Men don’t talk much about their prostate problems. Knees? No such reluctance: “Yeah, the right knee’s been playing up. Might have to skip golf this weekend.” Shoulders? Not a problem: “Mate I dislocated it playing footy 30 years ago. It still pops out every now and then.”
Even at the risk of possible sexual innuendo, men can talk about an injury: “My wrist is killing me.”
“Overuse, mate?”
But when it comes to something amiss with our prostate, which becomes more likely as we age, we clam up. Why is that?
The most likely reason in most cases is that if the problem is serious, the prostate may require surgery. That, in itself, is not an issue for men. “Check out the size of my scar!”
It’s what may happen after surgery that prompts men to clam up. That’s the potential loss of sexual function. While society no longer expects half of the adult population to be alpha males, many men, even those over 50, link sexual performance to their identity as a ‘real man’.
Around 70 per cent of men lose sexual function after prostate surgery, with erectile dysfunction the key contributor. And of those 70 per cent, I’d wager 95 per cent would not be raising the issue with their mates at the pub.
What, then, can be done to resolve this sensitive issue?
Declaring a prostate of disaster
This reluctance to discuss prostate issues can cause problems long before any sexual dysfunction comes to pass. There’s a poignant irony to this. By broaching the subject at an early stage, you’ll actually reduce the chances of ever suffering from that dysfunction.
That’s because a discussion with mates will probably encourage you to chat to your GP. If you open the line of communication to medical experts early enough, your prognosis is likely very good.
And with a new medical advance being trialled here in Australia, the prognosis will be better still.
The advance comes in the form of a device that’s the size of a thumbnail. This little piece of technology is placed in patients at the time of their prostate removal operation. Once that’s done, it will – in theory at least – regenerate damaged nerves. It is damage done to these nerves during prostate surgery that can result in erectile dysfunction.
According to Royal Melbourne Hospital urological surgeon Philip Dundee, it’s the proximity of these nerves to the prostate that causes trouble. “They run so close to the prostate,” he said. “Sometimes … we have to sacrifice some of those nerves in order to ensure that we get all of the cancer out.”
How hard it can it be?
But the new device could help minimise the impact of such an invasive procedure. And although the trial is at an early stage, the results are very promising. The Herald Sun last week reported that two men have successfully undergone surgery at Royal Melbourne Hospital, both retaining sexual function.
Further trials are about to begin. If successful, those trials could open the way for prostate surgery to be successful in two ways. It could save a life, save a sexual life and save many men from psychological distress.
And that distress is very real. “The psychological impact of sexual dysfunction is devastating to a lot of men,” says Australian Prostate Centre nurse Michael Cromer.
If the new technology proves successful, men will no longer find it so hard to get hard after surgery.
Have you had prostate issues? Were you able to bring yourself to discuss them with friends? Or even your GP? Let us know via the comments section below.
Also read: Older women and sexuality – the times are changing
Many men need assistance to help them to be better informed prior to any prostate cancer decision making.
When I was diagnosed with prostate cancer eight years ago at 66 I was given the choice of surgery or radiation therapy. The urologist told me I would lose one of the two major nerves responsible for getting an erection with surgery leaving me about a 30% chance of remaining potent. I didn’t like those odds so chose radiation therapy as Cairns Hospital where it was done had the latest high tech equipment installed and an excellent radiation therapy annex.
All went well and seven years after treatment at 74 I remain tumour free. But I also regained a little prostate function about a year after surgery and am potent although it’s not as easy as it used to be or gets as hard.
I had my prostate removed in April this year after a biopsy showed it was the highest level grade 5 cancer, meaning it was very aggressive and malignant. I discussed options with the specialist and surgeon and told them, and my family and friends, that they only had one job to do. That was to keep me alive, as I am not ready to leave earth yet, and save the erectile nerves.
Alas, some of the nerve could not be saved as some was stuck to the side of the prostate, possibly as a result of the biopsy.
After an initial blood test 6 weeks after surgery I had more PSA blood tests 4 months later that showed that there is still prostate cancer in the body. A PSMA scan did not show any specific area so it was determined to do a 6 week and 3 days radiation treatment in the prostate bed and areas up to the pelvis area.
This will finish in early January and will need to have have further PSA blood tests over a long period of time (some years) before really knowing if it was successful.
It is likely after recovery from surgery and radiation that I will not regain an erection until quite some time and maybe never. Options discussed are the blue or yellow pills, penis pump, injections into the penis or an implanted device.
I have been open with the medical fraternity, family and friends and that has been welcomed. Nothing is taboo as far as I am concerned, as it means that I am getting the best advice from the experts and family and friends aren’t second guessing what is or isn’t happening.
Error. The prostate was removed in late March
two years ago I was diagnosed with prostate cancer, but had the great good fortune of being referred to a urologist who was involved in a pilot program for laser focal therapy. It involves robotic surgery using a laser that is extremely accurate and does not damage anything except the cancer cells. Two years on and the latest MRI and PSA tests confirm that the cancer is completely gone and, best of all, ZERO side effects, none, nada, zilch:-) I was so lucky to get into the pilot which, unfortunately, has now finished. My doctor told me that the technique is going through the process to be authorised by the TGA but can still be obtained but unfortunately until it gets TGA approval is not subsidised by medicare. Given the case studies I had read of men who did chemo or traditional surgery I know what I would do. But you have to be diagnosed in the early stage for it to be viable. My doctor said people are lining up for it because of the lack of side effects.
My paternal grandfather died, very badly, as the result of Prostate Cancer in 1961, aged 69. He couldn’t get enough analgesics to keep him comfortable at the end because of the medical profession’s fear in those days that he might become addicted. As my father said to his doctor, “What does it matter if he gets addicted? We can sort that out if he survives.”
Years later, my father got Prostate Cancer, but because of his father’s experience, Dad had regular checks so he eventually died (at age 92 from Pneumonia after a fall) with Prostate Cancer, not because of it.
Men should no longer be dying from Prostate Cancer. It can easily be detected early enough to be successfully treated, as it was for my father.
I have been having a simple Prostate Specific Antigen (PSA) blood test every year since I was 50. Levels under 4 ng/ml are considered normal, although it can be possible to have Cancer with a lower level. My level started at 1.25 and has crept up to 2.7 in my mid-60s.
I’m having some typical prostate symptoms such as sudden urges and night time frequency, so my doctor referred me to a Urologist who prescribed an Alpha Blocker. This is easing the problem for now, but the time will eventually come when I will need a TransUrethra Resection of Prostate (TURP), sometimes jokingly referred to as a ‘rebore’. I am guessing that this is the procedure that King Charles has recently had. He has been an excellent role model by encouraging International public discussion about this issue.
Two of my 3 older brothers have had at a TURP, and one of them found he had some Cancer, but it won’t kill him because it was found early enough to treat. Both of them have had their urine frequency and urge problems completely resolved.
There is nothing to be frightened of by regular health checks and early treatment. There is plenty to be frightened of if we don’t!