Men's things XXXI: Can Intimacy Be Reclaimed After Prostate Cancer?

The Unspoken Battle

It is the unspoken conversation, one I have barely had with myself and definitely not with others, including my partner, my medical and cancer support teams.

When I was diagnosed with malignant prostate cancer in June 2024, the first physical urge that left me was sexual desire, as though someone had just kicked me in the balls. It wasn't pain, just a numbness of confusion and incapacity.

Preparing for the Obvious

Even for a man with African heritage and no need for machismo, I have been open about the bowel and bladder issues. I was quite read up on them and ready to attend to the matters concerned. I didn't want a catheter insertion for whatever reason, but incontinence underwear? I was ready to model it for men of a certain age and body, if necessary. I do like my underwear, and I have used linings too; the situation is manageable.

However, on the sexual part—the big mammoth in the room—I have ignored its presence and viewed it as part of the weight-bearing structure of that space, insignificant if it played dead and never moved. But 17 months after radiotherapy, with all things looking good, the mammoth is awakening from its imposed hibernation.

Weighing the Options

If I wanted sex, and I enjoyed sex, this diagnosis exacerbated and crystallised the ideas of sexual dysfunction in my mind.

In choosing the option for treatment, I first spoke to the consultant surgeon about the radical prostatectomy procedure. A year before, a men's advocate who had undergone it explained that the expert surgeon was able to save the nerves necessary to retain some sexual functions.

The surgeon was quite candid with me: my prostate gland was so enlarged that he couldn't guarantee anything could be saved of my nerves until he was in there conducting the surgery.

Imagining the Aftermath

As this procedure is conducted under general anaesthetic, the prospect of waking up to a surgeon trying to express happiness and sadness in the same facial expression was one I was not intent on seeing.

His professionalism and years of experience might have given him the skill as a comic piece, but it would have been a joke at my expense. “Mr Akintayo, we successfully removed the prostate gland. However, your sex life is gone; you're impotent. But we can make some interesting toys for you, to have some sensation and other elements of pleasure.”

I'd be crying tears of joy for being free of cancer, catheter inserted as there is no urinary control for months, finding where my pelvic floor is, and living happily ever after.

Then I ask, even if this smacks of medical paternalism: should surgeons be more proactive in discussing sexual health outcomes?

Learning from Others

Another friend had undergone the procedure a few years before. He, a straight man, came to me to seek advice about the kinds of sex I know. Much as I could have helped, I felt he needed to join a men's support group to appreciate the experiences of men in similar circumstances before thinking of this, because his views were explorative to my hearing, rather than developed.

From that surgery discussion, I knew it was not for me. At the same time, I needed that cancer excised because, whichever way you look at it, dead men do not have sex.

Another question arises: how do cultural expectations of manhood affect seeking the essential prostate health check-ups first, before considering the treatment decisions and recovery?

Radiotherapy and Its Consequences

As I took radiotherapy, the immediate and enduring side effects have been bladder related, with a few bowel issues. My sex drive is depleted by being unsure of ability and compounded by lacking confidence. It is also not something that can be addressed with bravado.

As you can read, I am tackling this issue alone because I do not understand this vulnerability enough to appreciate the kind of help I need.

The Medication Dilemma

Yes, I can get erectile dysfunction medication and pop pills like sweets, but that not only becomes a prop; it does not address the emotional and mental issues. Rather, it becomes a legalised version of chemical sex, getting a prescription from a pharmacist instead of illicit drugs delivered by a dealer.

The question then becomes, how many highs can I have before drug-induced priapism or severe hypotension with the risk of death is the danger?

Furthermore, because it has been offered, is the medical establishment over-reliant on pharmaceutical solutions rather than psychological support?

Rethinking Intimacy

As men, we are fixated with erection and penetration as the full expressions of sex; the absence of either or both feeds a kind of sexual frustration for the person and their partner. Does sex become a distant memory rather than a present experience with a hopeful better consummation, or are damaged goods being repackaged for a partner with different expectations?

For gay men, where physical intimacy and sexual expression often form central parts of identity and connection, the loss can feel particularly acute. The dynamics of same-sex relationships, where both partners understand male sexuality from lived experience, can create a unique space for empathy and shared problem-solving.

