Good Times - wet vs. dry

Hey Everyone,

Some of you may know me. I posted a few weeks ago about my best friend. Background info about us is in prior message thread: https://www.healingwell.com/community/default.aspx?f=35&p=1&m=1448753

Again, I'm essentially his significant other and have immersed myself in prostate cancer study since we learned he has it. Finally, only as of today, do I have all his stats:

46 years old
diagnosed April 2009
PSA 3.13
Gleason 3+3+6
Grade T1c
2 cores out of 11 positive, 5% and 3% respectively

I went with him to the urologist today for an informational follow up visit. Since I learned from *this* forum that if treated for PC my friend would lose his ejaculatory fluid, I asked the Dr. about it. He said that ALL pc treatments of ANY kind would result in this side effect. Is this absolutely true? Or is there some treatment out there that would still leave a man with a "wet" orgasm? The Dr. did not tell my friend on his prior visit about this losing his 'juice' and he's now furious and depressed, saying he won't be getting any treatment if he has to sacrifice his ejac. fluids. Of course, I'm extremely saddened by his response and hoping he'll change his mind after he gets over the surprise. From what I understand now, his stats are amazing (low) and he has a VERY good chance at "cure" if he gets treatment.

Thank you in advance for your help with this 'sticky' subject.

Best,
Danielle

He’s going through a lot and getting all sorts of bad news…BUT, you might have to smack him into reality at some point. Women will be the last thing on his mind when he gets to the advanced stages of cancer.

 

He can look into Sperm Banks incase he has a notion to still being able to father a child.

Dear Best Friend:

If your friend was older then, with his stats, doing nothing (watchful waiting) might be a good option.  However, at his age, that is not a good idea in my opinion.

And, your urologist is incorrect when he states that ALL PCa treatments result in total loss of ejaculate.  I suggest you look on this forum at the threads started by realziggy.  He successfully underwent targeted focal therapy, which is akin to lumpectomy for breast cancer.  In that treatment, the patient undergoes an extensive biopsy, then needles are inserted into the prostate to destroy the cancer only...not the entire prostate.  Ziggy was perfectly clear that he retained his ejaculate.

Beyond that, brachytherapy results in loss of some or all ejaculate.  I can't seem to finds stats on what percentage of patients retain some and what percent lose all.  But, my radiation oncologist told me there was a "decent chance" that I would retain some ejaculate in the long term.  6 months out I have reduced ejaculate and I can't tell the difference between before and after...but, it's still early for me and I may yet lose it all.  JustJulie on this forum has a longer term view with her hubby and she may weign in with their personal experience.  Also, this whole thing with brachytherapy may be age and case dependent, as is the situation with lots of this PCa stuff.  Somewhere along the line your friend should speak to a radiation oncologist anyway, so this question should be posed to him/her.

Good luck,

Tudpock

Danielle,

One thing that you might consider is buying your pal Dr. Patrick Walsh's book "Guide to Surviving Prostate Cancer" available at your local bookstore. If he has any sense, he must come to terms and study up on the disease, it's diagnosis, treatment and possible life effects. Buy the book and tell him that he must take some quiet time to review his situation. Walsh gives alot of info and you buddy will find his situation adequately described. Doing nothing is not an answer.

TeddyG

Danielle et al.

I know this is a sensitive subject but it really shouldn't be - once you're diagnosed with prostate cancer there are no sensitive subjects anymore so I will answer this question for you.

Brachytherapy = no ejaculate = UNTRUE - either that or my husband is a freak of nature ... does that answer your question?

Seriously, if we are afraid to discuss EVERYTHING about this disease we risk making decision on inaccurate information.  Mind you, every man is different, and time may change things but for the time being (and forgive me if I offend anyone) I still don't like sleeping on the "wet spot" LOL!

 

I've learned to overcome all forms of modesty.  Since I've had kids and my husband has prostate cancer - nothing is too secret to discuss - especially around here.  It took me awhile to get to where I am but I figure if I can't laugh about it I'm going to cry and I don't like the second option as much as the first.

Just a note to you - kudos to you for doing the investigation your significant may not be able to - my husband's a smart man but not so computer literate so he relied on (and still relies on) me to help him through the investigation part of this process and if I can't help him then it makes my life that much better.

Regards,

JustJulie

Danielle:

I finally found what I was look for at www.prostate-cancer.com.  Here is some info and some percentages re staying "wet" with brachytherapy:

The prostate gland and the seminal vesicles are responsible for creating the fluid that makes up semen. Consequently, most men report a decrease in their amount of ejaculation. Men are still able to experience orgasm though their ejaculation will be reduced. about 5% of patients who have undergone brachytherapy report completely dry orgasms, while about 5% of brachytherapy patients report no change in their ejaculation.

So, there is a 95% chance that there will be some ejaculate with orgasm after brachytherapy.

Hope this helps,

Tudpock

Danielle, I think it quite reasonable for your friend to undertake a period of "watchful waiting". This does not mean "do nothing" -- rather it means careful monitoring of progression (if any!), with regular PSA tests and biopsies where indicated. Also, diet may help, although opinions are divided on how effective it is.

There have been discussions here and other places about the risk of over-treatment. Any treatment your SO has will have side effects, so he is correct to be concerned about those. Uncontrolled cancer has side effects too, and he should also be concerned about those. But he may be one of the lucky ones where the cancer progresses slowly, and he ends up dying of something else.

With his numbers, there is no need to rush. Take a year or two to consider the options. There is no "right" solution. Take time to research the treatments possible to find the one that gives him the best outcomes with the least risk and side effects. Best for him! That may indeed be a "do nothing" option, but I believe it is a decision best made by examining all the options and not by burying his head in the sand.

Geezr99. Boy did you ever it that nail on the head. I could not have said it better.

HI, Danielle,

OK, listen up. It is true that if you have surgery there will be no ejaculate. But on the positive side, they are longer, better than any O I've ever had. I liken it to the female orgasm where the woman also has no ejaculate, but she seems pretty pleased, and darn near worn out afterward. For all you guys who have seen this, I think you know what I mean. If this is getting into the feminine side of myself, then bring it on. I had no idea it was going to be this way and I don't mind it a bit.

Besides, no one has to sleep in the wet spot. Truly, hope this helps.

Bob