even if in many cases this means a rethink in the mind.

What happens after a prostatectomy?

Let's assume a radical prostatectomy. If the cancer has not yet spread beyond the prostate, the nerve tracts necessary for an erection can be preserved under certain circumstances. This should definitely be discussed with the operating doctor! Because then an erection may still be possible. However, you have to be patient until the nerves have regenerated after the operation. And this can take a few months. During this time, you should definitely practice vigorously. Because once a penis has been inactive for a while, the erectile tissue is gradually broken down. This also applies to all older men who are not affected. Practice makes perfect, whether alone or as a couple. You can discuss with a sexual health professional which method is most suitable, be it erectile tissue injections, penis pumps or PDE-5 inhibitors such as Cialis, Levitra orViagra.

Couples should not forget that erectile function slowly declines with increasing age anyway. So if you expect to respond to every arousal with a firm erection, you have unrealistic expectations and are putting yourself under unnecessary pressure to succeed. Well done, well done, I say. And of course, not everything is the same after an operation. Because without a prostate, there is no more ejaculation. Both partners have to get used to this as well. Orgasm, on the other hand, is usually still possible, but in some men it is weaker. In the months following the operation, it can happen that a man loses urine uncontrollably. Understandably, this causes uncertainty on both sides. Unfortunately, this can also lead to a loss of desire. These are all small but significant vicious circles that need to be broken.

Rethinking the mind: how do we want to experience sexuality?

Now we have to ask ourselves what sex means to the individual. If the focus is on penetration and orgasm, serious problems certainly arise. But sex is not the same as sexual intercourse. There are many other ways to satisfy a man or woman and, above all, to make love physically. It also becomes difficult when a man's self-esteem depends on whether he has an erection and how strong it is. Sex that only consists of male imposing behavior can quickly become boring and dull. This is often the reason for a woman's lack of sexual desire. In addition to the pleasure and reproductive dimension, sexuality also has a relationship dimension. Sex is not just about physical satisfaction and proving yourself. Through sex, we convey feelings of acceptance, closeness, safety, intimacy and security to our partner. In older people's relationships, priorities usually shift in this direction anyway and tenderness takes on a higher priority. However, we always want what we don't (or can't) have - in this case a nice erection with a liberating ejaculation.

If sex has been going in an undesirable direction for years anyway, now is the right time to rethink: get out of the old patterns of behavior and onto new paths - together! An erection doesn't make a man and most women are delighted to receive oral and manual attention. Talking isn't everything, but it's okay to talk about how your sexuality should be in the future. This relieves pressure on both sides.

Regular examinations are a preventative measure

Finally, the most important thing is very clear: if a carcinoma is detected in good time and is limited to the prostate, almost all men survive this disease. And I would also like to take this opportunity to point out that not every complaint equals cancer. On the contrary, around 40% of men complain of symptoms requiring treatment that can be attributed to benign enlargement of the prostate - benign prostate syndrome (BPS): Problems urinating, weakened urinary stream, urinary stuttering, night-time dribbling, frequent strong urge to urinate at night and more. And this can be treated well. So if you have a partner who complains about symptoms or generally doesn't like going to the doctor, you should take their concerns seriously and support them as much as possible.

Anja Drews - sexologist for ORION