Yet it can also mean both partners acutely feel the absence of what was, and the uncertainty of what might be possible. The fear of being seen as “broken” or inadequate in a community that sometimes prizes sexual vitality can compound the isolation.

For straight men, the challenge often involves navigating conversations with partners who may not fully grasp the psychological weight of erectile dysfunction on male identity. There's the added pressure of traditional gender roles and expectations around male performance.

Meanwhile, bisexual men face both sets of pressures, depending on the gender of their partner, alongside navigating healthcare systems that may not fully recognise or address their specific concerns.

Regardless of sexual orientation, the fundamental question remains: how do you maintain intimacy and connection when the language of physical expression you once spoke fluently becomes halting and uncertain?

Confronting the Fear

Yes, I have literally thought through all this with a clear indication that I probably need to re-engage with a support system that would address many of the pertinent issues after treatment for prostate cancer. The questions are not abstract; they are real issues in existing relationships.

You might wonder, if I have managed the bowel and bladder issues that well, why am I struggling with the sexual one? Whether we like it or not, it defines, to a certain degree, manhood, manliness, performance, and self-esteem. Maybe, just maybe, this is part of the fear that stops us black guys from talking about men's things.

One last question: are Black men receiving adequate support and information about sex, sexual health, and sexual expression after cancer treatment?

Moving Forward

Yet we need to talk. Prostate cancer cannot be the last story, and navigating a way to fulfilled sexual satisfaction after prostate cancer treatment must not be greeted by the shock of the experience, but by the hope of new possibilities through therapy, support, and understanding.

How intimacy changes in relationships is a journey that has no clear answers for both parties, and that might not be the prospect a partner desires in what looked amazing before cancer struck and stole our virility.

Check your Prostate Cancer risk in 30 seconds.

Blog - Men's things XXX: Let's talk Prostate Cancer

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Blog - A prostate cancer diagnosis, one year on

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A Google NotebookLM AI Audio Overview Discussion of this blog

I’ll have that boy

No face in this race

From the moment I saw the byline in an email message, I had a feeling something was not quite right with the proposal. In fact, everything seemed wrong about it, but at the very least, I needed to humour them by sincerely reading the story before commenting.

The teen founder turning male fertility into a sport

The Hustle - Jay Fuchs

At the questionable border of sports entertainment and male fertility is Sperm Racing, a startup that recently closed a $10m seed round.

As the propinquity of perspicacity and perspective grants permission, the author of the piece in The Hustle, which is the sales blog of Hubspot, not to be confused with Hustler Magazine, could not have had a more unfortunate name, if pronounced in a certain way, in his role as the managing editor, Jay Fuchs.

Moving on, Eric Zhu is the 18-year-old entrepreneur and founder of Sperm Racing, an outfit set up to address the issue of seemingly declining male fertility in a rather novel way, while promoting a dialogue on the matter too, and everything you think it is, is probably all it is and more, from the name of the company.

The straight-faced debate

To determine the best swimmers on a microscopic racetrack with high-resolution cameras capturing the event, think of the desert camel races of the UAE with robot jockeys, but the sperm will run under their own steam.

Apparently, the viewership of these race events is in the high six-figure range, and the venture has closed a $10m seed round.

This almost Onanist leap from mobility to motility suggests many questions difficult to articulate, but I can see an end in sight, with a visit to a sperm bank or considering a competition between these depositories of human propagation for an open race to all comers.

Equipment set up for the race to save manhood and humanity, Guinness World Records adjudicators ensuring no underhand tactics, spectators jockeying for position, urging their colours forward, until one breasts the tape and she says, “I’ll have that boy.”

One artificial insemination later, if the winner has not been stripped of all dignity to learn of their secret of triumph, a stud farm, humans, horses, bulls, and chickens, and the business of reproduction becomes the survival of the fittest sperm, with happy endings following even more happy endings.

In the ideas market, let’s just agree, more is to come.

