A wife's manual for her husband's prostate cancer support

A black-hearted manual for wives reluctantly enlisted in the prostate cancer wars

There is no medal for this. No parade, no flag, no swelling orchestral soundtrack as you stand beside your husband in the oncology waiting room, clutching a tote bag full of medical documents and snack bars he won't eat. You’re not Joan of Arc. You're just tired. And now you're married to a man who's being chemically neutered in slow motion.

Prostate cancer is, allegedly, a “good cancer” to get if you enjoy being slowly unmade in body and spirit while everyone around you insists you’re lucky to be alive. There are no pink ribbons, no empowering slogans. Just the quiet, grinding bureaucracy of survival: bloodwork, bowel prep, and the ever-diminishing definition of manhood.

As the wife, your job is to watch this unfold like a long, awkward play where the lead actor keeps forgetting his lines and occasionally wets himself. You are expected to smile, encourage, and listen. You are the sponge that absorbs fear, the administrative assistant to decline, the emotional custodian of a man who now gets hot flashes and cries during Jeopardy! reruns.

Let’s speak plainly. Your husband is changing, not in some uplifting “journey of transformation” way, but in the sense that his testicles are retreating like shy woodland creatures and his emotional range has been expanded to include “despair,” “impotent rage,” and “wistful whimpering over lost erections.” You, meanwhile, are supposed to adjust. Silently. With compassion. Possibly in beige slacks.

And yes—this part must be said—not all men lose their erections. Some carry on with a surprising and frankly irritating degree of function as if the laws of biology just skipped them out of politeness. But others, many others, begin a tragic quest not just to regain physical sensation but to reclaim something far more elusive: the illusion that their manhood resides in a single, occasionally operational appendage.

You will bear witness to this crusade.

It starts innocently enough. Maybe a blue pill. Then a stronger one. Then, a combination of pills and complicated rules: take this with water but not food, not after 6 p.m., avoid grapefruit. Grapefruit, of course, now becomes his mortal enemy. When pills no longer deliver the resurrection he seeks, he will wander deeper into the pharmacological forest. He will emerge with a vacuum erection device—essentially a transparent phallic chamber attached to a bicycle pump- and he will stand in the bathroom making mechanical whirring noises while you wonder how your life became an off-brand episode of Black Mirror.

If that fails, there will be creams. Gels. Suppositories. Pellets are shoved into the urethra like tiny space probes. "MUSE," they call it. An acronym, presumably for "My Urethra Suffers Eternally." He’ll wince. He’ll lie. He’ll pretend it worked better than it did. You’ll pretend you believe him.

And then—eventually—he may pull out the syringe.

Yes, the penile injection. Self-administered. On purpose. Not because he’s a masochist, but because he’s chasing the ghost of himself. He will hold the needle like a man about to defuse a bomb, trembling, focused, determined. He is not trying to arouse you. He is trying to resurrect himself.

You may ask, internally or aloud: Why?

Why do men place such desperate, disproportionate weight on the existence—or non-existence—of an erection? Why does this one hydraulic function determine so much of their emotional stability, identity, and sense of purpose?

You could say it’s biology. That it’s evolutionary. That society rewards virility and strength and uprightness, in every literal and symbolic form. But deep down, it’s simpler. The erection is not just an act—it’s a memory. A tether to youth, to potency, to simplicity. To the time when life didn’t revolve around radiation side effects, PSA scores, or how many times you’ve voided before your appointment. It’s not about sex. It’s about proof. Proof that he is still here. Still alive. Still him.

And so, he stabs, and pumps, and swallows, and prays—not for orgasm, but for a sense of continuity. For the illusion that all is not lost. That something, some part of the machine still works.

You, the wife, are expected to smile through this carnival. To encourage the experiment. To affirm, affirm, affirm. To reassure him that this counts. That he counts. Even when his penis resembles a science project. Even when intimacy feels like a choreographed dance designed by pharmaceutical reps and sadists. Even when what you really want is a cup of tea, a warm bath, and a day where the phrase “intraurethral insert” is never spoken aloud.

Support, in this hellscape, looks like not laughing when he fumbles with the vacuum pump. It means nodding gravely as he explains the blood flow mechanics for the third time. It means pretending the sterile, mechanical attempt at intercourse wasn’t tragic, even as you both silently grieve the loss of spontaneity, mystery, and warmth.
This is marriage in the oncology era: a co-authored descent, where the vows get reinterpreted to include “in sickness, in degradation, in mild psychosis, and while hallucinating from hormone swings.”

And yet—because you are still here—somehow this is love. A love not made of candlelight and sonnets, but of cracked jokes in the parking lot after blood tests. Of silent forgiveness after hormonal meltdowns. Of saying “we” instead of “you” when the doctor uses the word “metastatic.”

It's the kind of love no Hallmark card would dare print. The kind forged not in passion, but in mutual unraveling. Dark. Bitter. Ferocious in its own bleak, unyielding way.

So yes, support your husband or your partner. Stand beside him as he fades and returns and fades again. But don’t pretend it’s noble. Don’t pretend it’s easy. And for the love of all that’s unholy, don’t forget to keep something of yourself intact. You’ll need it when the next test result comes in. And again after that.

Cheer his victories, however strange and pharmacologically enhanced. But ask the real question, too: Who are we without this obsession? Because love, in the end, may not be about erections at all, but about showing up. Staying in the room. Holding each other in the silence after everything else has failed.

Because cancer may be his diagnosis. But the fallout? the awkward, noble, grotesque, human fallout—that’s the shared part. The hardest part. The most real.

Welcome to the long goodbye. There’s no guidebook

And if all else fails… well, there’s always gin.