Prostate Cancer's Aftermath: Erectile Dysfunction and Other Side Effects, Part 1

Victoria Hallerman knows all too well the effects that prostate cancer treatments can have on a relationship – both emotionally and intimately. Her book, How We Survived Prostate Cancer: What We Did and What We Should Have Done, is part memoir and part guidebook for other couples facing the journey through prostate cancer treatment and recovery. Victoria’s husband, Dean, was diagnosed with prostate cancer after the couple had been married 33 years. Her book is described as an “unflinchingly honest account of one couple’s difficulty and ill-informed choices during prostate cancer treatment."

Victoria generously shares her intimate story in the hope that it will help others make better choices if faced with this disease. Today in part one of our two-part interview, Victoria answers questions about Dean’s diagnosis, the effects his treatment had on their sex life, and what she wishes they had done differently. 

Denene Brox: What prompted you to write your book, How We Survived Prostate Cancer? What were your goals?

Victoria Hallerman: I had no goals originally, it was just a journal prompted by loneliness, fear and confusion. My husband was rushed into treatment by his original urologist and primary care physician, without any real sense of what alternative treatments were available. I went looking for books that would clarify the treatment choices and offer advice, from a wife's perspective, on how to cope with what was happening to us, but no such book presented itself. If I ultimately had a goal in writing the book, it was to reach other wives and partners, as well as patients and tell them how hard and confusing and life-changing treatment really is. 

DB: Share with us a little bit about Dean’s prostate cancer diagnosis and treatment.

VH: His case was typical of those men who are diagnosed via PSA: A PSA rapidly escalating, a Gleason 6, stage T1c.  His primary care doctor had been following the PSA, then sent him to a urologist who continued to monitor it. Both doctors urged him to go for Brachytherapy (he had the impression from them that it was the best treatment available). In order to make seed implantation viable for a man with a prostate as large as his (90 cc's), hormone ablation (ADT) treatments were recommended to shrink his prostate, so he received six months of ADT. 

DB: The subtitle of your book is "what we did and what we should have done." Give us a couple of examples of things you feel you should have done and why. 

VH: We both wish we'd joined Man to Man--the prostate cancer community we currently belong to --sooner. 

• We wish we'd gotten more than one opinion. 
• He wishes he'd asked for my help, and I wish I'd offered it!  
• We were woefully under-informed about treatments available. Given Dean's age at the time (mid- fifties) and the size of his prostate (90 cc's), he might have been better off getting a prostatectomy. At the time of diagnosis, he was hesitant to undergo surgery on account of his work schedule, but if he had it to do over again, he'd do practically anything to avoid the ADT treatments and their effects. 

DB: In your book you candidly discuss "post-treatment surprises" – specifically some unexpected sexual side effects. What are some examples?

VH: We had the impression (mistaken) that ADT would cause temporary unpleasantness. In reality, it changed our lives in ways so profound we're still coping with the aftermath. Libido was the greatest (permanent) loss, but erectile dysfunction, lethargy, weight gain, and the loss of his general sense of manhood were also considerable. Post-treatment surprises having to do with radiation included burning and scarring, painful urination and incontinence which lasted longer than predicted, nocturnal leg twitches, and bowel complications. 

Some of these may have had to do with the fact that his prostate was still larger than it should have been at the point of seed implantation. My book was born, ironically, out of the loneliness and separation I felt when we were sleeping apart -- on different floors.

Don't miss Friday's post when Victoria shares what she learned about erectile dysfunction and her advice to other couples struggling with sexual intimacy after prostate cancer treatment.