Men need to talk about prostate cancer and its effects

Strong and silent is a good way to miss a better outcome

By Bonnie Miller Rubin, Chicago Tribune reporter

October 17, 2012


Treatment for certain cancers can affect your sex life, causing a range of symptoms that can make sex with your partner more difficult — or nonexistent. But that doesn't mean you can't have a healthy sex life, says Jeffrey Albaugh, a urology clinical nurse specialist who runs the new Ross Clinic for Sexual Health at NorthShore Glenbrook Hospital, which treats both male and female sexual dysfunction.

Albaugh, who has been addressing sexual health for more than 25 years, has just published a book, "Reclaiming Sex & Intimacy After Prostate Cancer: A Guide for Men and Their Partners." It's a subject many people find awkward to talk about, but Albaugh is eager to start the conversation.

Q. Why write about sexual side effects, when there are so many other concerns with cancer?

A. Because prostate cancer is the number one cancer for men ... and sexual dysfunction is the most common side effect. It's the big white elephant in the room. Over the years, after working with thousands of men and their partners, I kept hearing how desperately this information is needed.

Q. Are men not well informed about prostate cancer and side effects?

A. Women are incredible advocates for health. Look what they've done with breast cancer ... they will not stop when it comes to health issues. They're the ones who'll ask their partners, "Have you had all your screenings?" But men like to minimize things. ... We tell ourselves "If I don't think about it, it doesn't exist." It's the male mantra.

Q. Why do you think there's such a big difference between the genders when it comes to confronting health?

A. First, because men just aren't as health conscious and second, because these are very private issues. No man wants to hear the words "digital rectal exam."

Q. What are the most common prostate cancer interventions?

A. Prostate cancer is most commonly treated with radiation, surgical removal of the prostate gland or androgen deprivation therapy. Prostate cancer needs male hormones (testosterone) in order to survive. Hormone therapy decreases the amount of testosterone, which can make the tumors shrink. Whatever the treatment, there are side effects — sexual, along with urinary and bladder issues. Now this part of the body is no longer functioning ... and can be devastating.

Q. If a patient is going through cancer treatment — and may be dealing with other side effects, such as nausea and fatigue — is it reasonable to ask someone to be amorous, as well?

A. It's not just about sex. ... It's about intimacy and connection.

Q. What else can cause sexual dysfunction?

A. Besides cancer, it can be heart disease, high cholesterol, diabetes. ... These are all diseases that affect blood flow and nerve conduction, which sexual function is dependent on.

Q. A lot of these other conditions you mentioned are part of aging. Isn't a decrease of sexual activity just a normal part of the aging process?

A. It doesn't have to be. People are living longer and here you've had this life partner that you've been with for years and you don't have this connection anymore? It's a quality of life issue. So, you've got to start talking. And once again, it's usually women who initiate the conversation.

Q. So, how would you bring it up?

A. I'd just start with something like 'Maybe you're scared to touch me ... can we talk?' Maybe he'll say 'I'm afraid to hug you because I don't want you to think we can have sex.' He may not know that there's help out there ... but just talking about it will make things better for both of you. It will reduce anxiety and strengthen that connectedness.