Source: Chicago Sun-Times
Author: Judy Masterson
Published: October 14, 2013
A diagnosis of prostate cancer can mean the beginning of a new way of life for men and their partners who must make big decisions about treatment options and learn to cope with the effects of both the disease and medical interventions that can leave a man impotent.
Mind-body therapist Corliss Ivy works as part of a treatment team at Cancer Treatment Centers of America at Midwestern Regional Medical Center in Zion to help couples grappling with such issues.
“There are many assumptions that come with prostate cancer,” said Ivy, 31, a resident of Waukegan. “Many couples fear they may never again have an intimate relationship in terms of a sexual relationship. It may not be like before, but even though it may not, they can still find deep meaning and satisfaction in their sexual relationship.”
Ivy, a nationally certified, licensed professional counselor, said that for some partners, a cancer diagnosis can bring preexisting problems to light.
“There’s an assumption that people are losing their relationship,” Ivy said. “But what they find is the quality of their relationship is not what they wanted it to be in the first place. How do we begin to process that? They have to ask, ‘What is the meaning of my life and how has that meaning changed because of cancer?’ ”
Ivy is counseling a couple in their late 70s.
“It’s very, very powerful to witness them discovering how to be connected, how to enjoy each other‘s company again,” Ivy said. ”One thing I would tell patients, or tell anyone, is they do not have to be afraid to ask questions. They are not alone. They have the tools and the strength to take the best care of themselves.”
Erectile dysfunction happens to between 15 and 60 percent of prostate cancer patients after surgery, according to CTCA medical oncologist Dr. Evan Pisick, who cited age and pretreatment factors as reasons for the wide variance. Men undergoing radiation have a 25 to 50 percent chance of impotence, Pisick said.
“There are so many factors that go into determining outcomes for each patient,” Pisick said. “Not everything can be fixed with medical procedures and medication.
“We always say ‘mind over body.’ If we can’t restore erections to a man, there are other ways to achieve intimacy. Corliss really helps these men and their significant others. Intimacy is part of a powerful relationship between two people who love each other. But that’s not always about erection, ejaculation and sex.”
Ivy uses movement-based exercises to help restore intimacy. In one, couples sit back-to-back, spines aligned and breathe gently in-tune. Moving and breathing in sync stimulates feelings of intentional togetherness, said Ivy, who also encourages the development of a daily routine of nonsexual, intimate activities such as kissing and hugging upon leaving or reuniting as a reminder of love and care and scheduling alone time without TV or other distractions.
Therapy sessions afford a space to feel safe, to allow vulnerability, openness and honesty.
“Couples need to be honest about their feelings and concerns in coping with loss,” Ivy said. “In doing that, they’re discovering things about one another, things that enhance their relationship.
“We build together very concrete tools and steps in creating greater intimacy,” Ivy said. “It’s about creating a home environment that is loving and safe.”
Another enemy of sexual intimacy, for cancer survivors and just about anyone else, Ivy said, is stress.
“If we’re not getting enough rest or we’re overwhelmed by daily tasks, it shows in how we function physically,” Ivy said. “If we’re in stress response, the last thing the brain will tell the body to do is to perform sexually.”
About Prostate Cancer
About 265,000 men are diagnosed with prostate cancer in the United States each year.
Cancer Treatment Centers of America medical oncologist Dr. Evan Pisick said more men who are diagnosed with a low-grade disease are opting for “active surveillance” over immediate medical intervention.
“They’re putting putting off treatment ’til they need it, if the cancer becomes more aggressive, down the road,” Pisick said. “Sometimes there’s more anxiety over treatment than the cancer itself. “
Men with prostate cancer may have no symptoms. But symptoms can include trouble with urination and erectile dysfunction.
“We recommend any man who has abnormal urinary issues sit down with their primary doctor and determine if a PSA (prostate-specific antigen) test is right for them,” said Pisick, who added that he doesn’t recommend “everyone willy nilly get a PSA test” and noted, “biopsies are not side-effect free.”
With the advent of the PSA test, more men are being diagnosed with early stage cancers, said Pisick, who dryly observed that it’s preferable for patients to “die with prostate cancer, not from prostate cancer.”