When Doug was first diagnosed with prostate cancer, sex was the last thing on his mind.
Like anyone facing a cancer diagnosis, his focus was on fighting the disease and continuing his life.
It was an added blow when surgery and radiation treatment left him suffering from erectile dysfunction (ED).
It impacts one in three Australian men aged over 40 at least once a week, but is rarely talked about.
At an annual health check in 2006, Doug, then in his 50s, found he had elevated prostate-specific antigen levels.
It was soon confirmed to be “very severe” prostate cancer.
Within a month he’d had major surgery to remove the cancer, but a follow-up biopsy found some cancer cells remained.
“That was really the worst,” Doug said.
“There’s just got to be one cancer cell left and it’ll start multiplying again. And that’s what happened. I was gutted.”
Radiation therapy was able to eliminate the rest of the cancer but he was left with ED.
Going into the surgery, Doug had been told there was a good chance he’d suffer from the condition afterwards.
But he was determined not to let that stop him.
“I wasn’t giving up sex at that age, that’s for sure.”
A tough issue to talk about
Urologist Devang Desai said ED was part of a “trifecta” when it came to treating prostate cancer.
“Foremost is obviously curing someone of their cancer, but second is incontinence and third is erectile dysfunction,” Dr Desai said.
“I think the functional outcomes eventually are just as important as their cancer outcomes are.”
It’s not just men undergoing prostate surgery who can be impacted — men with diabetes, heart and blood vessel disorders, high blood pressure and high cholesterol can also suffer from ED.
It can be damaging not just to an individual’s mental health and confidence but for their partner too.
“I think intimacy is very important in a relationship and for men who undergo prostate cancer, that’s not the first thing on their mind,” Dr Desai said.
“But to be a cancer survivor and then lose intimacy in a relationship, it makes you feel incomplete, depressed and unhappy.”
New research from the Prostate Cancer Foundation has found 64 per cent of Queensland men who have experienced ED felt the condition robbed them of intimacy with their partner and 40 per cent said it strained their relationship.
Doug joined a support group as soon as he got the diagnosis and said it was one of the best decisions he ever made.
“You turn up and go, ‘I’m the new boy, can you help me?’ and of course they all crowd around and want to give you their version,” he said.
“Hearing from other men who’ve been through similar experiences gave me the strength to keep going.”
Dr Desai said it was important for men to talk about, especially in the wake of a life-changing cancer diagnosis.
“When you drop the word cancer, everyone stops listening after that,” he said.
For some, it might be years down the line before they return to their doctor to talk about ED.
Finding help
There’s a range of options for men suffering from ED and Doug started with the easiest and most accessible — Viagra.
When that didn’t work it was on to injections.
“It’s as bad as what it sounds but I’m a great believer in trying things,” Doug said.
“It worked but it’s very dramatic to have to put an injection into your penis, and if you get it wrong then it’s painful and it doesn’t work.”
Eventually he heard through a friend, who had also suffered from prostate cancer and ED, about penile implants.
Dr Desai said it was an option patients were often initially reluctant to choose because it required surgery – a confronting decision for someone who may have already undergone major surgery for prostate cancer.
“It’s a very amazing piece of equipment. You’ve got the inflatable cylinders [in the penis] that are attached to a pump in the scrotum, then a reservoir which is placed inside the abdomen.”
For Doug, it was life-changing.
“You just reach down and there’s a little pump there. You just pump it up and then when you’re finished you just push the valve and it deflates. It was fabulous.”
Unfortunately, his cancer returned in 2016.
He was able to manage it with hormone injections and said at 73, he was thankful to be alive and happy.
“I said to my wife, if I fell off the perch tomorrow it would be with a smile on my face because I’ve had a life that far exceeds anything I could have imagined when I was young,” he said.
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