Men: How Surviving Prostate Cancer Can Improve Your Intimacy Skills

Men rarely talk about intimacy

Men rarely talk about intimacy, and less rarely about prostate cancer despite the fact that in Australia more men die annually of prostate cancer than women of breast cancer.

Women are probably more at ease talking about both intimacy, and issues like breast cancer. Mention prostate cancer in a group of men where none has experienced it and the conversation will stop.

It’s a threatening topic.

The unspoken fear of prostate cancer

Among men there is an unspoken acknowledgement of the fear of prostate cancer. Without knowing what it actually is and the real consequences, the universal fear is that it means the end of sex. Or, even worse, the end of erections.

No man wants to acknowledge that that thought even exists in their mind, let alone talk about it and ponder its frightening and unfathomable consequences.

The consequence is that there is zero readiness in a man’s mind to cope with, and understand, what is unfolding in his life subsequent to having prostate cancer treatment.

Note: I’m talking mainly about “treatment” being prostatectomy — the surgical removal of the prostate gland.

And what is inevitably unfolding, unfortunately, is the destruction of their sex life as they knew it.

“I didn’t realise this would happen”

This is compounded by both the lies, or should I more correctly say, the vague reassurances of the medical profession, and by the appalling lack of information given to men prior to prostate cancer treatment.

Talk to almost any man post-treatment and they will say two things in common with all the others:

  • “Things” are not back to normal; and,
  • They didn’t realise that this is what would happen i.e. they weren’t told.

What’s not “back to normal” and what they weren’t told (or may have been told indirectly) is that 80% will never have the erectile functionality they had before. Perhaps 20% will be roughly ok, 60% will have dysfunctionality, and 20% will be totally dysfunctional.

Of the 60%, few will have the functionality to be able to sustain an erection during intercourse, and rarely to the point of male organism. A substantial majority will also have incontinence problems, varying from minor to catastrophic.

What is shocking is that they will only find all this out after the event, when talking with those in the same boat e.g. at the gym. It is during those discussions that the devasting truth strikes home.

What has this to do with intimacy, and developing the skills?


Obviously, intimacy includes sexual intimacy and part of that includes common forms of intercourse. The brutal fact is that most men post-prostate surgery will be incapable of carrying out the common forms of intercourse.

This incapacity arises from both physiological and psychological reasons.

Physiologically the nerves which stimulate and erection may have been removed or irreparably damaged — this is the 20%. The nerves may have recovered but not be performing as before, meaning an erection can be achieved but not sustained. Despite the nerves enabling some form of erection stimulants such as Viagra may fail to work. Not only is this not uncommon but the reasons are complex and rarely solvable.

Finally, and no man has ever told me that they knew this prior to it happening, the penis may have suffered structural and “hydraulic” damage post operation during the recovery period by neglect. If the penis is simply “ignored” as a sad and embarrassing appendage during the 12 months post-operative recovery period then irreparable damage may have occurred within its internal working mechanisms.

Psychologically, any of the problems above create severe nervousness, stress, fear and reticence about sexual activity.

Crushing feeling of inadequacy

A man will feel inadequate. Many men have enormous difficulty coming to grips with the fact that they cannot easily achieve organism, and if they can the feeling of ejaculation has gone or been severely diminished. For those that do achieve some form of ejaculation even this can be embarrassingly mixed with urine leakage due to the common occurrence of incontinence mentioned earlier.

All in all the sexual part of man’s ego is crushed by these issues, and it leads to withdrawal from sexual activities, shame, loss of confidence, a feeling of no longer being a real man, relationship breakdowns, social withdrawal, and suicides.

For men seeking a relationship — dating — it becomes a ringing issue in the back of their heads.

When will she find out that I am incapable, or I’m not responding to a kiss or embrace? When will I tell her that I need aids that require planning and preparation and are mood killers? How much need does she have for “normal sexual intercourse”? Will it be the deal breaker? This is not something that you put on your dating profile — it is not a winner.

However, there is an opportunity which arises from all this.

The opportunity to grow a new mindset

The opportunity is to break out of your mindset of thinking that women are looking for “normal sexual intercourse” or selecting women who might strongly desire that, and to think more broadly about intimacy.

Not something men normally think about, right?

So now you have been blessed by cancer. That blessing offers you the chance to expand your life experience. Not only will you regain your confidence, but the expression and experience of deeper intimacy will develop who you are and your own humanity.

And your future partners may get more pleasure from you, and be more satisfied, than your pre-cancer partners. This is almost certain.

That’s remarkable but perfectly achievable.

What the heck does it mean, you ask? How? Well you’re right to think that it will take effort. But you’ve experienced cancer and you’ve come through. You can take on learning about intimacy.

Just to give a very clear example. For couples in long-term relationships studies have found that for men, the strongest predictors of sexual satisfaction, in order, are: mood setting, sexual variety, and communication.

For women, it’s how frequently they orgasm, mood setting, and communication. Did you read that twice, because you should. There are a multitude of ways to help a woman achieve organism, many you’ve never thought of yet, and most don’t require penile penetration. Developing your intimacy skills covers all those elements mentioned and much more.

What is intimacy?

So what is intimacy, man to man?

Intimacy is sharing your thoughts, emotions, sexuality, bodies, without fear.

It is not being afraid to be who you are.

It is reassuring your partner that they need not be afraid to be who they are.

It is being prepared to expose your fears and vulnerabilities and experiencing the warm glow of your partner reflecting back compassion, understanding, kindness and acceptance — without judgement.

It is developing the mindset that intimacy, deep intimacy, is far far more than sexual intimacy, and that “normal sexual intercourse” is a small subset of sexual intimacy.

It is understanding deeply and fundamentally that because “normal sexual intercourse” is such a tiny part of deep intimacy, that what prostate cancer has taken from you is something tiny.

And it is appreciating that prostate cancer has blessed you with the opportunity to begin a journey to understand and to practice intimacy in its fullest and most fulfilling sense with your partner — current or future.

And if you have the right partner she will be delighted and grateful.

You’re a lucky man!

Follow me Walter @adamson and on Blab /adamson

You might also like my Mindful Passion, Poise and Posture and Not Minding Leads to Confidence, Not Caring to Disengagement and Depression and A Kind of Loneliness: when your cancer comes back