Reclaiming Sex and Intimacy after Prostate Cancer: A Guide for Men and Their Partners by Jeffrey Albaugh, Jannetti Publications, Inc., 2012; first edition, paperback, 94 pages, US$12.00. ISBN-10: 0984659714, ISBN-13: 978-0984659715.

Authors


There are a growing number of books offering help to patients who have prostate cancer with concerns about loss of sexual function and intimacy after prostate cancer treatment. It is my impression that these books fall into two categories, split along gender lines. The majority have been authored by, or co-written with, women, the wives of patients with prostate cancer. A few books though have been written solely by men. Albaugh's book is the newest addition to the second group.

Books written by women typically emphasize ways to be intimate independent of penile erections. The ones written by men, in contrast, are strongly focused on treating erectile dysfunction (ED) and are overwhelmingly phallocentric. Albaugh's book fits that second pattern. Despite its title, which claims to serve both patients and their partners, this book is much more about the penis than the partnership. It covers the same ground as John Mulhall does in his 2008 book ‘Saving Your Sex Life’, which is all about ED treatments and not much else.

Albaugh's book is short, with large print, and many good illustrations. It is an excellent introduction to all ED treatments, with good tips on how to use ED aids most effectively. It is more succinct and direct than Mulhall's longer and larger book. It also is aimed at an audience with lower reading skills.

I think I would be happier with Albaugh's book, if it had a more honest title and/or said more about dealing with sex and intimacy beyond ED treatments. So, for example, there is a single paragraph that starts with, ‘You may need to grieve the loss resulting from the many changes associated with sex following prostate cancer treatments’, but that paragraph is all there is on adapting to change when full recovery of penile function is not possible.

Similarly, there is a single short paragraph for partners (in the one chapter written for partners) that starts with ‘You also have sexual needs and concerns, and it may be important for you to think about how you can deal with your own sexual desires while being supportive to your partner.’ The rest of the paragraph gives no hint as to how a partner might do that. This text is just too simplistic and patronizing. Given the book's title, again, I expected more.

Here's another problem. About half of all patients with prostate cancer will be treated at one time or another with androgen deprivation therapy (ADT). Beyond acknowledging that this treatment decreases sex drive and causes ED, all that is said about ADT is that the diminished sex drive ‘may also diminish motivation for dealing with the added burden of ED …’. Nothing is said about what the patient or partner might do about that, and for that reason I would not recommend this book for couples dealing with ADT.

Granted, Albaugh repeatedly states the importance of open communication between partners in order to maintain intimacy. That point is raised in several places, but often without any guidance on how to achieve that. The fact is that the challenges brought on by prostate cancer and its treatments are more complex than one would suspect from reading this book. In reality, when ED treatments are not fully effective, men don't always wish to talk about it. Instead they withdraw from their partners, who understandably then feel rejected. What this means is that prostate cancer treatments that diminish sexual function can indirectly lead to psychological distress in patients' partners. All too commonly the loss of communication leads to the partner feeling isolated and becoming depressed. The book doesn't deal in any depth with the concurrent, but not necessarily matching, problems that strain the bonds between patients with prostate cancer and their partners.

So, what is the bottom line? Albaugh's book is a great little guide to ED treatments. But that's it. It is not nearly as comprehensive as its title suggests.

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