Most people think of it as a man's disease, but prostate cancer can affect both men and women.
Indeed, this disease affects most women who know and love men who have to contend with prostate cancer and its treatment side effects. Even more than other cancers, it tends to alter intimate personal relationships between men and their spouses and partners. And women are also affected when this cancer and its treatment side effects strike their fathers, sons, brothers and other male relatives and friends.
Prostate Cancer's Impact on Women
Prostate cancer can affect both men and women in several ways. For instance, most men experience erectile dysfunction (ED) after prostate cancer surgery or radiation. About 70 percent of men develop ED immediately after surgery, and about 50 percent of patients who undergo radiotherapy develop ED, usually within three to five years after treatment. How could this fail to have an impact not only on them, but on their wives or partners?
When ED or impotence occurs, the wives of all too many survivors have to deal with their spouses' self-doubts about their manhood. In turn, a man's loss of self-esteem tends to cut into the intimacy he and his wife once enjoyed. As a prostate cancer survivor, I initially had plenty of self-doubts without being aware of it. For that reason I withdrew physically from my wife for months after my surgery. And this had an adverse effect on both of us.
In addition to this disease's effect in reducing sexual intimacy, many women are also affected by their husband's urinary problems. These issues may be short-term or long-term, as permanent incontinence occurs in 5 percent to 15 percent of men following prostate cancer surgery (radical prostatectomy) or radiotherapy. A man's incontinence can be an issue for women if they feel compelled to clean up after their husbands.
For two weeks after my surgery in 2007, my wife lovingly took it upon herself to clean my catheter bags. In subsequent weeks, when I was still not yet "leak-proof," she put my urine-stained underwear in the washing machine. Even when a woman does not take on a care-giving role, she may have difficulty dealing with her partner's self-esteem issues arising from incontinence.
In spite of the high survival rate for prostate cancer, most women find it disturbing, if not downright frightening, to learn that a man they love has cancer. Women often experience anxiety and stress just knowing that someone they love is under duress.
The Testosterone Connection
How strange that a widely respect website, HealthandAge.com, says, "There are certain health conditions that only affect men, such as prostate cancer and low testosterone." Nothing could be further from the truth, as I've already illustrated.
What about testosterone - is it true that low testosterone affects only men? Hardly! First of all, a man's testosterone decreases about one percent a year from the time he reaches age 40. Prostate cancer and its treatment can intensify the pace of a man's testosterone loss. I know first-hand about this, since hormone treatment after my diagnosis lowered my testosterone to a near-castrate level.
Reduced testosterone often leads to increased male anxiety, a lower libido, increasing muscle flab, and greater distractibility. Anyone in a close relationship with such men, especially wives or partners, can't help but be affected during what I call "MANopause." Add to this women's entry into perimenopause or menopause - around the time when many cases of prostate cancer occur among men - and you've got a real cause for marital conflict.
And what about a woman's testosterone? Just as men's testosterone levels diminish with age, so does a woman's testosterone. Of course, her level of testosterone is much lower than a man's to start with. But a woman's continued loss of testosterone, starting around age 40, along with the loss of estrogen as she ages, impacts a woman's life and often reduces her energy, libido and physical fitness.
What Men and Women Can Do
The first step is for couples to recognize that hormonal changes and prostate cancer can affect both men and women. Both partners should seek ways to lessen the impact on their lives and their relationship. In addition to medical prescriptions and devices, options include counseling, support groups, and sex therapy to counter treatment side effects and hormonal changes. Armed with understanding and knowledge, couples can regain their intimacy, strengthen their relationships, and renew their lives.
Rabbi Ed Weinsberg is a prostate cancer survivor and patient healthcare educator with a doctorate in gerontology. He is the author of Conquer Prostate Cancer: How Medicine, Faith, Love and Sex Can Renew Your Life, and is a member of AASECT, the American Association of Sexuality Educators, Counselors, and Therapists. For more tips, download your free reports at the Conquer Prostate Cancer blog.
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