Living Well

January 26, 2010

Prostate Cancer: Personal Mission Helps in Facing Identity Issues

Consultations can be overwhelming.  That was the case with my own prostate cancer consultation two weeks after my biopsy showed I did have cancer.  My doctor, Dr. John Ramsey of Urology of Indiana, spent three hours with my wife and me discussing the biopsy, treatments, and the outcomes of any decisions we would make.  My wife and I sat as he drew pictures, explained in detail procedures, and thoroughly outlined any options we might have before us.  He answered a lot of questions.  In the end, because of my age (53 at the time), the best option out of six potential solutions was surgery.

This is where personal mission, faith, and belief in living well help one to make decisions that matter for the long term.  Knowing what is important allows us to evaluate all the complexities and make more effective decisions in the moment.  Having a written mission statement and living it out can make decisions easier.

I have to back up a little to describe one of the issues that men MUST face, discuss, and talk through related to prostate cancer.  It is the issue of male sexuality.  Again, I am no psychologist, but I do understand myself and am aware of the many innuendos our society places on virility, mostly subconscious.  As a teacher and student of ancient history for thirty years, I know that sexuality has permeated every culture of the ancient world, from fertility cults to ritual practices to architectural design.  It doesn’t matter if you consider the Far East, Ancient Middle East, or Meso America, you will find sexual rites a part of every society (we just don’t read about them in our history books).  The phallus (as well as women’s sexual anatomy) can be found in all cultures as a representation of masculinity, virility, and power.  In ancient myths, sexuality, intercourse, and male power displayed in the phallus are commonplace, even if we never read this kind of literature in polite circles.

One of the very real outcomes of prostate cancer (whether through surgery or leaving it untreated) is the loss of impotence (erectile dysfunction).  This is a fact of the male reproductive system.  The nerves that allow for a male erection are side by side with all the nerves connected to the prostate.  While I do not know all the physiology, I have given recommended websites to help men understand their anatomy.  The bottom line is that erectile dysfunction will increase with prostate cancer.  Thus, men must think through this part of who we are.

So a question has to be answered.  Will men lose their lives to try and save an erection by not having surgery (or other treatments) or take the treatments or have surgery and save their lives?  Will my identity be wrapped up in my ability to have an erection or will it be built on character, purpose, and living well in all life areas?  Our world is saturated with sexuality.  It tells us if we are not sexually capable, we are actually not men.  Just consider hand gestures used in profanity.  Consider statements made in movies, like “what’s the matter, can’t get it up?”  Men are portrayed as less than adequate in all kinds of commercials and media if they are sexually unable to perform.  Prostate cancer leaves men with this very possibility of impotency.  It is important to know that if nerves get cut during surgery or even damaged by radiation or other treatments, the ability to either get an erection or maintain one will be diminished. Viagra, Cialis, and other ED drugs can help, but men MUST know that they DO NOT restore an erection to 100%.  So, this section and answering these questions are critical for men and their wives related to prostate cancer.  (More in future blogs about ED drugs).

For some time, I had the Bible verse on my mind that whoever seeks to save their life will lose it, but whoever looses it will find it.  That verse along with my desire to live well forced me to have to think clearly about this part of prostate cancer.  My friend David, however, was the one to force the issue.  I did not know he knew I had prostate cancer.  David had undergone a prostatectomy (full removal of the prostate) about a year earlier.  He stopped by my office to just “talk.”  He asked how I was, but then forced the discussion of sexuality and impotence.  I am a private man by nature, but I needed him to talk frankly with me.   I needed him to be honest with me from his own experience.  He talked most candidly about the change in the sexual relationship with his wife, but also the joy of it….the deeper parts of intimacy came through.  They had found newer ways to love each other sexually.  But before he left my office he said, “Seek the higher good; save your life to find more life.”  That was honest and that was the confirmations of my own thinking…possibly lose the potential of some sexuality to find wholeness, well being, and life.  Trust in God and trust that my life decisions would matter over the long term.

So it was at the end of the three hour consultation that Dr. Ramsey asked, “What do you want to do?  You can leave and take a few days to think about it, if you like, just don’t wait too long.”  I leaned forward onto the table where we had talked that evening and said to him, “There is something you need to know about me.  I am a man of deep faith and a man with a mission and purpose in life.  I want to grow old with my wife because I love her and there are things I have yet to do in this world.  I make the decision to have a prostatectomy.  When do we schedule it?”  Dr. Ramsey chuckled a little in response, “You are pretty sure. That is one of the most purposeful responses I have ever heard.”  My wife nodded in agreement.   He continued, “Sometimes men leave here because they cannot consider the possibility of impotence and never come back.  It is an important decision to make so that it doesn’t take your life.”  And with that, we scheduled the surgery for the next opportunity.

You see, it does matter that we have a sense of purpose, a mission, a deep faith that will help us think through difficult issues, even the issues of sexual identity and performance.  If we know what we believe, we can be confident in whatever life presents us.  In the blogs ahead, I want to outline tools to use for writing a personal mission statement.  I will return again with frank sharing on the topic of prostate cancer, because I needed a place of authenticity in my own journey; but I did not always find them.   I some future blogs, I will talk about these last 16 months of my own prostate cancer journey and the aftermath of it.  But for now know that a personal mission can help you choose life in life’s toughest moments.

Grace and peace.

David Neidert

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