See Also

ABC 7 News: Bay Area student organises 1st-of-its-kind sperm race to raise men's health awareness

From 50 Cent to 1 Pound on the BBC

Tuning in to BBC

Let’s just take a break from this tummy upset that has overstayed its welcome and seek a sense of mirth that I apparently missed in the news until it appeared on one of those American night talk shows.

Perfection Plastic Surgery and MedSpa is the business of Angela Kogan who amongst other things does help put the long in schlong quite perfectly, or so it seems. For that, she has gained some notoriety and a lawsuit, because she has in her promotional material suggested 50 Cent (Now to be known as 1 Pound in the light of the crash of the Pound Sterling), was a client. [Independent: 50 Cent suing Miami doctor for allegedly suggesting rapper had penis enlargement surgery]

There is a picture of them together somewhere and the inference from 50 Cent is that she has suggested that he tuned in to the BBC. I cannot say how many channels can be tuned into, but this public display of phallic endowment and the disputations that follow can quite easily lead respectable blogs like mine into the abyss of tawdry lewdness.

Please, don’t

Now, if this does make it to court, I doubt the core aspects of discovery would be limited to proving whether 50 Cent was a client, for anyone with serious legal chops would be expected to ascertain if indeed there has been an enhancement whether cosmetic or radical and who might in his history have tuned the knobs on his television to watch more than a live performance on the BBC.

I adjure anyone who reads and listens, please, go to court on anything and everything, but never on the premise of submitting your manhood as evidence, it never has a happy ending, regardless of what you are packing. At best, frighten the living daylights out of her and find a settlement, for you will never be able to sustain an objection when the jury is curious.

If I recall, this blog did once find a doctor offering these same services, it is heartening to know that both male and female specialists are in the game to ensure that the result is fit for purpose, whatever, that might be.

Blog - Hello Dr Dick, my friends need a ... (2015)

Fathers for the laws of human gravity

Gravity rules again

I was standing in the bathtub having a hot wash being supervised by my father when he approached me and felt that undercarriage in what I soon learnt was to determine if my balls had descended. I believe I was around 7 years old and that might have been the only time I think my dad took interest in my sexual health and probably allayed of the fears that the boy who barely fit in the palm of his hands at birth, might well, grow up to be a man.

In the news, there is some alarm, as a doctor has found that phthalates are causing human babies to be born with deformed genitals. That would suggest it is not enough to check that the balls have descended, but to ascertain that there is an appendage, it has some function of endowment and the absence of deformity, after which we need to address the matter of low sperm counts. [Sky News: Human penises are shrinking because of pollution, warns scientist]

It is a serious problem

The question is what we are going to do about this existential crisis, whether we are going to allow this to become an evolutionary process of the decline of reproductive health leading to a possible extinction of the human race in the worst-case scenario, or begin to act decisively to tackle all forms of global pollution, global warming and a refocusing of reproductive health from the regulation and abuse of female genitalia, their sexual expression, and the decision matrix around birth rate and abortion.

Meanwhile for the babies who have presented the issues observed in Dr Shanna Shaw’s report, there opens a possible new branch of genitourinary medicine with an essential component of plastic surgery as pioneered by André van der Merwe, otherwise known as Dr Dick, from South Africa where the aesthetic and reparative will include the corrective and interventionist to ensure that the demonstration of certain prowess is maintained and probably enhanced for these unfortunate people afflicted innocently by the world they have been born into.

Blog: Hello Dr Dick, my friends need a ...

Get interested and involved

The medical profession having highlighted an issue that should engage us all, engendering activism, informing policy, should fully persuade politicians locally and globally to act in the interests of humanity.

Fathers and the male folk whilst on the one hand feeling for irregularities that presage prostate or testicular cancer might as well be ready to be involved enough to be fully interested in the development of their scions to observe the forces of gravity and the thriving of the organs of reproductivity.

A case of peloton dysfunction

Lance, my hero

What got me fascinated and interested in cycling was the story of one man, Lance Armstrong, he recovered from testicular cancer and went on to win 7 consecutive Tour de France titles. That was the story, there is life after cancer.

