Prostate Snatchers: Sexuality and Intimacy after Prostate Cancer Treat...

Prostate Snatchers: Sexuality and Intimacy after Prostate Cancer Treat...: BY MARK SCHOLZ, MD

After having my prostate cancer removed in 2006 I have been doing a ton of research on the problems after surgery. This is one of the things I wish I know before surgery. I guess it is the best to get the information out first that others don't have to find out what happens after the fact. As I find the information I will post it.

Sexuality and Intimacy after Prostate Cancer Treatment

Posted: 26 Feb 2013 06:03 PM PST

BY MARK SCHOLZ, MD

My life is turning into an evangelistic crusade to raise awareness about the risks of prostate cancer treatment.  Tens of thousands of men are undergoing unnecessary radical prostate cancer therapy with dire sexual consequences. These inappropriate and often fatefully wrong treatment choices are made because men are often completely unaware of the irreversible effects of the treatment itself.

Thankfully, I am not alone in this battle to inform men about the harm associated with prostate surgery. Another prostate oncologist, Dr. Celestia Higano from the University of Washington, recently published a scientific review on this very topic in the Journal of Clinical Oncology (JCO). For those of you who haven’t heard of the JCO, I consider it to be the most prestigious scientific cancer journal in the world.

Today’s blog will offer quote seven selected sections from Dr. Higano’s important article. To add some gravitas to the eye opening statements you are about to read, please realize that every one of her comments was referenced to a specific scientific report.  In other words, these statements have nothing to do with opinions. They are genuine outcomes from published scientific studies.

So without further ado let’s start with the first quote from the article:

Quote #1: “Unfortunately, many couples believe that even if they have problems with erectile dysfunction (ED) … they will be able to resume their normal sexual practices through the advances of modern technology.4 They are not informed that sexual function will never be the same after any form of therapy and they are often unprepared for the changes in their sexual and intimate relationship.” (Italics mine)

Quote #2: “PDE5 inhibitors (Viagra, Cialis) and other erectile aids are not successful for all patients with ED and, even when effective, half the patients stop using them within one year.11 Why couples stop using ED therapies has not been adequately investigated , but disappointment that sex life is not the same … likely contributes to this outcome.”

Quote #3: “In a Memorial Sloan-Kettering series of 475 men … 20% of men who had radical prostatectomy (RP) had climacturia at one year, and climactauria as associated with both painful orgasm and penile shortening.13” (Climacturia means that orgasm results in the ejaculation of urine instead of semen).

Quote #4: “At the Karolinska Institute, 1,288 patients had either open or robotic-assisted laparoscopic RP, and of the 691 men who were sexually active, 38% reported climacturia at least sometime during sexual activity. Of the men who reported climacturia, 72% had climacturia less than half the time, 17% more than half the time, and 11% all the time.14”

Quote #5: “In a review of 1,459 men who had RP at New York University, climacturia was found to decrease from 44% at 3 months to 22% at 24 months after surgery. Climacturia is a common complication of RP but is often overshadowed by concerns about ED and overt urinary incontinence.14-16”

Quote #6: “In a study of VED (vacuum erectile device) use after RP, the length and circumference of the penis decreased in 63% of patients who did not use a VED after RP compared with only 23% who did.18-20”

Quote #7: “Surgery can also result in Peyronie’s disease (also called, “crooked penis”) in up to 16% of patients.23"

When patient are informed of the dire consequences of surgery they are often mystified as to why urologists, who must be aware of the damage surgery causes, continue vigorously to recommend it. I have heard many patients voice the opinion that urologists are driven by a selfish desire for financial gain.   

The financial motive, however, fails to ring true. As medical procedures go, prostate surgery is poorly reimbursed. Also, when urologists are diagnosed with prostate cancer they themselves often proceed with a radical prostatectomy. So money is not the primary issue. Rather, consider that performing surgery is part of the very fabric of a surgeons’ persona. From a surgeon’s point of view, if you are not operating, you are not a surgeon.

Men considering surgery for prostate cancer need to be aware of its substantial risks. And when getting advice about which treatment to select, patients also need to realize that surgeons usually can’t provide balanced advice. They are too close to the trees to see the forest.   

Will the fighting end?

