Regrets? I’ve got a few …

The sense of regret I was trying to articulate in my previous post is not unusual for men who’ve had prostate cancer surgery.

In today’s Australian Financial Review, health journalist  Jill Margo writes about how hard it is for men to admit we’re not OK.

A year after a radical prostatectomy, 15 per cent of men will still be leaking urine in some way.

And only one in six of us are likely to have resumed sexual activity, post-op.

Yet when we’re asked if we regret the decision to have the surgery, most of say it was a good decision. When asked if we feel the surgery may have harmed us, we’re inclined to say no.

“On the surface it looks like the world is in order,” says leading urologist Claus Roehrborn, professor and chairman of the department of urology at the University of Texas.

But in fact it’s not. Here’s why…

The daily grind and how to beat it

It’s not possible to write about Body Electric without raising eyebrows, without risk.

Because as soon as you say, or write, the words “erotic massage” a whole suite of judgements jump into our head. Or at least they did into mine.

Hippy shit. Psycho babble. Key parties, pervy pooves and creepy crap. And that’s just for starters.

So the first thing you’ve got to do if you want to get a handle on Body Electric is to turn off that inner critic. We also need to agree that eroticism and sex are inter-related but they’re not the same thing.

Sex, mostly, is about genital contact that leads to orgasm or ejaculation. A very basic definition, I know. But bear with me…

Eroticism, on the other hand, is not focussed on genitals. It’s about the erogenous zones that exist across our bodies and within our minds, and it’s about the actions or objects that activate those zones.

Over the weekend just passed, I participated in a Celebrating the Body Electric program with a group of 20 men and it was freaking amazing.

I’ve never parachuted, because I think the laws of gravity are more powerful than rope and silk. But I imagine the feeling you get after a parachute jump would be similar to how we felt at the end of last weekend.

We checked-in on Friday night as strangers to each other. Over the next 48 hours, we learnt about intimacy, trust and honesty. We learnt how to generate and sustain our erotic energy, and how to give and receive erotic pleasure without erections and/or ejaculation.


Not really. It was challenging and sometimes scary. It took us way beyond our comfort zone. And I have to admit to plotting my escape at least once or twice in the first 24 hours.

Thankfully, my internal critic was overwhelmed by the sheer bloody thrill of engaging with other men in ways that we rarely do in our everyday lives.

So why did I do it?

I want to re-establish my sex life. Previously, sex was a no-brainer. But as you know, that all changed after prostate cancer surgery. Without semen, and without an erection, I was feeling well and truly mansacked. My sex life, if that’s what you’d call it, was  now medicalised, dysfunctional and dissatisfying.

Body Electric is not a magic cure. But it did significantly broaden my horizons and lead me back in the world of possibilities.

For the past year or two, I’ve been grinding my teeth in my sleep. Expressing pent-up frustration, anger and sadness.

My dentist made a mouthguard to wear to minimise the damage, and that kind of worked. Well, it addressed the symptoms, at least, but not the cause…

The thing is, that mouthguard has sat untouched on my bedside table since I got home on Sunday night.

Seems like there’s nothing like a bit of erotic energy to beat the daily grind.



The prostate matters in a gay man’s sex life

Today’s Australian Financial Review picks up on the impacts of prostate cancer on gay men.

The article highlights the Prostate Council of Australia’s publication of four booklets written specifically for a gay cohort (and mentioned on Mansacked recently).

“After being invisible in the prostate cancer community for 20 years, gay and bisexual men are finally being seen,” writes the AFR’s Jill Margo.

“Late in 2015, a set of four booklets was produced in Australia specifically for gay and bisexual men.

“This is thought to be a world first and the initiative was funded by the federal government via a Cancer Australia grant.

“The booklets take a frank look at the role of the prostate in gay sex.”

Margo’s article makes no bones about articulating the issues.

“Without a prostate there is no ejaculation and no semen exchange, which has an important role in the sexual play between men who have sex with men.

“Without a prostate, the receptive partner in anal sex doesn’t get the benefit of having his prostate massaged, a process that augments orgasm.

“Without a prostate, the active partner might not have an erection rigid enough for penetrative anal sex. While men might recover some erectile function after surgery, vaginal penetration is generally easier.

“Surgery can cause problems with urinary continence, which can reduce a man’s sense of being sexually desirable. It can also lead to the leaking of urine on orgasm.

“For some men orgasm becomes painful, although this generally doesn’t last.

“Apart from creating a scar, surgery can reduce length and width of the penis, further affecting body image.

“Radiation has a range of issues too, such as a slow decline in potency, reduction in ejaculate and bowel complications.

“Following radiation, the receptive partner might find anal sex makes the pain worse and damages the delicate lining of the anus and rectum.”

Read more:


Frank discussions, worth sharing

A fellow blogger, Dan, wrote a post not too long ago addressed to men recently diagnosed with cancer.

His letter to the newly diagnosed is worth reading if you’re beginning to grapple with cancer or know someone who is.

