More trouble healing mentally than physically

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New Member

Date Joined May 2009
Total Posts : 7
   Posted 6/24/2009 4:02 PM (GMT -6)   
I posted here several weeks ago, but to recap my problem - I had prostate surgery to correct a urinary problem, not for cancer. The doctor neglected to inform me the surgery would result in retrograde ejaculation. Then when I approached him about it, he denied being negligent (no surprise there).
Anyway, the loss of ejaculate along with the felling of being helpless to do anything about it has been mentally devistating for me. I have been in therapy and on anti-depressants for about a year now. (And, yes, I am changing urologists). While I am still able to perform physically - although to a lesser degress due to the anti-depressants, any sexual act reminds me of what I have lost and how big a jerk the doctor was about it.
I feel myself falling into a trap. I avoid sex because of the anger it triggers and I fell like less of a man because of what I have lost. Between the anger, anxiety and depression, I have little interest in sex lately.
Has anyone had to deal with this? Does feeling cheated because you got cancer equate to anger, too? Why am i having such a hard time getting past this?

James C.
Veteran Member

Date Joined Aug 2007
Total Posts : 4462
   Posted 6/24/2009 4:52 PM (GMT -6)   
I don't know that any of us can offer you any further advice or suggestions than was given the last time.  Therepy, anti-depressants, and really accepting that you got a raw deal, but in the overall scheme of things you are fortunate, when compared to prostate cancer victims here.  We feel, but we can't do anything for you.  I suggest trying one of the other forums,- Anxiety/Panic or Depression will give you more results as far as advice, assistance and the emotional support you seem to need.  In all honesty, the majority of the guys here probably consider your complaint of dry ejaculations a minor problem in their life now, so have no real way to relate to your situation.   Do consider going to the other 2 groups and reaching out to them.  They are very much more equipped to be of help to you.
James C. Age 62
Co-Moderator- Prostate Cancer Forum
4/07 PSA 7.6, referred to Urologist, recheck 6.7
7/07 Biopsy: 3 of 16 PCa, 5% involved, left lobe, GS 3/3=6
9/07 Nerve sparing open RRP- Path Report: GS 3+3=6 Stg. pT2c, 110gms, margins clear
21 mts: ED- 50 mg Viagra 3X week, pump daily,Trimix .35ml 2X week continues
PSA's: .04 each 3 months

Regular Member

Date Joined May 2009
Total Posts : 476
   Posted 6/24/2009 6:39 PM (GMT -6)   
Well put, James. I consider myself lucky that I am around, feel well, and even able to have sex lately.

Father died from poorly differentiated PCa @ 78 - normal PSA and DRE

5 biopsies over 4 years negative while PSA going from 3.8 to 28

Dx Nov 2007, age 46, PSA 29, Gleason 4+4=8

Decided to participate in clinical trial at Duke - 6 rounds of chemo (Taxotere+Avastin)

PSA results:            1/8/2008-33.90, 1/11/2008-29.50, 1/31/2008-38.20,

2/21/2008-32.00, 3/13/2008-26.20, 4/3/2008-26.60, 4/24/2008-20.60

RRP at Duke (Dr. Moul) on 6/16/2008

Pathology:              Gleason downgraded 4+3=7,   Duke: T2c N0MX, one positive margin,

2nd opinion at Sloan Kettering: T3a N0MX, extraprostatic extension, two positive margins

PSA undetectable for 8 months, then 2/6/2009-0.10, 4/26/2009-0.17, 5/22/2009-0.20, 6/11/2009-0.27

6 Months ADT: Casodex started 6/12/2009, Lupron 6/22/2009

IMRT to start mid-Aug

Elite Member

Date Joined Oct 2008
Total Posts : 25380
   Posted 6/24/2009 9:36 PM (GMT -6)   

We do sympathize and empathize with you on the loss of ejaculation, for those of us with PC that had surgery, that is a fact of life. It took me months to "get over" that part in my mind. It's only a natural man thing to have fluid with an orgasm. Once I got past that point, I realized how fortunate I was, I can have sex without any ED issues (rare among men with PC surgery and some of the other primary treatments), my orgasms are longer and deeper than any pre-surgery, and more importantly, I am thankful that for now, at least, my cancer is somewhat under control, I am still alive, with my wife and family and friends. My manhood, and yours too, is not framed by the ability or lack of ability to ejaculate. You should have been informed by your doctor, or you should have asked more questions, or both, but in the bigger picture of things, you are doing better than you think. I hope you feel better soon about your situation.

And don't forget the best part of your story, you don't have prostate cancer, you aren't surgically or radiated impotent, you aren't wetting yourself for months learning to be dry again.

Not preaching to you, brother, just trying to help you keep the priorities of things correct. Come back for encouragement anytime.