When I then had life-threatening cancer in 2009, after months of denial, at the point of acceptance, I began to believe there is a life for me beyond my ordeal. That Lance Armstrong was then found out to be a drug cheat and stripped of his titles is unfortunate, but that is not the story that resonated with us, cancer survivors.

Indeed, one can die with great integrity and be eulogised quite ordinarily, or die having achieved notoriety, ignominy, and even disgrace, but with a life to live there is some opportunity for redemption if it comes. If it does not, you are still there for the ones you love and still love you and that for me is an extraordinary story. Lance Armstrong as a person remains a hero.

Medicine for the race

As the world unravelled around him, the mantel fell to the UK to retrieve the reputation of cycling from the dust. In track and road cycling, at the Olympics and peloton Grand Tours, cyclists from the UK took golds and titles, we were cheering from the rafters and men rose from their knee to become knights of the realm.

Great men like those of old, men of chivalry rescuing damsels from distress. Erm, well, there was a Dr Richard Freeman, the team doctor meant to see to the medical needs of the cycling teams and in his position would have been able to acquire medicaments to treat all sorts of conditions. Saddle soreness, for example, and anything in that region that might need attention.

Challenges of manhood

He however highlighted one condition about a male head coach that drew recriminations and rebuttals. You can challenge a man about many things, but not his manhood and its efficacy at performance and surely not in a public forum. Yet, Dr Freeman will have us believe that he ordered 30 sachets of testosterone to help Shane Sutton with his erectile dysfunction. I am a tyro, but I thought you got Viagra or Kamagra for that, but what do I know?

Anyway, with that order comes the possible taint of the achievements of the British cyclist, though, meanwhile, Dr Freeman, free with words, free with the truth has been freed from medical practice. Sadly, he might have set the peloton in dysfunction.

In a brotherhood we stand at !Audacious Church

In brotherhood we stand

Last weekend, I attended a men’s conference at !Audacious Church which goes by the title Brotherhood.

The theme of the conference was “Faith for …” and one can only say that the messages were enlightening, inspiring and exhilarating.

Yet again, from another perspective as I have seen in other men’s conferences in Pentecostal circles before, these gatherings are overtly muscular, an orgy of heterosexual celebration seeking an inlet to the vulnerability of full-grown men.

The view from the book

We were not disappointed and really I cannot take issue with situations that I willingly and wilfully let myself in for.

This conference taking place just as we celebrated the first gay marriage in the UK elicited comment from the Pastor about what the bible says and I guess we’ve heard it all before and again.

My concern stems from the fact that I do know what the bible says, we all, if religious, know most of what our religious tomes say and how sometimes we tend to hang on every word of the letter and leave out the humanity needing ministry.

Beyond the book to people

Now, this is not to attack anyone, but I have many times come to understand that what the bible says might mean a lot to me yet very little to others. The others whose impressions of religion have come from the experiences they have suffered from being put down as unworthy, unclean, common, hell-bound, hopeless, dirty and much else.

Their lives have been made miserable by people who portend to have some spirituality with the arrogance of ‘knowing’ that they are closer to God than others.

In that vein, it is difficult to see how to persuade and proselytise without bludgeoning the person into helpless submission, it is unhealthy.

My Good Samaritan view

I hope that when I encounter the broader diversity of our humanity, I am a light than a flame, that I have an embrace of warmth to offer than an accusative finger pointing out where they are wrong, bad, difficult, rotten or inferior.

For some people the spirituality I espouse would only become effective when I meet them where there is a need, an angel of compassion than hopes that the encounter would bring a thankfulness, a cheerfulness, some happiness and a hope. I believe that gets further than “the bible says.”

If the Samaritan who we now know as the Good Samaritan had followed spirituality over humanity as the priest and Levite had done before him as they walked past the man left for dead by the wayside, we would have had no such lesson of how our humanity matters more above spirituality. Neighbourliness transcends norms.

Left a spiritual Humpty Dumpty

Yet, in these conferences, we have ample space for conviction, though in some more vulnerable than others, they would be consumed with guilt and condemnation, broken and helpless, the showing of hands with a prayer supposed to transform the person almost in an instant. But some are left spiritual Humpty Dumptys with no king’s men to put them back together again.