And for gay men, there’s an especially valuable resource called the Prostate Cancer Pack: Information for Gay and Bisexual Men, published by the Prostate Cancer Foundation of Australia (PCFA).

Like Dan’s blog, the cancer pack mentioned above offers insights gleaned from first-hand experience, as well as frank discussion about prostate cancer from a gay and bisexual point of view.

Only one of the many health professionals I’ve encountered during the past six months knew about the PCFA information pack. Others were surprised to hear about it and wanted to know more. So this is a link that’s well worth sharing because there’s something here for young and old, gay or straight, married or single…


Dan’s journey

Dan was 52 when he was diagnosed on 11 November 2010.

He’s been blogging about his experience of prostate cancer and life after surgery “as a creative and sometimes irreverent means of venting and sharing my thoughts, feelings, and latest status. If I don’t do this, my head will explode.”

Know what you mean, Dan. And thanks for sharing.

It’s good to know there are other men rabbiting on about incontinence and erections and everything else that goes with having prostate cancer and surgery. Now I don’t feel so self-obsessed. I can point to Dan’s blog and say to myself, “he’s doing it too.”

Am sorry to hear, Dan, that your PSA has kicked up a little after being undetectable for so long. I’d assumed that if you’d had undetectable PSA for several years after surgery, you could pretty much say goodbye to PSA-anxiety and everything that goes with it. Here’s hoping your next test in December gives some peace of mind.

Blood tests are undoubtedly a most amazing diagnostic tool. But jeez they’re bloody brutal, too. They don’t take anyone’s feelings into account.

In wishing Dan peace of mind I’m also wanting same for myself, of course. I see my urologist tomorrow for the results from blood and urine samples I provided last week.

It’s early days for me.

I had the prostate operation just five months ago, on 5 June 2015, and returned a zero PSA reading when I had my first post-operative check-up two months later. I’m expecting no change tomorrow because it feels way to soon for things to be otherwise.

Fingers crossed…

You can read more about Dan at

It’s cocktail hour

Funny how what started out as a cancer thing has morphed into a sex thing.

With a zero PSA level recorded in my latest blood tests, the focus has shifted from dealing with the cancer to dealing with the collateral damage.

But first, a pause to acknowledge and give thanks. That  zero PSA reading is a real achievement.

If my blood keeps delivering zero PSA levels for the next few years, we can say with certainty that I’m cured of this cancer.

Huge thanks, then, to Dr Eisinger for a successful operation; to my local GP, Dr Paul Sztolcman, who initiated screening a year ago; and to my partner Malcolm for supporting me all the way through this with humour, patience and hard labour.

Thanks also to friends and family. Your support is invaluable.

So, moving onto the sex thing…

I’ve injected myself twice now with a triple mix of drugs prescribed by Dr Chris McMahon, who is a Genitourinary Physician at the Australian Centre for Sexual Health.

The drugs are alprostadil, papaverine and phentolamine. They come in liquid form, in a small vial stored in the fridge.

At least every couple of days, you’re supposed to fill a syringe with 6 units of this cocktail and inject it into the shaft of your penis. And then let the fun begin.

Am still getting over the creepy factor. Sticking a needle into yourself is hard at the best of times. Sticking one into your dick is even harder.

The injections are part of a rehab strategy designed to stimulate the penile nerve tissue that is inevitably damaged during a radical prostatectomy.

But as wikipedia explains, there’s more to getting an erection than meets the eye. There’s a complex set of psychological, neural, vascular and endocrine factors at play. And it’s likely that the triple mix I inject into my penis, and the daily dose of Cialis I’m taking, address some but not all of these factors.

So we’re not there yet but I’ll keep injecting for the time being because as the doc explained, it’s a matter of ‘use it or lose it’. Those words would have sent a shiver down my spine in earlier years …

Talking the talk

Listening to other men talk about their experience of prostate cancer is illuminating and disturbing.

It becomes clear that there’s a spectrum. Some men heal quickly, others are seeing their PSA levels rise several years after surgery. That’s not good news.

Then there are the in-betweeners, men who have had the op in the past year or so and who are on tenterhooks each time they present for blood test, fearing that an elevated PSA reading would keep them in the cancer zone.

Most men continue to experience varying degrees of incontinence and erectile dysfunction. Some have other cancers. These can be caused by their prostate cancer, but not always. Sometimes it’s just genetic.

So it’s illuminating to hear 10 men’s stories and get a sense of the spectrum of experiences. As with most things in life, there’s no single story that adequately captures or explains what’s going on. But there are commonalities.

It’s disturbing, too, because some of these stories point to end-of-life. One of the men who spoke offered the observation that everyone we know will die in our lifetime, or we’ll die in theirs.

True. But not exactly uplifting.

We finish talking, pack our chairs into stacks at the back of the room, say goodbye, and melt back into the street.

From the conversations I was part of, its clear that the condition of our bodies is not the only thing on the spectrum.

Psychologically and emotionally, we’re variously anxious, unburdened, embraced and adrift.