You and your doctor have likely discussed how sexual functioning can be adversely affected by advanced prostate cancer. For many people, discussing sexual functioning and related intimacy issues – whether with a partner or a physician – can feel uncomfortable. As a man, your sexuality may be strongly tied to your sense of masculinity, and the thought of not having full sexual feeling or ability can lead to a sense of anger, loneliness or even depression.

The Path to Communication

Studies of the impact of prostate cancer on the sexual life and emotional issues of couples have identified factors that can have a significant effect on the relationship. For instance, the level and depth of communication between a man with prostate cancer and his partner can have a strong effect on their sex life; allowing each person to talk about how they feel and brainstorming ways to enhance your sex life together may lead to increased sexual satisfaction. In fact, sometimes couples find a new path to sexual satisfaction that is different than it was previously, but may turn out to be just as good or even better.

Try to keep in mind that even if it is more difficult to achieve and sustain sexual functioning, you are still a sexual being. Sexuality includes making your partner feel good in ways that may include, but also go beyond penile penetration. For many women, hugging and cuddling are as much a part of intimacy as sexual acts. Intimacy also includes giving your sexual partner permission to explore alternate ways to make you feel good.

Try to be open to the advice or education materials your healthcare provider offers. Some of it may work and some may not, but trial and error may lead to solutions that work for you and your partner. Talk to your healthcare team about your concerns in the area of sexual intimacy.

While navigating the road of intimacy with advanced prostate cancer, please also remember to brake – and give yourself a break. You are dealing with a cancer diagnosis, deciding on or undergoing treatment, and still doing your best to carry on with your daily activities. You can assume that if you have a partner, they are also struggling with intimacy issues, and are likely very concerned about how to make you feel better while coping with their own feelings and issues.  Letting your partner take the wheel with you may lead to a more intimate life together.

Potential Impact on Sex & Intimacy

Prostate cancer is often referred to as a “couple’s disease” because it affects men and their partners. If you are in a sexual relationship with a man with advanced prostate cancer, you are in the driver’s seat with him as he navigates the challenges of sexual intimacy that frequently accompany the disease. These challenges may include:

• decreased sex drive
• trouble or inability to achieve or sustain an erections
• fatigue or loss of muscle mass

But as a sexual being yourself, you are likely experiencing a wide range of intense feelings and fears:

• How can I help my partner with his sexual functioning and feelings of masculinity?
• Will the physical side effects of his treatment have an impact of my sexual satisfaction and do I have the right to this concern in light of the serious disease he faces?

While your primary concern is likely to be for your man with advanced prostate cancer, it is important to recognize that you have a right to all of your thoughts and feelings. You are not selfish to be concerned about how your sexual relationship will be affected. In fact, these concerns can lead you to take steps that will help both of you achieve a new definition of intimacy that you find satisfactory, or perhaps even better than before.

For some people, sex is a critical part of their relationships, while for others it is pleasant but sporadic, or not very important. Whatever your and your partner’s perspective, it’s still important to recognize that many men’s sense of masculinity is closely tied to their sexual capability. Your sexual life together can have an impact on your relationship as a whole, and should be dealt with as openly and proactively as you both are able.

The Path to Communication

Studies of the impact of prostate cancer on the sexual life and emotional issues of couples have identified factors that can have a significant effect on the relationship. For instance, some studies have found that the level and depth of communication between a man with prostate cancer and their partner can have a negative or positive effect on their sex life, and that allowing each person to talk about how they feel and brainstorming ways to enhance your sex life together may lead to increased sexual satisfaction.

In fact, sometimes couples find a new path to sexual satisfaction that is different than it was previously, but may turn out to be just as good or even better. Seeking therapy – as a couple as well as individually - with a psychologist or social worker experienced in the area of sexual intimacy can also be very helpful in opening the door to communications between you and your partner.

You and your partner are taking this journey together. Issues of intimacy require more than just steering around obstacles – sometimes you’ll need to work together to remove roadblocks to redefine your sexual relationship in a way that works for you both.