Prostate cancer is the most common type of cancer in men. Every year this diagnosis is made about 900 thousand times, in developed countries the disease affects up to 14% of the entire male population with oncology due to longer life expectancy. We spoke with adult prostate cancer survivors.
Mike, Florida, 72 years old, engineer
Mike says that everything was in order before the diagnosis: he went fishing, hunting, doing his own business, he could not even think about cancer. True, twenty years ago he already had problems with his prostate: “I probably caught a cold while fishing while standing in the river.” Then it worked out with a short medical treatment, and he forgot about everything. A few years ago, his relatives “reminded” him to go to the hospital and take tests. Mike’s daughter took full responsibility: she found a hospital, a doctor, and paid for everything, says Mike. She decided to send her father for a physical examination, as she understood that prostate cancer is dangerous for every adult man. At first, Mike postponed the date of the consultation, saying that nothing hurts, which means that he didn’t need to take any tests, but the family insisted on it. Then there were a series of studies, an increased test result for a prostate specific antigen (PSA), a biopsy and a diagnosis at a doctor’s appointment, where almost the whole family was present.
“I didn’t have any emotions at that moment. I understood: even if you have cancer, you can live five years. Rather, they were worried about everything around,” he says. Mike was diagnosed with cancer at an early stage, urologists usually explain that radical treatment is not required in this case, but Mike’s relatives persuaded him to undergo surgery. And he did not argue. He did not worry and was not afraid: “What is there to be afraid of? Nothing hurt.” Nothing hurts even now, but prostatectomy is a complicated surgery and has its own costs.
Four years passed after the surgery, three of them he wore diapers, it was difficult to get along with the new circumstances. But he still went for fishing, work, shopping.
Mike notes the huge discomfort of wearing diapers, rather than shame or embarrassment: I always had several spare diapers with you as I may need to change them at work or while fishing. “But you get used to everything,” Mike says. But sometimes there was a benefit: he recalls with a laugh how he stood in the middle of the river in a high rubber suit, a fishing rod in his hands and wearing a diaper is convenient, you don’t need to get out of the water.
Over the past six months, he has refused such underwear, but sometimes it is difficult on long car trips or traffic jams, so Mike tries to guess the time without traffic on the roads. At the same time, his doctor promised that involuntary urination would disappear six months after the surgery.
Mike’s “potency vanished”, he was not warned about this. “Everything was normal before that, now everything is not normal. Nothing at all. “I lost one of the most vital organs,” he says, embarrassed.
He had a hard time getting used to impotence. “I read literature, examined anatomical pictures, but in the, end I put up with the fact that it would not be possible to restore potency. Mike is reluctant to share this.
After the surgery, the man completely stopped thinking about cancer. “I live a normal life: go fishing and hunting. Like I used to.”
Victor, Nebraska, 63 years old, teacher
Victor was diagnosed with prostate cancer at the age of 57. The results of the PSA test showed an increase in the norm at one of the annual physical examinations. For several years, Victor was observed by a doctor and treated with medicines – a year later he underwent a point surgery and a small part of the prostate was cut out. But two years later, cancer cells began to develop more strongly, and in 2018, Victor had the entire organ removed.
“I had no moments when it seemed that life was over. There is a disease, so it must be treated. I didn’t even think that it was fatal,” he says. Victor is very closed and reluctant to recall the experience. According to him, in life, neither before nor after the two surgeries, nothing has changed, except for the attitude of his wife. “She took full responsibility for the treatment and experienced much more than I did,” he says. The man and his wife visited about ten clinics in two years until they found the one where Victor underwent the surgery.
No one knows that Victor had cancer, except for his wife, son and his doctor. He didn’t even think about talking with friends about his problems – it’s not customary to discuss such things outside the family.
“Everything is fine with sex and intimate life”, Victor laughs. Thanks to the more expensive da Vinci prostatectomy, the surgeon managed to save the nerve endings responsible for potency. The surgery cost about $10,000 and Vitor had to find money very quickly as it was dangerous to postpone the intervention. He used all of his savings but it was not enough so he had to take out two easy online payday loans for a total amount of $1,500. The money was in his bank account the same day so the surgery was timely and successful. Applying for a payday loan was the fastest way to make cash as the surgery was needed urgently. Banks tend to process loan applications much longer – for up to 5 days. Victor knows that because he had already applied for a few personal loans with banks. Although he even had to borrow money, according to Victor, $10,000 is a very small price for recovery. However, the consequences are still there: the orgasm has become dull.
Brandon, North Carolina, 73 years old, pilot
Brandon calls himself “lucky”. “I found out about my diagnosis by accident – I got to the hospital with a stroke in 2013, when I was 65. They performed a general health examination and said I had an elevated PSA test. Then I was observed for a year in the hope that the cancer cells were non-aggressive and the surgery would not be required, but the disease progressed.”