Between denial and acceptance

As you wander between discernment and critique, it is important to know when you have become part of the mass hysteria as the crowd is worked up to a frenzy. It is at that time that so many things Anglican allow for a personal and private spiritual awakening within a public celebratory space.

Pentecostal circles are highly expressive, seeking a public declaration and almost at the same time bringing a sense of satisfaction to the protagonists who deign in acknowledgement, the power of persuasion.

The atmosphere is combative to the point of being aggressive, your response is required else you are almost condemned for being ashamed that it compels you to react – on whether it is right, I cannot say. But if God knows the heart of every man, does a man have to see the hand of every heart?

Choose where I go

I left the conference sat on a fence disputing between who I am and whether I should accept myself or reject myself. Under that kind of mental duress, much harm can be wrought, for a man who is not a husband or father, nor aspiring to be one, a lacking is exposed that only having been happy with yourself before and having learnt to love who you are can help dampen the supposed inadequacies.

At my age, I sometimes wonder if men’s conferences have much to offer me after from a stark realisation that I might well be too radically different from others who bare, seek or manage the responsibilities of husband, father, marriage and strongly conservative leanings.

I am well advised to choose the conferences I attend wisely.

Thought Picnic: Before you call him a man?

In distance and in nearness

Distant and near has been the journey from home, distant in person and near in the mind, distant in its reality but near in the memory, distant in the possible but near in the impossible, the ambiguity and ambivalence of existence captured in realities that life is changing and priorities are shifting as one becomes more distant to others and near to oneself.

It was never easy, the hold that beliefs had on all of them that led to initiations into activities that simply weakened the bonds whilst creating longings that none could fulfil as needed and left the journeyed way out at sea that there was no boat to go home.

Once of the same beliefs

What the eyes have seen that reside in the memory is no more the reality, it is far gone that it has become the stuff of dreams, dreams that relive times that can never be now but come into the now with fearful impact from the unresolved, the undiscussed, the unsolved and the ignored.

There is anger, there is regret, when they could have listened to each other, they attacked each other and now that the listening could have been of the greatest value the bridges are too tattered for a crossing that risks a plunge down into eternal oblivion, they have grown more distant and never so near.

They all once believed the same, attended the same temple and grew knowing it did not have to be hard, at least that is what the children thought but amongst them, they fought, they railed, the jostled and rivalled.

They did things

She went out to wildernesses of supplications to prophets of the eerier and the utterly bizarre, rituals of incantations derived from Psalms prayed into all sorts of liquids, candles lit to outshine the sun, there were enemies everywhere; at home, at work, amongst enemies, amongst friends, within family and far abroad, to her marriage, against her children, they were consumed in a never ending battle of Psalmist wars that they were never sure they will win, each glimmer of hope was one that was almost but never grasped.

He had his issues, always denying lechery but seemingly always compromised, a dab hand at the core animist rituals, shaved heads, tortoise shells, charms and many more things that unlike her were kept away from the purview of the kids, discretion was evident and at play though in the end you never knew what he believed, the old or the new, the customary or the fashionable, he seemed to be able to straddle both systems in marriage, in involvement and in engagement belying a maturity to be envied.

He saw things

The boy was lost in all worlds of identity, discovery, expression and impression, each path seemed fraught with danger and peril, he never found the opportunity to reach out when it really mattered, things happened in ways that brought the empathetic out of her and the sceptic out of him.

It all culminated in one fateful night when earlier in the day, the stories shared to the hearing feasted on the most fertile imagination that as the dark came, it was able to create apparitions that only those eyes could see and voices only those ears could hear, all in the presence of people who could not understand the beginning of the knowledge of fear that brought terror beyond the control of all around.

Whatever it was, he had seen the devil and that was twice in 6 hours, red-chested, horned, tall and scary did not begin to describe it, he has searched and been unable to determine what that phrase he heard in middle of the night was – Poofau! Poofau! It was terror that put horror to flight and the gateway to much else that defined a journey that has never found words.

