It is a fact that a diagnosis of prostate cancer doesn’t just affect the patient, but also his partner. The first wave of emotional impact will likely consist of shock, worry, fear for the future, and confused decision-making. Troubling feelings may have an impact on the couple’s love life during the research and decision-making period, as will the fatigue that accompanies the first steps on the road to recovery. What happens to those feelings once treatment has occurred, especially if there are sexual side effects?
A new study from the University of Michigan focused on radical prostatectomy (RP) patients to learn about a particularly intense emotional aspect of the journey: regaining sexual intimacy after treatment[i]. Twenty couples participated in semi-structured interviews before radical prostatectomy (RP) and three months after. The men’s and the women’s sexual function were assessed separately, and questions about their emotional experience were part of the interviews.
Not all of the couples were equally sexually active (30% of men had ED and 84% of partners were postmenopausal). However, they all valued sexual recover and were concerned about treatment side effects. Most of them overestimated erectile recovery, and lost confidence because of the post-RP sexual dysfunction. Their intimacy decreased. According to the study, “Couples reported feeling loss and grief: cancer diagnosis was the first loss, followed by surgery-related sexual losses.” Part of overcoming the disappointment was learning to schedule sex, use erectile aids, and deal with each other’s lack of interest. In a very real sense, they had to work consciously at sex in order to once again enjoy unselfconscious intimacy. The authors recommend that pre-RP patient education include the effects of nerve damage, and address feelings of grief and mourning in sexual recovery.
Not every prostate cancer patient will be a candidate for focal treatment, and not all focal treatments will be able to assure immediate or even long-term return to baseline sexual function. Focal laser ablation (FLA) is incredibly promising with regard to preserving erectile function. Despite the lack of long-term data regarding efficacy against cancer, even the short-term studies indicate that for upwards of 95% of patients, FLA has no effect on their potency—and if it does, return to baseline will occur within a few months at most.
At our Center, we understand that not just the patient, but also his partner are going through a scary time. All the more reason to turn to each other to express love at every level, including physical love. We are grateful that FLA allows that all-important aspect of their relationship to flourish through all stages of a journey that both members of the couple share.
[i] Wittmann D, Carolan M, Given B et al. What couples say about their recovery of sexual intimacy after prostatectomy: Toward the development of a conceptual model of couples’ sexual recovery after surgery for prostate cancer. J Sex Med. 2014 Oct 31.