When the diagnosis was announced to Brandon, he decided not to fly abroad. The doctors of the Advanced Prostate Cancer Clinic gave him hope. Brandon assures that he remained calm: “Of course, the disease is not very good, but I tried not to panic. There was no certainty that everything would be fine. Blind faith and hope helped me”. At that time, he had three friends who had undergone prostate cancer, so he did not worry so much, unlike his family who learned about the disease two weeks before the upcoming surgery. “The relatives were shocked, of course. But I’m a calm person, I don’t like it when they jump around me, it starts to annoy me,” he says.
During the year between the diagnosis and the surgery, Brandon had no pain or psychological signs of the disease. But it often happened that unpleasant thoughts about death came into his head before going to bed.
Brandon walked in diapers due to urinary incontinence five years after the surgery. He admits that at first he was ashamed, so he put on wide trousers. Now Brandon uses voluminous pads. He didn’t face jokes and toxic questions about this, because “men don’t joke about this.”
The most difficult thing for him was the complete loss of potency: Brandon had his nerve endings cut out due to the wide spread of cancer cells. But he was used to it too. “Sometimes, of course, you want to do something like that,” the man says with a laugh. “But the relationship remained excellent, the main thing is that now I am healthy.”
The man says that he was very worried when he the doctor examined him after the surgery – he was afraid of a relapse. “I had to take a PSA test every three months. The first year was especially scary, I was so worried every time I came there”. The fear left him when he once again visited the hospital, and the next appointment was scheduled a year later with the doctor’s words: “Go ahead, live your life!”
Why is prostate cancer so common?
Prostate cancer is an age-related male problem, the main reason why cancer cells develop in the prostate is aging. More than 70% of patients are diagnosed with prostate cancer disease after the age of 65. Other causes may be smoking, heredity and eating habits: a large amount of saturated animal fats in the diet, lack of plant foods and overeating. Nevertheless, prostate cancer is not as fatal as it is commonly believed: according to statistics, every fifth man on the planet is at risk of getting sick, and only every thirtieth dies. If the patient contacted the urologist in the early stages of the disease, then he will survive in the next five years in 100% of cases. If the patient came for help when metastases developed in his body, the five-year survival rate is reduced to 30%. At the same time, prostate cancer in the early stages does not affect the patient’s well-being in any way. To detect it, annual observation by a urologist is required. It is recommended to be examined annually starting from the age of 45, and if the patient has a hereditary predisposition, then from the age of 40. A doctor may send you for a PSA test or prostate biopsy.
In such cases, family adaptation is very important. Men with strong, supportive families are much more likely to seek help in the early stages of illness.
Why do prostate cancer patients not always need radical treatment?
Cancer cells can be of several types – aggressive and conditionally passive. The peculiarity of prostate cancer is that it is not a severe and long-term developing disease.
Due to the fact that the vast majority of patients are over 60 years old, they already have other diseases – in most cases, they risk dying from them. If a doctor sees that the patient’s cancer cells are non-aggressive and nothing threatens him for the next five to ten years, then he usually advises not to perform the surgery.
The fact is that the quality of life after surgical removal of the prostate deteriorates: in most cases, potency disappears, urinary incontinence appears, and the reproductive function always fades away. If the potency remains, the sensations from sex become very dull.
But not every patient is ready to postpone the surgery. The presence of cancer cells in the body worsens the psychological well-being of the patient: according to a study, about 20% of non-operated patients expect to die due to the disease, and 75% of patients have a high level of anxiety. At the same time, in most cases there is no real threat to life, these are the consequences of carcinophobia – a general irrational fear of a diagnosis not only among patients but also among doctors who insist on surgical intervention. Half of the patients choose surgery and its consequences over the safe extension of normal life. But, again, we are only talking about cases in which the cancer cells are non-aggressive.
Oncologists should have an individual approach and provide a choice to the patient. Cancer treatments are often aggressive and hostile not only to the disease but to the body. The doctor must understand: if a man will be killed by cancer in the near future, treatment is needed, if there is another disease, then there is no need for it. However, the choice is made by the patient, this is the standard of world practice.
Does regular sex help prevent prostate cancer?
There are many studies, and their results can be controversial: men often have sex or masturbate because they are in good health, and, conversely, men who are sexually inactive can have low levels of testosterone and other sex hormones, the so-called hypogonadism. This disease may predispose to prostate cancer. Therefore, if a person has low testosterone, it will be difficult to force him to have an active sex life. A drop in libido due to low testosterone is a sign that a man needs to be examined not only for prostate cancer but also for diabetes, depression, atherosclerosis, and other diseases.