Candid Confessions of a Cancer Survivor – Part One: Radical Prostatectomy – An Unnerving Experience

You consider your options very seriously when you’ve been told that you have cancer cells in that walnut sized organ, the prostate. To the average person, having prostate cancer is considered to be a matter of fact situation. “Oh, prostate cancer is one of the most easily treated cancers”, say the overly optimistic friends. With these expert’s encouraging words, it’s easy to go into self denial, but you soon realize that the medical experts don’t take it that lightly and think you should act, sooner rather than later. More serious now, you do research and learn of the ramifications that the conventional treatments may result in, including but not limited to incontinence and impotence. As scary as losing bladder control is, it’s nothing compared to the threat of impotence. So being aware that only a relatively small percent of prostate cancers will actually become aggressive (metastasize) and kill you, you feverishly start to Google for alternate, less invasive therapies. There is the holistic approach, laser treatments and HIFU, but in the end I opt for going with what I consider the most likely procedure to result in the eradication of the problem; a radical prostatectomy. My primal instincts have kicked in and survival has risen to the top, superseding even the need for sex. After having weighed the pros and cons for some time, one achieves a certain amount of peace, having finally made up one’s mind. Still there is a considerable amount of apprehension as the day approaches. Not only are they removing something situated in the lower regions, perched below the bladder and next to the large intestine (almost close enough to the back door to see daylight), but they are extricating the very essence of ones manhood.

Prior to this stage you’ve already been exposed to some fairly inhumane treatment. The urologist suspects that you have cancer due to an elevated PSA value, but he has to confirm his suspicions Px7 primal flow with a biopsy. All men over 50 have had the fun of the famed finger exam. Well that’s nothing compared to a prostate biopsy. First an ultrasound probe is inserted into the rectum to determine the size of the culprit. This is followed by a gun that shoots darts into the prostate to take samples. So when the time comes that you hear the dreaded “C” word, you kind of think, “How much worse can it be”? If you only knew what surprises lay ahead!

The first step is an appointment with a nurse navigator. I always thought this was a term pertaining to guiding a vessel through a dangerous waterway. Come to think of it, there are some analogies that could be made to the matter now under consideration. Anyway, the navigator is there to lay out the alternatives that are available to deal with the cancer cells. First there is plain old radiation therapy. Radiation is fired externally in the general region of your prostate. They’ll kill the cancer cells all right. They also kill any healthy cells surrounding the prostate. In fact, the oncologist said the area would look like a “bomb site”. Not in my opinion, a strong recommendation for the procedure. Then there is a specialized radiation treatment called Brachytherapy. Here, radiated pellets are shot through your perineum into your prostate. But this procedure only works with a small prostate. If one’s prostate is too large it must be shrunk with hormone therapy, which removes all testosterone from your system. You have to wonder if shrinking your prostate will cause collateral damage to other areas also involved in sexual function. Shrinkage notwithstanding, some other nasty side effects are obesity, lack of energy (including but not limited to lack of desire), an increase in vocal pitch and the development of the mammary glands which I believe are non functional. After hearing all this one begins to think, “How soon can I go under the knife”? But the surprises are just starting. First there’s the little problem of incontinence. Most men, you are assured, given enough time become more or less continent. The navigator moves right on, wanting to save time for a more glamorous subject; the delicate matter of impotence. Delicate for me of course, but not to the navigator who has done this a hundred times before. She, smiling radiantly, describes the procedures, should the need arise (bad choice of words) for external forces to be applied to the member in question to achieve adequate results. One is presented with two options, neither of which seems particularly appealing.

First there is the unsettling suggestion that one inject, yes, the penis, with a chemical substance that will cause an immediate response. Now that’s a titillating twist to foreplay! I doubt even sadomasochists have thought of that one. If one is too squeamish about needles in places that weren’t meant for needles you might try a vacuum pump. This involves placing the member into a chamber with a pump to create a vacuum that will draw in sufficient blood to cause an erection. I assume there will be a warning on the box that over pumping may cause permanent injury, seek medical attention immediately if… Once the desired state has been achieved a rubber ring is placed at the base to trap the blood in the engorged member. This procedure is reminiscent of that used to castrate calves on the farm by mechanically stretching a rubber ring over the testicles to cut off blood supply. Eventually the testicles shrivel up and fall off. One assumes there will also be a warning on how long it is safe to keep the rubber band on the penis. However you are given a “faint hope clause”. If the surgeon in his wisdom deems it safe to spare one, or if lucky, both nerves that run on the outside of the prostate, normal erections may occur over the course of time. This is fine for someone with the faith of an evolutionist who believes that given enough time anything can happen. Red-faced, hot and bothered, I leave. The still cheerful navigator awaits her next victim.