Every week, New York Times editor Dana Jennings shares his experiences coping with prostate cancer.
Dana Jennings. (Lonnie Schlein/The New York Times)Well, I can’t say I wasn’t warned. Eight months after learning that I had prostate cancer, my sex drive has vanished into a drug-induced limbo.
As recently as two weeks ago, my libido hadn’t yet checked out. But since then, hormone injections — like the oncologist’s elves — have kept doing their job, which is to suppress testosterone. No testosterone, no sex drive, and, my doctors and I hope, eventually no prostate cancer.
But even with the promise of being cured, the physical changes in my sex life and, more shockingly, my recent loss of interest in sex, are among the most difficult aspects of having prostate cancer — not just for me, but for my wife, too. Men often don’t want to talk about these changes, as if words and impotence couldn’t possibly coexist.
Prostate Cancer Journal
One Man’s Story
Dana Jennings blogs about his experience with prostate cancer.
But we men need to talk about it. Silence is the enemy when it comes to any disease. If we can talk about it, it will help us, help our spouses and help those who come after us.
Before surgery for prostate cancer, my sex life was like that of any other healthy 51-year-old man. But prostate cancer would change all that. My doctors told me that after surgery, attaining an erection might be difficult at first. And they told me that the hormone injections and radiation that came after could take a further toll on my sex life.
In the first few weeks after my surgery, though, I found myself so improbably and surprisingly aroused, even more than usual, that my teeth hurt. I had my first orgasm about three weeks post-op. But it arrived with two significant shocks: there was no erection, and it was dry.
Now, my surgeon might have told me about the “dry orgasm” before my surgery, but I sure don’t recall the subject being mentioned. And I don’t believe that the post-op literature dwells on it too much. Maybe I’m just not a good listener. While I knew that sex could be challenging after surgery, it never occurred to me that the prostate gland and seminal vesicles that are removed are the organs that produce ejaculatory fluid. After surgery, orgasm is still possible, but nothing comes out.
Those first post-op orgasms were reasonably intense (and they hurt my still tender incision a bit). Even after surgery, my interest in sex didn’t wane. But a hormone treatment called Lupron has ruthlessly slammed on the brakes. The first sign that the Lupron was doing its job was a decline in the intensity of orgasm. My last one was a faint ripple, a pebble flipped into a pond. With Lupron, first the orgasms diminish, then the lust.
Don’t misunderstand. I still find women attractive, especially my wife, and I still like the idea of sex. But there’s a keen sense of detachment as my testosterone level plummets, as my blood doesn’t rush and eddy toward the appropriate whorls and whirlpools. It’s as if I can only hear an echo of the carnal creature I once was.
But, if there’s one thing you learn from prostate cancer, sexuality is not sex, a fine point that our over-sexed mass culture has managed to blur, if not obliterate. I still want to hold my wife’s hand and snuggle. And I’d be only too happy to carry her books home from school.
So, whether you’re in the wistful grip of Lupron, or the throes of desire, I’ve realized that how well you cope with the after-effects of prostate cancer treatment boils down to how you want to define yourself as a man.
If you’re the kind of strutting rooster who grades himself solely on muscle mass, sexual gymnastics and the size of your Hummer, prostate cancer will send you spiraling into deep despair. If you treat this disease like a war, you’ll find yourself in a quagmire of depression that will get worse before it gets better.
As much as I savor, and ache for, the robust life — having once been as fit, randy and Guinness-loving as any rugby player — prostate cancer and its treatment have imposed on me a certain necessary asceticism.
I’m more content to cocoon at home — curled up on the couch in the den like a woolly-bear caterpillar — with family, good friends, books and music. I drink less. And now, sex is temporarily fading. It often feels as if I’m somehow being purified in a crucible of cancer.
That said, the mind still pants and leers, says, “Yeah, sex would be really, really nice.” But with less testosterone, without that hopped-up, hormone-injected V8 engine, the body gets distracted. Then the mind wanders. And instead of sex, I suddenly crave a Reese’s peanut butter cup, or pine to listen to the jazz trumpeter Lee Morgan slow-blues his way through “I Remember Clifford.” Or I want to watch Daffy Duck and Porky Pig lisp, stutter and sputter through “Duck Dodgers in the 24-1/2th Century.”
So, yeah, my libido has pretty much run away from home. But my doctors tell me that it’ll ramble back some old day — the prodigal libido — once treatment ends. And I trust them.
Meanwhile, wherever my sex drive has gotten to, I hope it’s having a damned good time.
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