            Today is Saturday, a gray and cold, but beautiful day. It’s mid-afternoon and I figure that I should get out of the house and go and play in the snow. Not really, just kidding.

            I thought I would write something about my cats, Tom and Jerry. I really don’t know what has gotten into them the last few years, but it’s driving me nuts. A couple of years ago my cats got wind of some female pheromones. I found out later there are a few female cats or just the one, living under my porch.

            I know that this had been going on for quite a while but, at that time, all of a sudden my cats started to fight and I mean bloodletting and blood-curdling screaming at each other. I’m talking about scars across their faces, legs and their ears. These fights would go on about every couple of times a month or so. It seemed like in the winter, the fights would stop, but only because I closed the windows and doors to keep those smells out.

            Last year, 2012, it seemed like the fighting would end and it did for the most part. Then there was a new lady in town and she too decided to spend her time in my yard and under my porch. This lady calico cat not only caused a dysfunction with my cats, but she stopped the birds from gathering in my back yard and now that I think about it, the squirrels have disappeared, too. The only things that come into my backyard now are deer and a few dogs that feel they have to take a dump in my yard.

            Now, this past winter Tom and Jerry had, kind of, been cordial with each other. Not really fighting; Jerry just hisses at Tom when Tom wants to play. Tom loves to play. He loves to bat his foam balls around the house and I do love watching him chase those balls. Sometimes I open the basement door, just wide enough that he fits through and I toss the ball through the door and watch him chase it down the stairs.

            Every now and then he would bring the ball back up the stairs then drop it and go about his business. I usually get the hint at that point. But I pick it up (I think they are training me) and throw it back down the stairs. Or I throw it anywhere and he go nuts over that ball. Of course Jerry just watched.

            The only problem is that he doesn’t bring the ball back to me. He brings it up the stairs bats it a few times then moves off to do something else, like rest.

Jerry on the other hand is the “A” alpha cat or so he thinks. He has gotten big, maybe fat, I have caught him eating Tom’s food and I just yell at him to, “Eat out of your bowl!” and he goes and eats out his bowl, until I leave. Jerry is the, “I’ll wait until Tom does something before I will do it” kind of cat.

If Tom doesn’t do it first Jerry won’t try it. Jerry will go to the basement door, stand on his hind legs and tap the doorknob. I get up and open the door. He will back off and sit across the room. Then Tom will come out of nowhere and go down into the basement. Jerry goes to the door and just looks on for a few minutes before will go downstairs.

            Anyway, as of the last few weeks, Jerry will play; wrestle, with Tom and then run up the stairs and all over the house. When he doesn’t want to be bothered he will hiss at Tom. Tom kind of looks at Jerry, like, “What did I do now” kind of look, and then goes and looks out the window.

            Last Saturday was my birthday (60^th) and the cats were with cool with each other, Jerry still hissed at Tom but nothing came about it. This past Tuesday I noticed that darn Calico cat (Now that I think about it, it was that male cat that has been hanging around as of late) at my window but this time it sprayed my window, twice and Tom went off. He was so loud and angry it scared me. I was afraid to touch him. Tom was so hyped that he broke the plastic slat in the blinds trying to get at that outdoor cat.

            So, Tom and Jerry, for the past few days have been at each other’s throats. Tom chases Jerry into the kitchen where Jerry jumps into the chair; he thinks that chair protects him. In the meantime Tom has destroyed my suede chair with his swiping at Jerry perched in said chair.

            I woke up this morning and Tom was curled up on my left side and Jerry was curled up on my right side. So far so good. Usually Jerry had been spending his time sleeping on the sofa downstairs or in the hallway outside my bedroom door. But he has calmed down for today.

            Tom, when the alarm goes off in the morning jumps off the bed but comes back a few minutes later. This time he goes to where Jerry is laying and they touch noses.  Another good sign. So, Tom decided that things were fine and he then decides to mess with me until I get up and feed him. I get up and feed them but Jerry doesn’t eat, at first. He just watches from the top of the sofa on the other side of the kitchen.

            Later they were running and playing (wrestling) but not hurting each other. Another, somewhat, good sign.

            As I sit here typing, I hear the hissing so, I am guessing that the truce is over. It is quiet now. And Tom is sitting behind me playing with a stuffed (with catnip) mouse. I guess he is tired of Jerry, but in a few minutes he will go and mess with Jerry and the Hissing from high places with start again.