David in SC

Age 56, 56 at DX, PSA 7/7 5.8, 7/8 12.3,9/8 14.5
3rd Biopsy Sept 08: Positive 7 of 7 cores, 40-90%, Gleason 7, 4+3
Open RP surgery 11/14/8, Right nerves spared, 4 days hospital, staples out 11/24/8, 5th cath out on 1/19/9
Post-surgery Pathlogy Report:Gleason 3+4=7, pT2c, 42 grm, tumor 20%, Contained in capsular, clear margins, clear lymph nodes 
First PSA Post Surgery   2/9 .05, 5/9 .10, 6/9 .11, July 13 - meet with radiation oncologist

Post Edited (Purgatory) : 6/24/2009 8:39:02 PM (GMT-6)

Veteran Member

Date Joined Apr 2009
Total Posts : 990
   Posted 6/24/2009 10:02 PM (GMT -6)   
I think, like a lot of members, I saw your earlier posts and did not respond. This is a group not much given to anger – we cast the dice with Fate and we deal with the result.

This is not to deny that your anger is not real and incredibly painful. The fact that you are here shows that you know that the pain needs to be treated. I agree with others who urge you to seek a group that deals with issues of anger, perhaps a local group that meets face to face in a church or civic center.

On the other hand, we are people who are crippled in much the same way that you are. If there is an ethos of this group, it is to move forward from where we are and to appreciate how much of life remains. Look around. If we can help you in appreciating and enjoying what physical capability remains to us and to you, then join in our journey. In any case our hopes and prayers are with you.
Age at diagnosis 66, PSA 5.5
Biopsy 12/08 12 cores, 8 positive
Gleason 3 + 4 = 7
CAT scan 1/09 negative, Bone scan 1/09 negative

Robotic surgery 03/03/09 Catheter Removed 03/08/09
Post surgical pathology report. Lymph nodes negative, Seminal vesicles negative
Surgical margins positive, Capsular penetration extensive Gleason 4 + 3 = 7
At 6 weeks: 1 pad/day, 1 pad/night -- mostly dry at night.
At 10 weeks: no pad at night -- slight unpredictable leakage day/1 pad.

Regular Member

Date Joined Apr 2009
Total Posts : 179
   Posted 6/25/2009 6:27 AM (GMT -6)   
IWasRobbed said...
 Does feeling cheated because you got cancer equate to anger, too?
I might have felt anger except that I don't feel cheated. In some ways for me the cancer was a gift. That may seem odd but I have to say that prior to my dx I was just drifting through life, unconnected to those around me and frequently wasting this gift of life. The cancer was a slap in the face and notice that what we have is precious and, whatever our condition, there is very little of what we've been given to waste.
Age 62, Sex Male
PSA - 3-20-08 2.7; 4-17-08 3.1; 9-18-08 3.6; 1-22-09 3.8
DRE negative
Ultrasound/biopsy 2-12-09, 50cc
4 of 12 samples positive 3+3=6, Right mid-medial <5%, Right mid-lateral 10-20%, Right base medial 10%, Right base lateral 10% adenocarcinoma

open RRP completed 5-5-09
Post surgical pathology report:
Gleason 3+3=6
Lobes involved - left and right
Extraprostatic extension - none
Surgical margins - very small area of margin involvement in right lobe
Seminal vesicles - Free of neoplasm
Vascular/Lymphatic invasion - none
J-P drain, staples and catheter removed on 5-13-09
No incontinence issues, no ED issues.
Back to work (desk job) in 9 days from surgery.
Surgeon: Dr. Gary B. Bokinsky

6-19-09 PSA<0.1

Remember, don't let the bastages get you down !!!

Veteran Member

Date Joined Jul 2008
Total Posts : 966
   Posted 6/25/2009 8:24 AM (GMT -6)   
jacketch said...
IWasRobbed said...
 Does feeling cheated because you got cancer equate to anger, too?
I might have felt anger except that I don't feel cheated. In some ways for me the cancer was a gift. That may seem odd but I have to say that prior to my dx I was just drifting through life, unconnected to those around me and frequently wasting this gift of life. The cancer was a slap in the face and notice that what we have is precious and, whatever our condition, there is very little of what we've been given to waste.

Well put feelings exactly

You are beating back cancer, so hold your head up with dignity
Age 58 at Diagnosis
Oct 2006 - PSA 2.6 - DRE Normal
May 2008 - PSA 4.6 - DRE Normal / TRUS normal
July 2008 - Biopsy 4 of 12 Positive 5 - 30% Involved Bilateral w/PNI - Gleason (3+3)6 Stage T1C
Robotic Surgery Sept 18, 2008
Pathology October 1, 2008 - Gleason 7 (3+4) Staged pT2c NO MX - Gland 50 cc
Seminal Vesicles and Lymph Nodes clear
Positive Margins Right Posterior Lobe
PSA 5 week Oct 2008 <.05
                   3 month Jan 2009 .06
                   6 month April 2009 .06

