Being told that you have cancer is devastating. Being told that the cancer can’t be cured and you may only have 2 years to live is indescribable. In my case it led to an immediate spiral into despair and darkness.
Thankfully, starting a treatment pathway helps to bring back some stability. But after 4 years of treatment and talking to lots of other men, it’s very clear that psychological support is at a premium, and that men who need psychosexual therapy really struggle to source it.
A tragic statistic
Given the lack of support – and, of course, lots of men’s reluctance to seek it even if it were available – is it any wonder that one study found the suicide rate among men with prostate cancer is 4.24 times higher than for men in general, at 274.7 per 100,000 compared to the average of 55.32 per 100,000?1
When I relate that horrendous statistic to my own experience, I can absolutely understand why the rate is so high. And I can’t imagine how challenging it must be to live with advanced prostate cancer for single men. I’m absolutely blessed with the support of an amazing wife who constantly picks me up when I’m down.
It makes me feel even more ashamed that when I had to tell her about my diagnosis, the first thing I did was push her away, as I was no longer able to look after her as I always had. Thankfully her response was to hold me tight rather than thump me on the nose!
Knowing where to look for help
Depression rates are high among men living with prostate cancer, and we must conclude that greater support is needed but isn’t always available unless you know where to look.
Here in the UK, support would generally be offered in the first instance by Clinical Nurse Specialists (CNS) before being escalated for support from a psychologist. However, CNS’s have huge clinic sizes and are seriously stretched, despite offering essential support, and many men are simply not allocated a CNS.
If we turn to psychosexual therapy, many men who have had or are having treatment may lose libido and sexual function. Even if sex therapy is recommended, there may be a long wait for it on the NHS.
Is this remotely good enough, and is it a surprise that men can’t cope and thus suicide rates are so high?
Psychosexual therapy services may also not be covered by private health insurance. So dig deep fellas, because insurers may not help!
The impact of longterm hormone therapy in emotional terms is huge. I’m generally in a much better place now, but my emotions vary significantly. I find that when I’m suffering fatigue from the treatment, I really struggle mentally, feel incredibly low, bordering on depression and constantly close to tears. Thankfully it normally passes quickly.
Do some men see seeking help as a sign of weakness?
I had a really challenging time 18 months after my diagnosis. I now realize that there are individual things that trigger my low mood, and as I can recognize those triggers, I know how to cope when they hit me. But in October 2018, I was hit simultaneously with 5 triggers, my younger sister going into a hospice for end-of-life care and some business problems being two of them.
Coping with a total meltdown
This led to a total meltdown and suicidal feelings, and I realized that I needed to seek help. I’m blessed that there is a nearby support center where I met a case worker and cried my heart out to her for 2.5 hours and felt so much better afterwards. Some counseling with a psychologist followed, and within a couple of months I had returned to my old self.
The message for readers is that it’s a sign of strength to seek help and not a sign of weakness, and there is help out there. So please don’t suffer in silence.
In the UK we are lucky enough to have charities providing free support such as Neil Cliffe, Maggie's, and Macmillan, and I commend them all highly.
If you or a loved one is struggling with the emotional toll of prostate cancer, there are resources for support.
Have you gone to a pelvic floor physical therapist?