Prostate Cancer Survivors






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"Fragile male self image"

Been thinking a lot about this one small side effect of PC treatment and the impact it can have on at least some of us. Its impact may be debatable and this little write up, little more than filler for this forum. I am talking about the loss of physical size of our prized possession, the penis - whether it be at a state of "attention" or in its relaxed state. After treatment, it is very likely to take a hit no matter what the treatment was. It is a subject none of us wants to publicize due to its private nature and due to our reluctance to reveal private thoughts and emotions that we men are suppose to suppress. We all take an unspoken pride in this part of our anatomy and to loose a portion of what we have lived our whole life with comes as a blow to our self esteem. We have all heard the saying of "size doesn't matter" and have taken that to mean, we are what we are and that is fine. To suddenly loose a portion of what we are (or were), does matter. We learn to accept this disappointment however and move on, hoping it is for a valid reason. It is ironic that our wives are being truthful (I think) when they say size doesn't really matter. They seem to understand the concept behind the thinking and lovingly bolster our self image with their input. It would seem that we men are the ones who think size matters. After treatment, little well meant phrases like, "It's the new you." aren't much comfort when faced with this little mentioned side effect. It seems like there should be a solution for this as well as a cause but until it is taken more seriously, I guess we are stuck with what we end up with. All silly concerns maybe in view of the bigger picture and all else that is lost in fighting this adversary but - still there. Jon R.

Re: "Fragile male self image"

Hello everyone,

Jon brings up an important consideration that most doctors will not explain prior to performing any surgery. It is a valid concern, and it can have a significant psychological effect on men who have undergone surgery to remove their prostate. Since the nerves that control erectile function are traumatized during the procedure, it is very common to lose the ability to achieve an erection for a year or two (maybe longer). Prior to surgery, most men experience spontaneous erections while they sleep -- it is the body's way of keeping everything flexible and in good working order. When we lose the ability to experience those spontaneous erections, we suffer the consequences of "use it or lose it" -- that is, some of the erectile tissues can atrophy from lack of regular exercise.

There are some good articles on the YANA website -- please see:

Best Regards,

Re: "Fragile male self image"

Thanks Mark for info to that web site. Interesting. It shows it is a more common problem than it seems on the surface, hidden from common knowledge because no one wants to share such depressing news and why the medical community refuses to address it and even admit that it happens. Another instance where we are truly not alone. My guess is that the medical community doesn't bring this up because they are afraid we are dumb enough to let that keep us from treating the cancer. I would also guess they figure finding a solution is not profitable enough to go to the trouble of addressing the problem. A lot of things go unanswered when questioning beforehand. I asked why the dorsal venous complex was severed and sealed off and what that important sounding structure served and was simply told, "It is in the way and it supplies the skin." I got the feeling it was something I wasn't supposed to know. Maybe this explains some of the loss of size due to limited blood circulation(?). Maybe someday they will find the will and a way to alleviate this "minor" side effect that can have such a major effect on emotional recovery from this ordeal. At present, us survivors have been written off as casualties. Jon.

Re: "Fragile male self image"

Self image, well, I'm glad I can still see mine in the mirror. I'm glad to be above ground, alive, breathing, able to hear the birds chirp, see sunsets, and be with my wife of 25-years.

The stress of having this cancer was overwhelming before that was unhappiness! Now I'm surprisingly (oddly?)content and happy, despite the, um, shortcomings I'm experiencing. Post surgery, I could barely extend to urinate, let along perform in the bedroom. I went dry after three months...first hurdle, then I started getting some length...between gravity and stretching, but not much. Never too endowed, perhaps I'm not missing much.

Still nothing like an erection after a year, with half-nerve sparing. I've refused pills and other post-treatment as I don't want to take more drugs or have procedures. Had to increase my high blood pressure pill dosage, and things are limper than ever down south. Appetite thankfully, has declined with lack of functionality, so maybe the two are in tandem.

The wife and I are busier than ever, just not in the bedroom, not that we don't try, and we do get a laugh out of the situation, amazingly enough. She calls me her support system. I give her a good tongue lashing (wink) in thanks.

I'm not sure how I'd process the whole post-experience if I were younger (under 60) or been more sexually active or had my sexual functionality more connected to my persona.

Re: "Fragile male self image"

Hi Jon,
I'm 64 and 4 months post RALP. Not being well endowd, I was concerned about shortening. I was advised to use a vacumn pump and 5 mg cialis daily to keep the blood flowing to preserve what length and girth I had after sugery. I did lose the 1/2" I was told I would. These seem to be doing the job! So far Viagra and Cialis do nothing for a boner. The vacumn can be used with a constriction band and allows enough erection for sex. We were very active before and losing that was my biggest concern before and after surgery. Reluctantly, I asked about the Trimix injections a month ago, tried it and after the learning curve and some experimenting, have become comfortable and pleased with the results!! The OMG inject my willie factor was the biggest obstacle and it wasn't near the issue I had feared. It's like being 18 again and lasting longer than ever before! The wife was dually impressed! This was huge to an already damaged self image. Orgasm is possible and a little urine leak is easily compensated for. That is supposed to subside with time. All this to say, don't give up!! Read everything you can find on the subject and try to get-keep it UP!