            My cats are seven years old going on eight. That’s about 49 years old in human years. I am guessing that Jerry is getting to be that old guy who yells at the kids to keep off his grass. And as of late he has been spending the most time sitting on my lap. I had to kick him off so I could write this piece. I am guess that is probably why Jerry is mad at Tom right now.

I now see that Tom has gotten into a bag that I have sitting on the floor. But, of course that’s going to end in a few minutes when Tom wants to play with his brother, Jerry.

Nope, it’s been 20 minutes, Tom is gone, out of sight and it’s still quiet. All is well…

           

The big 60!

Today is February 15, 2013 and tomorrow is my 60^th birthday. I have been trying to find things to write about but I didn’t know my life was this boring, as far as finding something to write about. Well, actually it isn’t that boring, but I have my dry spells every now and then and I am hoping that 2013 isn’t one of those boring (for writing) years.

            I did have a boring, I mean uneventful Valentine’s Day, but it is an over priced commercially created day. And since I have been divorced for the 22 years, 2 month, 5 days, 4 hours, 53 minutes and a few odd seconds ago, I really haven’t participated. Anyway, I need to write something.

            That brings me to today. I am going to start here, on this blog, and then take it from there. The more I look at my life and life in general; I have come to the conclusion that every day is a holiday, or my birthday, or Saturday, or Sunday, for that matter.

 So, tomorrow is just another day for me, considering I celebrated all of the above today. I will enjoy tomorrow, I purchased a 6 pack to help me celebrate, though, and it will be a first for me, being that I will be 60 Fracking years old! Yea!

I do know that I have to get ready for this coming spring and summer, because I plan to be as active as I possibly can. One of the things I am going to get, no matter what…some new running shoes!!! The last time I ran was in October.

I did walk this past December and January and I ran a couple hundred feet or so, but couldn’t continue running because I lost my wind, not doing anything in those past few months. I hate not working out, I miss it badly.

Those of a few of the things I need to do this year. I also figure working out  keeps me “young” (looking). But, since I grew another beard, this past October, I look like and old goat.

 It’s funny; I retired in June of 2006 and hadn’t had a beard in 15 years, this is the second time in the last two years, though. I really haven’t gone anywhere or done anything, so I figured, why shave. I am going to have to shave it off, soon, well at least when it starts getting warm again.

I guess I’d better start on my Short story. But, first I gotta get up off my butt, because it’s starting to hurt from sitting here in front of this computer for so long! Aches and pains, you can’t live with em and you can’t live with out em! Ouch! Yea, 60!!

             

For the love of coffee...

There has to be something magical about the smell of freshly brewed coffee. Waking up early in the morning, your coffee maker on auto; that brewed coffee aroma smoothly makes its way to your nose. You rise, dress and head downstairs to have that first cup of coffee.

You then wonder to yourself, do you add cream and sugar or is it going to be black, today?  Black and strong, it is. After that first sip you can feel the edge slipping, your eyes open and you are now, ready to take on your day.

Out the door and on to the highway you just realized that you left your coffee mug on the kitchen table. Your edge comes back with a vengeance. But you are safe, up ahead is a McDonald’s and you're feeling better. You roll into the parking lot but decided to go inside instead. You open the door and are greeted with the big, bold aroma of coffee, your day is made.

On the menu you notice that McDonald’s McCafé has nine selections. When it comes to coffee, your preference is black and rich, but today you decide to try something different. No iced coffee for you, though, that’s what you do on your way home to help you unwind.

Your choice now is between the McCafé Mocha, an Espresso drink, strong, hot, with milk, chocolate syrup, of course, whipped cream. But your second choice is the McCafé Cappuccino, made with nonfat, or your favorite, whole milk, steamed and topped with frothy milk. You don’t hesitate and pick the extra-large McCafé Mocha.

Your day is now set and you feel you do a full day’s work, that is until lunch…McDonald’s or…?

No time to fail...

I got this note today from a site I applied for. I used a few of my articles that were published on another site:

Regarding the clarity of your writing: I see what the writer was trying to express, but I'm still a little confused.

Regarding the flow of your prose: The thoughts linked together, with one or two notable exceptions.

