Coping With a Prostate Cancer Diagnosis
- Former Dutch soccer player and manager Louis van Gaal, who was diagnosed with aggressive prostate cancer a few years ago and is now managing the disease, has admitted that he’s no longer able to have sex after undergoing treatment.
- Van Gaal underwent radiation, hormone injections, and surgeries during his cancer journey and is sharing his story to help remove the stigma around prostate cancer.
- If you or a loved one has been diagnosed with prostate cancer, it’s important to remember that most types of prostate cancers are treatable. According to the National Cancer Institute, the five-year survival rate of prostate cancer in the U.S. is 97.1%. There is, however, a small number of men whose type of prostate cancer may become unresponsive to treatment, for example, when cancer cells develop a resistance hormone therapy, the treatment may no longer work.
- Although van Gaal says he can no longer have sex, there are ways men can return to being sexually active, Dr. James Brooks, Chief of Urologic Oncology at Stanford Medicine, told SurvivorNet in a previous interview.
- “Prostate cancer can require couples to think more broadly about their intimacy,” explains Dr. Brooks, who suggests men talk about their situation with their urologist and perhaps seek counseling with a sex therapist.
The 72-year-old soccer pro, who impressively guided the Netherlands at the World Cup in Qatar just one year after his diagnosis, opened up about how he’s coping with prostate cancer in a recent interview with Humberto a Paris.
Read MoreVan Gaal, who previously worked as the manager for Manchester United and currently works as an advisor for Ajax Amsterdam, explained further, “I am doing well. After three years of radiation therapy, kidney infections [and] prostate surgery, I can finally manage it.
“I can pee naturally again, which is important. But I cannot have sex anymore, that’s a problem.”
As for what helped him stay mentally and physical strong throughout his cancer journey, Van Gaal suggests his work and active lifestyle has kept him thriving through adversity.
RELATED: Sex Is Possible After Prostate Cancer and 5 Other Facts You Should Know
He added, “I even think that during the World Cup I managed it even better, because I had a goal. And with the cancer process it happens just like with the process of being a coach, you look for a goal. For me it was positive to deal with both things.”
Van Gaal also noted that he’s “used to death” and has remained strong after experiencing the loss of his dad, brothers, and first wife “too soon.”
“I know that death is a part of life, and you can deal with it,” he continued, explaining that he’s not fearful of the future as “you don’t die that quickly from prostate cancer.”
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He also admitted that although he’s not scared of dying from the disease, he’s not enjoying his life like he used to. However, that’s not stopping him from inspiring other men not to feel shame when battling prostate cancer
Van Gaal said he’s sharing his story to “Support the people who also suffer from it a little, so that they can move on. That it can also affect people like me, that is actually the reason. I am always open: I say what I feel and think.”
According to The Hague (AFP), before van Gaal led the Netherlands at the World Cup, he revealed he had underwent 25 rounds of radiotherapy without his players knowing it.
Before announcing his diagnosis in 2022, about a year after starting treatment, van Gaal said his players “think I’m in good health but I’m not.”
AFP also reported van Gaal saying in an interview about the release of his film “LOUIS,” “I’ve been through so much in my life, sickness and death, I’ve probably become richer as a person because of all those experiences.”
Dr. James Brooks Talks Sex After Prostate Cancer.
Understanding Prostate Cancer & How It Affects Sex Life
If you or a loved one has been diagnosed with prostate cancer, it’s important to remember that most types of prostate cancers are treatable. According to the National Cancer Institute, the five-year survival rate of prostate cancer in the U.S. is 97.1%. There is, however, a small number of men whose type of prostate cancer may become unresponsive to treatment, for example, when cancer cells develop a resistance hormone therapy, the treatment may no longer work.
Prostate cancer begins in the prostate the walnut-shaped gland located between the rectum and bladder that produces the fluid that nourishes sperm. Outside of skin cancers, prostate cancer is the most common cancer in American men with about one in eight men being diagnosed with this disease during his lifetime.
Expert Resources On Prostate Cancer
- Genetic Testing for Advanced Prostate Cancer Can Help Tailor Treatment
- PSA Test Is Not Perfect, But It Is Helpful
- Don’t Believe the Hype: Do Your Own Research on Prostate Cancer Treatment
- There’s No One Definitive Symptom for Prostate Cancer, But There Are Clues
- New Hope For Advanced Prostate Cancer: Delivering Radiation at The Cellular Level — Understanding Pluvicto, Now Approved By The FDA
It’s important to remember a prostate cancer diagnosis is not always preceded by symptoms. And even when symptoms do occur, they can be inconsistent and hard to pinpoint.
“Prostate cancer is a very odd disease in that it doesn’t have a particular symptom,” Dr. Edwin Posadas, director of translational oncology and the medical director of the Urologic Oncology Program at Cedars-Sinai, told SurvivorNet.
Still, it’s important to note changes in urinary function, like urinating more or less often or waking up at night to go more than usual, could be a sign of prostate cancer. So, even if you think there’s nothing to worry about, always talk to your doctor about changes to your health when they occur.
