It doesn’t need to be in CAPITALS and shouty, in larger font, or even centred; it gets your attention doesn’t it? So how as a nurse, did I end up with a title like that?
My Dad had prostate cancer five (5) years ago, and as he was older I was like “not to worry it won’t harm you”. My Mum was especially concerned about it ‘spreading to his bones’ and Dad was just going to follow “what the doctor thought best”. So, I had them see three (3) doctors. One keen on surgery, one on radiation and one that sits on the fence. It just so happens he was Declan’s oldest patient at the time and he came out perfecto! Dry and cancer free and as for the erectile function? well, I kept well away from that topic!
But one (1) year later we were all having a few afternoon beers up at the Bondi RSL. My dad (who is extremely shy) starts to mumble to me about wanting to ask about “down below and why does it not function?’. I quickly cut across him thinking please don’t go there, please don’t go there and blurted out as quickly as I could “yup the erections will be gone dad, they cut wide to get your cancer out, you can still orgasm but no sperm will come out anymore”. The relief in his face as he said “thanks, I thought it meant the cancer was back” was measurable and the comment heartbreaking.
One of my most precious roles as a nurse caring for men with prostate cancer is being open to the discussion (over the phone and face to face) about sex. Sex, whether linked to an illness like prostate cancer or not is one very large topic that many of us enjoy but find difficult to talk about leading to unnecessary confusion. It does involve the persons both physical and emotional well being and is therefore understandably complex.
As a nurse specialising in erectile dysfunction post robotic prostatectomy, I have learnt to use very precise words so I can establish exactly what we are talking about (being both on the same page at the beginning of the discussion is always a good start!). An obvious time when I created confusion was on explaining about “penile rehabilitation” post Robotic Prostatectomy. I suggested Viagra (full dose) and stimulation once a week. I had suggested Saturday morning as Viagra is more effective on an empty stomach and feeling relaxed. Unfortunately, the interpreted response was “ the nurse told us we have to have sex every Saturday morning! I now suggest self stimulation/masturbation.
Talking about sexual function is whatever the patient brings into the room. This can be libido and desire, length, hardness and girth, ejaculation and orgasm, intercourse or outercourse. I can go on and on and still have someone asking me something new. I owe it totally to the blokes and their partners (male, female, wife’s, lovers, singles, married) for what they open up to and share with me, and in return, I can share to help guide others in similar situations. From my room there is often the sound of laughter and my cheeks certainly get a work out with going red, but I am so proud these men, and sometimes the partners feel comfortable enough to share such intimate, truly private details about themselves. I am just there to help and do not want anyone to go through the uncertainty of thinking their cancer had returned like my dad thought. I certainly don’t have answers even half the time, but have no judgement, so if it’s a concern of yours just sharing it helps as I can tell you, you won’t be the only one.