Supporting the man with prostate cancer: The ground rules

A diagnosis of cancer always comes with great shock, and a sense that the world has turned upside down and inside out. The certainty with which we all live our lives is shattered forever and life seems as if it will never be the same. A diagnosis of prostate cancer is no different, and like other cancers, the reaction of the partner/spouse is important. Cancer is always a couple's issue, but never more so than in the case of prostate cancer. Here are some pointers to help make your experience as a couple dealing with prostate cancer more bearable:One of the only gifts from a diagnosis of prostate cancer is the gift of time. Even though the North American way of thinking about cancer is to get it out now, with prostate cancer you have time to consider all treatment options because it is generally a slow-growing cancer. Treatment does not have to take place immediately so take a deep breath, slow down and think about what comes next.Some men don't need treatment at all and it may be safe just to watch the cancer with repeated tests and act only if something changes (this is called active surveillance). Depending on your partner's age and the stage of his disease, it may be possible to actively monitor the cancer and avoid treatment and its side effects.Treatment is going to affect his quality of life, and this will have a profound affect on you as his partner/spouse. During the turbulent time after diagnosis, it may seem that you have to decide between life and sex and that choice may not seem difficult. This is rarely the case. Treatment of prostate cancer will affect his ability to have erections, but you do not have to choose between erections and life; prostate cancer tends not to be a lethal form of cancer for most men. Loss of erections will profoundly affect your sex life but also his sense of self and confidence as a man. These will impact on you too so before rushing into treatment you need to talk about how you will manage your relationship with an altered sex life and a man who may not see himself the same way. Even though he may not want you to, go with him to every appointment. Four ears are always better than two and having someone with him to hear the same information, take notes and ask questions will help you to feel more in control and help him make the necessary decisions. Be careful about the stories other men with this cancer tell you. They often minimize their side effects, especially bladder leakage and erectile problems, because these are embarrassing. You may want to talk to the partners/spouses of these men to hear their side of the story; they often don't mesh!Get a second opinion from another kind of specialist who treats prostate cancer. So if a urologist (who is a surgeon) recommends surgery, ask to see a radiation oncologist who treats prostate cancer with radiation. Weigh the pros and cons of the side effects of both kinds of treatment before making a decision. Remember, you have time!Be wary of stories that you read on the internet. They are often 'fronts' for treatments that have no proof and the experience of someone else, if they actually exist, will not be the same experience that you and your spouse may have. If something sounds too good to be true, then it probably is. Stick to valid websites such as the American Cancer Society, and large treatment centers like the Mayo Clinic. But remember that they are trying to attract customers (patients) too!Finally, remember that this is a very curable cancer with 97 percent of men surviving five or more years after diagnosis. Your partner/spouse needs you to support and care for him, and being an active part of his decision making process is a vital role that you can play.Anne Katz, PhD, RN, is an author and sexuality counselor at CancerCare Manitoba. Her latest book is "Prostate Cancer and the Man You Love: Supporting and Caring for Your Partner" published by Rowman & Littlefield. It is available online at Rowman.com and through Amazon and Barnes & Noble.