06 June 2023
By Tim Baker
So, the other day I jabbed a sharp metal needle into the shaft of my penis.
This is not something I’ve ever done before, and it wasn’t some strange bondage or piercing kink that drove me to this unlikely behaviour. This is a simple and effective medical treatment to address erectile dysfunction (ED). The needle, I hasten to add, is very fine and this was done under the supervision of a specialist urology nurse who was extremely good at her job. It barely hurt at all and felt less weird and awkward than I had expected, thanks mainly to the professionalism and care of the aforesaid nurse.
But, more than all that, it worked. After eight years of hormone therapy, or Androgen Deprivation Therapy (ADT), the results weren’t anything spectacular. It was a bit like being re-united with an old friend who I hadn’t seen for many years (nearly eight, to be exact) and was showing the effects of age. But there he was just the same, a bit reduced in size but recognisable and able to stand proudly erect on his own. I was flabbergasted.
“Some men say we’re doing God’s work here,” the nurse laughed.
It took all of ten minutes for the injection to work and last about two hours. After the surprise and excitement of discovering it was still possible for me to achieve an erection, there was a pang of anger and sadness. When I was prescribed ADT eight years ago for metastatic prostate cancer, and it was described as “chemical castration”, I wasn’t offered any advice or guidance on how to manage this or overcome the loss of sexual function. No one talked about it at any of the support groups I attended or at any of the countless medical appointments I’ve endured. My assumption was, that faced with a choice between death or impotence, I’d chosen impotence and simply had to cop it.
How is it possible that a urologist can prescribe ADT and not offer any advice on how a man might maintain or resurrect their sexual function? How many years of misery and despair might I have been spared if I’d had this simple procedure explained to me from the outset. Who knows? I might even still be married.
And I was angry with myself. For all the research I’d done into prostate cancer and its treatment, the management of its side effects and tools to maintain quality of life, how had this escaped my notice? For the first few years post-diagnosis I was so fixated on how to stay alive it didn’t seem like a priority. By the time I made an appointment to see a men’s sexual health specialist four years on, and his prescribed pills didn’t do the trick, I figured I was beyond help. Needles and pumps and surgical implants felt like a bridge too far, and unlikely to work anyway. And lacking a libido, it never seemed to make it to the top of my self-care to-do list.
The gradual loss in size of the penis over time from ADT can never be recovered which is another compelling reason to get on to it early. A simple regime of using a vacuum pump a couple of times a week, or even daily, finding whether a pill or injection can provide a sufficient erection for penetrative sex, can help maintain penile size and health. Even if you don’t have a partner, you might find it worthwhile even for the sake of bodily self-image and the prospects of meeting a special someone in the future.
So, my plea to men newly diagnosed with prostate cancer is this: Address this issue early on. Your chance of success will be much greater. If you are already in an intimate relationship, it may well save it and allow you to maintain physical intimacy and a healthy sex life. Involve your partner in the process and get them to come along to appointments with a men’s sexual health specialist or urology nurse. Caught early, something as simple as Viagra might do the trick. A vacuum pump can also help maintain penile health, supporting blood flow and tissue within the penis that would otherwise suffer from inaction brought on by ADT.
And my plea to urologists who prescribe ADT is, for the sake of all that is precious in the world, speak to your patients about managing ED, sooner rather than later.
I take no pleasure in writing about something so personal in the public realm, but I just hope others can be spared some of the misery and distress ADT has inflicted on my life and marriage over the past eight years. I still can’t understand why so many men are left to fend for themselves in this regard, unaware of treatment options for ED, or that there even are options. This must change. I was 50 when I was diagnosed, my ex-wife was 42. The idea that we would endure a lifetime of celibacy because of my diagnosis and its treatment was deeply traumatic and contributed to the breakdown of our marriage. I assumed I’d never re-partner because of my condition. Now there’s a glimmer of hope in that regard, but it still all feels a bit daunting.
And the tragedy is, but for some effective medical communication, it didn’t have to be this way.
About the Author
Tim Baker is an award-winning author, journalist and storyteller specialising in surfing history and culture, working across a wide variety of media from books and magazines to film, video, and theatre. Some of his most notable books include “Occy”, a national bestseller and chosen by the Australia Council as one of “50 Books You can’t Put Down” in 2008, and “The Rip Curl Story” which documents the rise of the iconic Australian surf brand to mark its 50th anniversary in 2019. Tim is a former editor of Tracks and Surfing Life magazines. He has twice won the Surfing Australia Hall of Fame Culture Award.
Tim was diagnosed with stage 4, metastatic prostate cancer in 2015 with a Gleason score 9. He was told he had just five years of reasonable health left, but eight years on, at 58, he’s still surfing, writing, and enjoying being a dad. His latest book, Patting the Shark, also documents his cancer journey and will be published in August. Tim will be sharing weekly insights into his journey to help other men who have also been impacted by prostate cancer.