Regarding the extent to which you kept the reader engaged: The subject was interesting and informative, but my focus still wandered.

Unfortunately, we're not able to reverse this decision. However, you are welcome to apply to other specialties...

That was disheartening, and I guess, a fail on my part. I know I am kind of rusty. Writing was a passion, many years ago. Now a must, I do have to figure out how to get back that passion. I would love to say I don't know what I am going to do, but that's not my way. But, I must figure out something and implement it as soon as possible.

I just read a book on how to make my prose more colorful (my word). And I guess I'd better re-read it, because I am missing something. In fact I have downloaded quite a few books, on the subject of writing, the last few months. Sometimes I feel that reading that much takes away from my writing. But, I have to get this done.
This shouldn't be hard, it wasn't, once upon a time, a long time ago. But, times have changed. I guess I'd better get off my butt, from in front of the TV and get back on my butt, in front of this computer and start writing and reading.

A bad case of Writer's Block...

Today is February 9, 2013 and I have finally come to the conclusion, on a great many things this day. All of them, in regard, to my writing life. I had a little talk with my daughter-in-law and it would seem that she has more faith in me than I do with myself, which is odd for me to lack one of the only things I have going for me when it comes to writing.

I am one of those people that have a positive attitude about life, love and the pursuit of happiness, since I retired in 2006. This includes my writing life. I was ecstatic when I self-published my book and of course I went through the roof when I self-published my second book, like a kid in an all you can eat candy store.

But, I digress…things are, I feel, different this year.  It has been difficult for me to put words on paper (on screen). I wouldn’t go as far as to say I have been procrastinating, or being lazy, (the latter is because of my retirement *smile*), but what has happened is that I looked back at the last few years and have seen something in me that kind of just punched me in the gut causing me to put a halt to writing and I have to find some way to get back on track.

I have finished two novels so far, one a book of science fiction and my fictional autobiography. Now that I think about it I have finished, in the last two years, two short stories to which I would to turn into e-books and two screenplays. And I have finished 29,107 words for part two of my fictional autobiography, out a series of five stories.

What I've realized is; I have been asking friends and family to help with my works until I can succeed an get them published, and make something (money) from my works. This approach isn’t working, though. Also, my cats have the tendency to fight as to see who gets to sit in my lap as I am writing and that’s not helping one bit.

Nevertheless, this world is based on “money”. In order to get things done you have to pay for what you get. I know this, but being a starving writer, it doesn’t hurt to ask. On that point, everyone wants to read my stories. That I really don’t mind, because I could use the feedback, bad or good. There are many problems with that, though. One is that most folks are busy, and I don’t have a problem with that, to the point that it has taken a year to get any answers. And as of right now I have gotten nothing back.

I even offered a family member some compensation; that apparently hasn’t produced anything. So, I can either save up more cash, (do make a few bucks selling books and odds and ends on eBay and Half.com.) and again offer it so I can get things done. Which is what I am going to have to do? Only because my novel is sitting here collecting dust.

Another thing that keeps coming up, I could learn to use and create cover art on my own. I looked at that for quite a long time and came to the conclusion, if I was 20 something I could learn how to really utilize Adobe Photoshop, but I’m not 20 something and I am trying to commit myself to finishing my novels and have them published. I am getting hungrier by the day.

I guess, the more I look at it and I can’t say I’m being let down by asking friends and family for help but it isn’t helping. Money makes the world go around, but seems like the buck passed my house by. All this means is that I am going to have to get up on my pony and do the giddy up.

I do know one thing; I am going to have to continue writing every day, again. I was doing well last year and I have to start writing every day again, starting today, now. And since the beginning of this year I have opened Word and sat and looked at the screen for hours. Can’t do that anymore. My stomach is growling right now, and I really miss my steak and Lobster, in a creamy butter sauce.

It took me ten days to write 29,000 words last year. Now I have to see if I can replicate those numbers. No, I don’t have to take ten day, I just have to finish, and continue to write! For whatever reason I just happened across a web site that offers jobs for freelance writers and I now and have taken advantage of that site. That should keep the blood flowing.

As I sit here, looking at the words flow across the screen, I have also realized that; am I being hard on myself and other by asking for their help? And not bugging them to finish? But, as I see it I can only blame myself for my failure or success. And hunger?