His road made out

Rituals too many to all sorts of religious practitioners and charlatans, baths in houses and groves, in forests and in pits, with lizards and too many unmentionable, everyone brought a story, a view, a prophecy or a reading, tackling it from all corners, he ate the inedible like performing magic tricks, scarified to draw blood on all parts of the body with all sorts of concoctions rubbed in, he had become a reliquary of absurd unexplainable theologies and a living receptacle of fetish practices that were forgotten lifetimes ago.

Conflicts came with the urge to break away when they were needed and then he veered off on a tangent of religious beliefs that left them first scared, then hostile and ultimately implacable, the purposes for which one was to exist failed as this path offered nothing but the reality of great disappointment.

Cursed from the source

One Sunday, he returned from church, she was livid with rage that the order never to believe as one had now chosen to believe was defied and there and then in her room, she stripped and cursed her son from the womb from whence he originally came that if he defies her again he will wander away never to be seen again.

He never understood the significance, there was nothing to fear from that act and they never talked about it afterwards though he did defy and did continue to do what he believed for himself and with that came separation and distance unbeknownst to the man who probably would have been absolutely livid with rage with her having tolerated much of her deviation from the conventional into the esoteric.

A wilderness of the world

He has however wandered away, far from all that is conventional, proper and expected, charting his own course away from prying eyes, he has died to emotions that once made them near, nostalgia is only a matter of taste than presence, the memories are things one lives, but the pictures today are too difficult to look at, the changes that come with age have wizened them all, they are all closer to the grave and as distant as ever in life.

That distance was consolidated when he found himself in hospital with just 5 weeks to live if the medicines did not work, he was there alone though maybe not alone, who could tell, but they were not there. He fought to live but lost everything else apart from the hope that something might just be made of a life that has done much and wasted much – time, resource, opportunity, fortune and relationships – regrets that could sink a man loom but they are ones you strive daily to walk away from.

How many roads must a man walk down, before they call him a man? To them, he has not walked enough roads and to him, he is honestly past caring, he cares enough for the basic connection that has history and a past but the present brings some resentment, some anger, some bitterness and very little forgiveness – this is not even half the story but it is a start - the wander in the wastelands of the world continue as tomorrow, if it comes, becomes another day.

Explaining a stolen lunchbox

Summer season news madness

I can only find amusement in what has become a sad tragedy of hysteria that lacks scientific proof but feeds the lynch mob in causing the death of innocent people.

Being the summer season, the newswires are usually bereft of useful intelligent news that anything can be spruced up as news. In the West, that really fetches true, however, in Nigeria, some things can be stranger than fiction.

Only yesterday, my friend in African Shirts lamented the fact that the new Superman was a bit less than a man, having a slightly reduced bulge, especially if you have been assaulted before the watershed with Linford Christie’s lunch-box doing the 100 metre dash, you would know what I mean.

There’s a coal in my pocket

I remember when I was in Nigeria, we were caught in a frenzy that required all men to put a piece of coal in their pockets to prevent the unfortunate loss of their manhood.

Somehow, rumour and some information dispersion mechanism that beggars belief spreads the view that if you rub off on a stranger, your manhood would shrivel into nothingness.

The fact is, I have never seen any real proof of anyone who has a manhood of any significance before the event, then show that his manhood has been a victim of involuntary and violable shrinkage.

However, all you have to do is grab your crouch and scream, better wail, pointing your finger at a hapless passer-by who forgot to say his prayers and that person is attacked and finished off long before someone with more than two grey cells warming up each other seeks the evidence of an alleged penile miniaturisation.

To really look at this matter, after the man has been murdered by the mob, there usually is no Aha! Moment, like dip into his pockets and produce that stolen piece of hardware.

Exposé on the lickle womble

Closer to the truth, I would surmise, the accuser has had a encounter where his endowment might have been one of the dramatis personnel of the nursery rhyme – this little piggie which went wee apart from the fact that it was a wee bit on the rather wee side.

How better to explain the lack of that aspect of male chauvinistic self-assuredness exemplified in the myth of James Brown’s sex-machine if you cannot rue the day you lost your manhood?

Reference

Mob kills lecturer over alleged theft of manhood – this site does not keep permanent links to its news items – this link might change after the 27^th of July 2006.