Gay Men with Prostate Cancer

| I would hope that Drs. don't give less than appropriate and meaningful care to someone that is gay over someone that is straight. |

Sadly, outside of large medical centers in big cities, a lot of doctors do. I don't think it's necessarily prejudice against gay men specifically but more of an assumption that everyone has standard vanilla PIV sexual intercourse and that other sexual practices don't exist or aren't discussed.

The reality, at least as I've experienced it, is almost everyone has some kind of kink or sexual interest that isn't quite mainstream and those are never discussed in the context of prostate cancer recovery. For example, even a super common activity like oral sex isn't discussed in the context of climacturia for those who have had surgery and certainly not if or when it's OK to have prostate stimulation after radiation.

I get that some doctors are reluctant to discuss these topics, but at the very least there could be a handout or some type of online information that helps men facing these kinds of situations.

I'm super fortunate in that my cancer center has a sexual rehabilitation program and my doctor is fully open and non-judgmental when it comes to answering ANY questions I might have. A lot of men aren't this lucky and don't feel comfortable talking to their doctors about this stuff.

@scottbeammeup

In the course of my coming to terms with my diagnosis and trying to anticipate what issues I may confront, I’ve learned that Northwestern Medical Center in Chicago has a Gay and Bisexual Men's Urology Program, one of the few on the country.

UCLA, where I am receiving my care has a division within the urology department that focuses on penile rehabilitation and sexual health. But you are right, most centers that offer sexual health services focus on penetrative vaginal intercourse as if that were the primary goal for all men. It is not so much that the health providers are insensitive or biased to gay men (and transgender women) but that their training does not focus on culturally inclusive care or how to talk comfortably to sexual minorities about their practices and needs.

Please know that after a prostatectomy you have over a 50% chance of getting an erection, with the odds being much better if you take Sildenafil or Tadalafil. Trimix also works but you need to inject it into your penis and may have an erection that lasts for hours. If you choose to go with ADT, your testosterone will go down to nothing and you will have erectile disfunction, hot flashes, frequent crying, depression and a lot of other side effects, both physical and psychological. Tough choices, but the good news is that either treatment can keep your cancer from killing you. Also know that you can still have orgasms whether you get an erection or ejactulate or not.

If all else fails, you can get an inflatable penis prostheses, which is saline filled tubes inserted into your penis with a reservoir somewhere in your abdomen and the control mechanism in your scrotem. It is all inside your body and works wonderfully. I had one implanted and I only wish I had gotten it sooner.

Also be aware that whatever treatment you choose, the old adage “use it or lose it” definitely applies. Blood flow to your penis is critical and needs to be maintained to combat atrophy.