Many couples struggle with sexual problems following treatment for prostate cancer. We interviewed Rhonda Fine, PhD, ARNP, MSN, Board Certified Clinical Sex Therapist with The Krongrad Institute, and Diplomate of the American Academy of Clinical Sexologists. Here are her helpful insights.
What emotions do men experience with prostate cancer, even before sexual problems occur?
“No one is ever prepared for the diagnosis of cancer. The diagnosis of prostate cancer is especially agonizing. There is a vast array of emotions that come into play. Extreme sadness, fear and grief are at the core.
Mortality issues surface. There is a feeling of isolation, loss of control, and aloneness. Sometimes there is guilt. There is an anxiety that wraps itself around the future. Will I survive? What will become of my family? Relationship? Children? Career? My financial status? Social status, etc.
There is anger and disbelief. Some men experience post-traumatic stress disorder. Others may drift into depression.”
How does a man’s perception of his “sexuality” further impact his mindset?
“A man’s perception of what it means to be a man impacts every aspect of his life, including his ability to deal with the diagnosis and treatment of prostate cancer.
Sexuality is very complicated as it is enmeshed within a man’s self-esteem and identity. The fear of being permanently impotent from treatment is overwhelming.”
What can wives/partners do to support their men?
“Men’s partners play a significant role in regards to their partner’s treatment and its successful outcomes. But support emotionally, physically and socially for the couple is paramount through diagnosis, treatment and the recovery process.
Supporting a man’s partner is as important as teaching them how to be supportive. Partners must first acknowledge their own feelings of grief, loss, fear and apprehension as it relates to their partner’s diagnosis.
The integrity of a couple’s relationship before prostate cancer is a key indicator of how the couple will deal with the impact of cancer. What level of intimacy did the couple have before cancer? How important was sex? How did the couple function sexually before? What are their individual and shared values, beliefs and concerns? Do they communicate effectively? Do they problem-solve successfully? These are but a few of the indicators.”
How can couples improve communication?
“Silence is a powerful enemy. Good communication enables one the freedom to share their feelings, fears and emotions. It eliminates mind reading.
Intimacy cannot exist without effective communication. Intimacy is a quality of life issue. It is the soul of one’s relationship. It’s about a profound devotion, which fosters feelings of being connected to something larger than oneself. It gives one a sense of security. It is intimacy, which will nourish the relationship during stressful times.
Intimacy gives the relationship the quality of togetherness and camaraderie. Acceptance and validation by one’s partner fosters that feeling of “being alive.”
Some men completely shut down when sexual problems arise. Why does that happen?
“Sexuality is a creative energy. A serious illness can zap this energy.
Unexpressed feelings can contribute to a quiet helplessness for both partners. Typically the man is dealing with survival, mortality, depression, anxiety, fatigue, fear, pain, loss of sensation, self-esteem and body image issues, a fear of not being able to perform or that their partner does not find them attractive any more.
In addition, the side effects of the treatments and medications wreak havoc with desire and one’s ability to function.
This is more than some can endure without professional support, education and help. Nothing dulls desire like depression. Fear leads to protective behavior that creates a cycle of avoidance and alienation, as men avoid engaging in behaviors that remind them of what they lost, such as hand holding and hugging. This diminishes their partner and strains the relationship.”
How can couples overcome sexual problems?
“It has been my experience that sexual education and counseling is essential to the healing process as it allows patients and their partners the ability to identify, plan for, address possible potential problems and have realistic expectations.
It allows for the couple to establish a therapeutic relationship with a professional that will be supportive and guide them through the process.
This is a time when a couple may face the reality, if they haven’t already, that sex will be forever changing throughout their lives. That sex doesn’t and shouldn’t return to the time before marriage, before children or before illness. It’s not supposed to. Sex and intimacy are supposed to evolve and improve.
This is the time for a couple to reaffirm the importance their relationship and their commitment. To reassess their definition of sex and intimacy. To become educated and allow their professionals to help them.”
Hisprostatecancer thanks Rhonda Fine for taking the time to share her insights about sexual problems after prostate cancer. Hear more from her in the video below.