There are many different treatment options for both early and later-stage prostate cancer including active surveillance, watchful waiting, surgery, radiation, cryotherapy, hormone therapy, chemotherapy, immunotherapy and targeted therapy. The disease is one where doctors may have differing opinions on the best treatment path to take, so don’t hesitate to ask lots of questions and seek out multiple opinions.
Second (& Third) Opinions Matter When Deciding Between Surgery or Radiation
“I think it behooves the patient to have multiple discussions or second opinions, not only by the urologist who did the biopsy and diagnosed that man, but also with other surgeons and other radiation oncologist just to get a very circumspect view of what the treatment options are,” Dr. Jim Hu, a urologic oncologist at Weill Cornell Medicine, told SurvivorNet. “Oftentimes, I think patients need to understand that our health system is based a lot on fee-for-service medicine.
“And so therefore, a lot of physicians, I think, who are very well intentioned, will believe that their treatment is best for that particular man,” Dr. Hu added.
Van Gaal didn’t go into detail about why he’s unable to have sec anymore but it’s likely due to sometimes during surgery for prostate cancer, the nerves that facilitate an erection are removed or damaged.
It’s important to know that a large percentage of men suffer from problems in the bedroom, or sexual side effects, as a result of treatment (radiation or surgery). Some men may also have trouble maintaining an erection, while others can no longer have an erection at all.
“There are neurovascular bundles on the back of the prostate, and they are responsible for erection,” Dr. Ethan Halpern, co-director of the Prostate Diagnostic Center at Jefferson University Hospitals and researcher at the Sidney Kimmel Cancer Center in Philadelphia, tells SurvivorNet. If those bundles are destroyed in the ablation (surgery) process, impotence will occur.
The side effects of prostate cancer surgery can be daunting, so how do you know if surgery is right for you? The answer, according to SurvivorNet experts, will likely differ depending on which doctor or hospital you choose. The challenge for your oncology team is whether to treat and if so, how, or just watch and wait.
How Long Does It Take to Regain Sexual Function
Although van Gaal says he can no longer have sex, there are ways men can return to being sexually active, Dr. James Brooks, Chief of Urologic Oncology at Stanford Medicine, told SurvivorNet in a previous interview.
“Prostate cancer can require couples to think more broadly about their intimacy,” explains Dr. Brooks, who suggests men talk about their situation with their urologist and perhaps seek counseling with a sex therapist.
A Healthy Sex Life Is Possible Following Prostate Surgery
Younger men tend to bounce back more quickly after surgery in the erection department. Sometimes it can take up to two years to be able to have a natural erection.
If your ability to have erections does return after surgery, it often returns slowly. In fact, it can take from a few months up to 2 years. During the first few months, you will probably not be able to have a spontaneous erection, so you may need to use medicines or other treatments.
“When a patient has surgery, nobody can get an erection for about six months afterward. It’s rare,” Dr. Patrick Swift tells SurvivorNet.
Dr. Swift is a radiation oncologist at Stanford and points to differences in side effects for surgery and radiation.
WATCH: Preserving sexual function after surgery depends on several factors.
“If you’re using radiation alone, the risk of you losing sexual function quickly is very, very low. And in fact, with external radiation therapy alone, at two years, about 80% of patients are still getting good erections, but they make less of an ejaculate,” Dr. Swift explains.
Meanwhile, if you undergo surgery, your sexual function is more dependent on your surgeon’s ability to spare the neurovascular bundles which are small collections of nerve and blood vessels.
“If both neurovascular bundles are injured at the time of surgery, the chance of getting back sexual function without some kind of prosthetic device is very, very low,” Dr. Swift said.
Hormone therapy can also affect your sexual interest which may inhibit your testosterone level.
Helping You Manage Your Mental Health Along Your Journey
For male cancer patients, a prostate cancer diagnosis undoubtedly impacts their mental health. If you are diagnosed with cancer or other chronic disease, you should be mindful of your mental health because it can affect your overall prognosis.
RELATED: Psychologist Dr. Samantha Board discusses managing mental health long-term
“For long-term mental health and living with cancer, flexibility is really at the core of how to manage long-term mental health,” says New York-based psychologist Dr. Samantha Boardman.
Dr. Boardman suggests asking yourself questions about how you deal with stressful situations to determine whether your strategies are working or need adjustment.
“Are your coping strategies in the way that you’re using them now? Are they as effective as they were in the past? Take a look at your beliefs. Do you have any fixed beliefs that are counterproductive and are impeding you from taking positive steps?” Dr. Boardman said.
To keep your mental health in check, it’s important to be aware of subtle signs that something is affecting your mind. These signs include:
- A change in eating or sleeping habits
- Losing interest in people or usual activities
- Experiencing little or no energy
- Numb and/or hopeless feelings
- Turning to drink or drugs more than usual
- Non-typical angry, upset, or on-edge feelings
- Yelling/fighting with loved ones
- Experiencing mood swings
- Intrusive thoughts
- Trouble getting through daily tasks
If you struggle in any of these areas, talk to your doctor or a mental health professional to begin your emotional journey alongside your other cancer treatment.
Contributing: SurvivorNet Staff
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