Love Making After Prostate Cancer

@folmajt

Nothing works for me anymore as I have zero libido and head splitting headaches.

My experience after 6 months of Orgovyx is I have no sex drive. I feel no urge to initiate sex or to respond to the interest expressed by my wife. None at all. Even though I am 76 and she is 77, we had a satisfying sexual bond that was important to us. Our relationship has survived this loss, so far.

So far, because the Orgovyx had a dramatic and immediate effect on my prostate cancer, I continue to take it. My wife has been completely in support of this effort to save my life.

I had good evidence of this effect as my PSA reading plummeted. As well, my RO observed dramatic shrinkage of my prostate. This made him comfortable to perform my requested HDR brachytherapy boost to the external beam sessions he had prescribed.

For months, ADT was the only treatment I was given. During that time, I was much relieved at the evidence that my cancer was experiencing, at least temporarily, a dramatic setback.

However, now that I've completed the HDR and external beam treatments, I will be assembling the best studies I can find to present to my medical oncologist and radiation oncologist as I ask them to limit the 1 to 2 year of ADT they have so far insisted is what my case requires to some lesser length of time.

I'm thinking there is strong evidence (i.e. the TRIP study) that in high risk cases, when HDR and external beam are applied, if the biologically equivalent dose is high enough, there is no advantage to extending ADT beyond 6 months.

Patients with higher risk staging than T3a were excluded from that study however: I was staged as T3b. If I can't get my RO to agree to a shorter ADT term, I'll submit my data to the guy who supervised the TRIP study, i.e. Dr. Roger Stone at Mt. Sinai, to see what he says, if he still sees patients or does 2nd opinions.

The thing is, the longer a man is on ADT, the more likely it is that he will never recover from the loss of testosterone. This likelihood increases with increasing age. Other side effects that can be difficult to counteract, such as mental decline, or osteoporosis, get worse the longer anyone is on ADT as well. Apparently, when drugs are given to attempt to restore the bone loss caused by ADT the resulting bone is not as good.

It seems like a high price to pay if these risks are not actually necessary, or even if an extended course of ADT provides a minimal benefit compared to a shorter course of treatment.

I'm so sorry. I believe talking about the issue is really important. If he won't talk about it, talk with a counselor. I've been on Orgovyx 18 months, just finished, and my wife and I haven't been able to have intercourse during this entire time. We do talk about it some, hopeful that my ability will return in the coming year. Castration, whether surgical or pharmacological, is traumatic to a man. I don't know what meds he is taking, but I describe my fatigue as "flat tired." We have tried foreplay a couple of times, but I only last a few minutes before falling asleep. I wish you and your husband the best and that conversation will begin soon. Blessings!

@pesquallie ditto,

My radiation oncologist told us that 90% of men will be able impotent six months post radiation and he offered to prescribe Viagra, which he did. At this point, the prescription goes unfilled but I know it’s available if needed.
Sex has changed between my wife and I and there are times when I am unable to climax but my desire seems only slightly compromised.
Prior to PC, we were quite physical - touching, hugging, kissing- and that hasn’t changed despite the fact that my sexual performance isn’t what it was.
At our age (I’m 68 and she’s almost 66 - shhh, don’t tell her I told you) sex has naturally become less frequent but it’s still an important aspect of our relationship and we are willing to work through the changes caused by PC.
We recently connected with a therapist to help us work through some of the issues which have arisen since my diagnosis and, if your husband is willing, talking through the issues with the help of a professional can make a significant difference.

@climateguy
There are numerous studies that indicate that long term ADT is not necessary unless you are very high risk. Some examples are:
https://corporate.dukehealth.org/news/study-solves-testosterones-paradoxical-effects-prostate-cancer
https://www.dukecancerinstitute.org/blogs/ai-tool-may-help-some-prostate-cancer-patients-avoid-hormone-
therapyhttps://www.sciencedirect.com/science/article/abs/pii/S1040842808002163

I am on hormone treatment, but I still make love to my wife using Trimix. While my desire is no longer there, it brings her pleasure and I find the experience is good for our marriage. I need to be better with hand holding and other forms of affection.