Veteran Member

Date Joined Jan 2009
Total Posts : 2229
   Posted 6/25/2009 9:50 AM (GMT -6)   
I am guilty of anger, self pity, feelings of inadequacy. The emotions are like clouds, they just pass thru unless I stay focused on them. Was walking around the lake at a State Park near my home last night about 6pm. What I noticed was that I failed to see the beautiful surroundings when I was focused on my pain and self pity. Would like to tell you it wont happen again, but I know better. When I stopped to look at the lake and the sunlight shimmering off the water, my pain was no where to be found. At this point if I watch television, I watch comedy such as reruns of Seinfeld, Everybody Loves Raymond, King of Queens and yes Andy Griffith Show. The bigger picture at age 60 is my legacy to my family, my children and grandchildren and of how they will remember me. So at low points I take my grnachildren to the lake and all of a sudden life is okay again.
Dx with PCA 12/08 2 out of 12 cores positive
59 yo when dx
Robotic surgery 5/09 Atlanta, Ga
Catheter out after 10 days
Gleason upgraded to 3+5, volume less than 10%
Margins not involved
2 pads per day, 1 depends but getting better
hope to start ed tx 7/17

Regular Member

Date Joined May 2009
Total Posts : 60
   Posted 6/25/2009 8:54 PM (GMT -6)   
See the posts a few pages back about the Jarvik Artificial Prostate transplant.  That will cheer you up.

New Member

Date Joined Jun 2009
Total Posts : 6
   Posted 6/26/2009 4:21 PM (GMT -6)   
Although I am not going through your particular journey, I am a very young PC survivor and to some extent have struggled more with the lack of ejaculation that some of the other fine members here. I was diagnosed when I was 38 years old, and had surgery to remove the prostate at the start of April 2009. It's been 11 weeks to the day since the operation and sometimes I feel that I am less of a man because I can no longer produce.

For me the mental side of things has been the most difficult to deal with. I am a sensitive chap, always have been, and I also tend to think deeply about things or so my wife tells me and this is why I have struggled. One thing to keep in mind though is that the will to over come these feelings you are having must come from within you. Pills only mask the problem, I know because I've been there, and in some cases make things worse. You have to believe in yourself, and to accept the situation you find yourself in. Then, and only then, will you be ready to take the next steps on your journey.

Regular Member

Date Joined Jun 2009
Total Posts : 77
   Posted 6/27/2009 4:41 PM (GMT -6)   
Very well said rondav. The Christian missionary Jim Elliot said it best when he wrote:

"He is no fool who gives what he cannot keep to gain that which he cannot lose"

I am curing my post surgery emotional issues by looking at the big picture - I have 3 sons. The oldest is 14. I am convinced that without my surgery, I'd probably not be around to see any of them graduate from college much less see my grand children. A lack of 'ejaculate' when I have sex wouldn't kill me but PC would. I kept my PC for a while (watching) and I am sure that I am emotionally better off now than when I walked about with an Erect penis capable of high pressure ejaculations but with PC at the back of my mind.
In my humble opinion, the decison to embark on this surgery journey for the sake of my children makes me a real man. I have seen and used enough 'ejaculate' and 'erections' in my life and at 45 I refuse to accept that a surgery that gives me a better chance of seeing my grand kids makes me less of a man because my erections are no longer spontaneous (there is still a chance this is temporal) and I don't see white sticky stuff when I ejaculate.
With this thing, no point looking back. What's done is done. Forward ever!
>Age 41 (At Dx-July 05) -Psa during annual physical went from previous 2.8 to 3
>Biopsy by 'primary' Urol Aug 05 - Gleason 6 low grade. 2nd opinion at  Hopkins confirmed Dx
>Chose Active Surv (AS)- modified diet etc.
>Around Oct 07 Psa moved up to 5.5. I decide to treat at Hopkins. Not sure what kind yet. My doctor decided on re-biopsy first.
>2nd Biopsy Dec 07 at Hopkins was NEGATIVE for Pca! Nothing found in 14 cores!
>'Primary' Urologist baffled. Planned a saturated biopsy (22 cores) to settle issue once and for all. I wasn't going to do 22 cores wide awake!
>July 07 - Did MRI just for comfort. Nothing significant found. No spread. I'd live! Still in AS mode.
>July 08 - Saturated Biopsy performed. Cancer confirmed again (of course, you took 22 cores)! Same Gleason score, same grade, similar numbers but Urol says treat very soon! I am thinking not so fast - numbers are same and you told me it means not aggressive! In any case I agreed with Urol that I will go the way of the Seeds. I research seeds more and I don't like it.
>July 08 - Dec 08 I re-lapse back into AS mode but seriously researching/considering treatment options beside surgery - went on to Mass Gen and Georgetown to explore proton therapy and Cyberknife respectively. Anything but Surgery! Both experts who are about my age were unanimous in strongly declaring they will chose surgery 'if they were me'. In addition, I learn that if either if these radiation methods (and seeds too!)  failed, no backup plan (or will be complicated)! I got the message!
>Jan 09. Went back to see my doc at Hopkins. I decide to put my fate in the hands  of the 'Da Vinci Robot' then!
> May 09. Had surgery. some Pain and discomfort but normal. Pathology all clear. Gleason 6 as before. Feeling very lucky. I gambled (based on my numbers and got 4 more years!) on the slow nature of the cancer and took my time. Very happy I finally did it. Hoping for a great recovery of all 'key' functions. Great wife and family helping out.

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