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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.
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As John Lennon famously declared, "Nobody told me there'd be days like these. Strange days indeed. Most peculiar, Mama."
Finished 28 treatments of EBRT 15 days ago. Been taking Orgovyx for almost 8 months, urologist and radiation oncologist advising 16 more months of Orgovyx. Urinary urgency, frequency, nocturia, manageable bowel movements, occasional flatulence, some brain fog, no libido, no hot flashes, can still exercise two hours a day. Some days are better than others but other days feel like the empty premise of my current life is like a sunless dawn.
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3 ReactionsAt first, I laughed while reading your “manual” then I cried for all the wives/partners out there who are experiencing the same things. (I’m one of them). This has been our life for the past thirty years, and it should be a public brochure insert in every oncologists’ office!
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6 ReactionsThank you so much for this insight!
If I can share my experience : my partner had a radical prostectomony via the the Da Vinci in 2019. The prostate was removed and his PSA readings are negligible which is great.
I am 50 and he is 57 and he is very old school. We have not had sex since 2020. He told me he is completely dead in that area even though he takes Taladafil and other drugs to keep blood flow intact . He will not try any injections or pumps etc so that side of our relationship is gone and I feel ashamed writing this but it is affecting me as we don’t talk about it it all. It is a closed subject which he basically has told me this is the way it is
Is there any advice out there please
Regards
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3 ReactionsHe doesn’t have to “perform.” You’re not asking for porn. You’re asking for presence. For warmth. For the idea that your body, your desire, your longing for closeness still matter. And if that can’t happen—if he won’t meet you even partway—then you are left, painfully, with the truth that intimacy isn’t just about physical loss. It’s about being unseen, untouched, and slowly, quietly exiled from the emotional core of your own relationship.
You’re not selfish for feeling this way. You’re not ungrateful. You’re not betraying him. You’re just someone who still has a pulse and wants it to be met with another.
And if that’s something he can’t or won’t face, then the next step isn’t fixing the sex—it’s deciding how long you can live like a ghost in your own marriage.
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9 ReactionsI think it's inherently difficult to know what my wife makes of my ADT induced loss of sexual agency. I read the books about ADT and I tried to start a conversation, albeit a selfish one, about how to deal with the loss of our sexual intimacy. Her reaction seems to be "what loss?". I really can't be sure but I think my wife thinks it's time to forget about sex and concentrate on grandkids and fixing the roof fascia. Letting go feels like dying.....
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4 ReactionsYou have completely hit the nail on the head! I feel so unseen and what makes it worse is that he will look at other women infront of me and I then wonder if it’s me who he is not attracted to! Five years ans absolutely no intimacy at all! Just the morning and evening kiss is as far as it goes! He will not undress infront of me ever since his op or shower infront of me . It has become akward . I then feel ashamed that I am being selfish for all these feelings when he has had to adjust to this huge loss as a man especially as he is an alpha male. I am afraid of the hard conversation as knowing him, he will become combative. I am becoming a ghost in this relationship
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2 ReactionsNot from personal experience, but I know for a fact observing some male members of extended family that "looking at other women" is way of compensation for feelings of inferiority and impotence. Some man try to prove themselves that they are still "attractive" even though they can not perform. It is very, very hurtful behavior and very demeaning in any context , not to mention for a wife who is trying to be loving and supportive. Do you have any way of going to family concealing with him. He is developing really troublesome behavioral patterns.
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1 ReactionHello starlight6,
My sex life ended with my prostatectomy at age 64. Previous to this, my wife and I enjoyed a very active, happy and imaginative sex life; just like that, it was over.
I tried a variety of penile enhancers, splints, vacuums, every kind of pill…nothing! I tried for quite a while to please my wife sexually in other ways and although my ministrations were successful, we BOTH kept feeling worse and worse emotionally.
She was totally unhappy with the fact that she could not “please” me, couldn’t make me feel good. She thought it was her, that I suddenly found her unattractive or unsexy.
I explained over and over that it was NOT her - it was ME!! I had my nerves destroyed by cancer and surgery and compared my penis to Chris Reeve, who really WANTED to walk, but couldn’t! And although she is a very educated woman who studied anatomy, physiology, etc. she just couldn’t believe it.
I felt bad as well, because little by little, my inability to have a satisfactory erection or orgasm left me drained and frustrated and I began to lose any interest in sex whatsoever.
I was just about to try TriMix injections, but my cancer came back and the ADT/IGRT really finished the job completely. I am still vain and I still want to look good physically but I, like your husband, feel awkward in the shower or naked in front of my wife, my shriveled manhood, surgical scars and umbilical hernia to boot. It’s not easy but it has gotten better over time; I don’t feel good about myself many days, in spite of my wife telling me how much she loves me, how she would rather have me alive as I am - than dead, in manly heaven with an erection😉
I am not an alpha male, yet I too felt an immeasurable loss of self; not so much now that 6 years have passed and sex is no longer the #1 on my mind. Although we both still miss the physical intimacy we can openly joke about it now.
Unfortunately, you and your husband are younger than we are - I am 70, my wife 69 - so your sexual desires are most probably greater - as they should be!
I understand your trepidation at broaching the subject, but the problem has to be addressed; you cannot go on living like a ghost. It can only breed anxiety, frustration and resentment.
I always jokingly tell my wife to get a young stud boyfriend…if she ever did I would just fall down and die on the spot. I think your husband (tough as you think he is) would feel the same way.
As gently - or forcibly if you must - I think you should let your feelings be known: that you are both young, you love each other, you REALLY, REALLY MISS having sex with him and you would like to explore ways in which you can get back to your pre- cancer days. Don’t get all heavy and emotional - men do not respond to that (trust me on this); keep it light, don’t force him into a corner but give him food for thought. Tell him you’re horny, tell him you “need him”. He’ll shrug, grunt or argue but you mustn’t get discouraged.
Just know this: It’s NOT you, you’re not selfish, you ARE attractive.
You are his wife and partner in life and this problem - like the rest of them in life - is best solved together. Best,
Phil
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12 ReactionsDear Phil
It is as if you have a front row seat into our lives and what we/ I am experiencing! My partner has the scars on his tummy and the hernia too. Added to that he is overweight and on Mounjaro to try and lose it . I have said the same as your wife in that I am glad he is alive as that is more important but he said if he could reverse his decision and have 10 more normal years he would take that rather than what he is resigned to! I do feel ashamed more now for feeling what is normal but having an insight as you have given have made me understand more what he has given up / had to live with. This coupled with the fact that he has a small bladder and needs the loo . Knowing him nothing will change ie in having a conversation as he will
Feel like it is an attack on his manhood.
Therefore I feel like I am
Resigned to a life without any intimacy from
Age 45 and in a way it breaks my heart. I am thank ful to you for putting into words what has been been happening in our life ! Sincere appreciation
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2 Reactions"I am not an alpha male,..." - this is a major difference between you and this presented problem here. Phill you are amazingly understanding, gentle, giving and generous husband that actually was initiating intimacy and trying so hard to address and resolve that aspect of relationship. I am really impressed < 3 and I am so sorry that your wife does not understand physical limitations due to nerve damage and tissue damage :(.
Contrary to you, many men have tremendous problem with discussing ED and have inhibitions for many reasons - emotional, cultural, character issues and personality issues.
When Starlight mentioned "anger" I immediately had red flags going on in my head since some men can become violent and I think that Stalight would have safer environment in canceling office to address this problem. "Alpha type" can be very reactive when "manhood" is questioned. It is one thing to be self conscious and shy about body changes and another to be angry and purposefully hurtful toward wife. 🙁
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