Fighting Prostate Cancer— and Reclaiming Intimacy
- Arizona firefighter Gary Schobel faced a life-changing metastatic prostate cancer diagnosis that challenged both his health and the intimacy in his 34-year marriage to his wife Christine. Despite the emotional and physical toll of his diagnosis, he chose to fight, sharing his journey to help other men understand the profound changes cancer can bring, especially the side effects of hormone treatment.
- Treating prostate cancer goes beyond targeting the disease—it also requires addressing the side effects that often accompany different therapies. Some of these effects, particularly those impacting sexual function or urinary control, can be sensitive topics that patients may find difficult to discuss.
- Treatment options for prostate cancer might include radical prostatectomy (surgery to remove the prostate gland), radiation therapy, and hormone therapy — and each approach has a unique side effect profile.
- Although side effects can be uncomfortable and sometimes difficult to discuss, many are temporary, and your healthcare team can recommend treatments and strategies to help manage them effectively.
- Discover more on “Men Beating The Odds”—a compelling series that shares the powerful stories of men overcoming prostate cancer and redefining what it means to survive—here.
When Gary, a man accustomed to controlling crises, was told he had cancer on June 30, 2023, he felt he received a “death sentence” and that a sudden “expiration date” was put on the life he had built with his wife and their two children, 31-year-old son Ryan and 29-year-old daughter Lindsay.
Read MoreScott Jennie, National State Director for the Firefighter Cancer Support Network (FCSN), reminds us: it’s not a single exposure but hundreds to thousands over a career, including training, non-fire calls, and contaminated environments. The National Institute for Occupational Safety and Health (NIOSH) research shows firefighters have 9% higher cancer diagnoses and 14% higher cancer mortality than the general U.S. population.
“Bottom line: Firefighters face repeated mixed carcinogen exposures (inhalation + skin), persistent contamination (gear/station/rig), and physiologic stressors (sleep/circadian disruption), which together help explain why cancer risk is measurably higher and why the occupation has been formally classified as carcinogenic by the International Association for the Risk of Cancer (IARC),” Jennie tells SurvivorNet.
Gary explains, “I remember they suppressed my testosterone and moved through the hormone therapies. So, I have a whole lot of estrogen and no testosterone.
“They laugh when they say that put me into menopause. And I don’t know how ladies deal with hot flashes …I get like eight or ten of those a day.”
Hoping that his story will help other men understand how “real” the hormone changes are, which has made him more emotional, Gary admitted, “I’ve never cried so much. At one point I told my wife, ‘I’ve got to get some testosterone. This is crazy. I’m just crying all the time.”
In an effort to be fully transparent to anyone hearing his story, “It’s going to change the way you are as a man. Where would your relationship be with your spouse if intimacy was absent, gone? You don’t even have those thoughts anymore. And I didn’t see this coming.
“Nobody told me about this, and I was grateful when my wife asked me, but I was puzzled when my wife asked me one morning, ‘Gary, do you even love me anymore?'”
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His wife recalled them being “too much like business partners”and unable to connect on a deeper level. “We were just going through the motions and weren’t taking care of one another,” she added.
After Christine recounted how Gary wasn’t giving her the same attention or excitement to be around her, he admitted, “I didn’t realize I was doing that. Nobody told me about that.
“We were following the rules and I started this drift. Nobody told us about it. We had to realize we were heading in that direction and we had to make a change.”
Balancing Treatment and Quality of Life: What Men Should Know About Prostate Cancer Care
Reflecting on his experience, Gary wants other men going through similar challenges to take his advice to heart.
“Don’t let that drift. Be intentional. Be ready to work. We’re better because we really recognize that we owned it,” he said, acknowledging that he and Christine’s relationship had grown stronger, thanks to the choices they made to deepen their “togetherness” and “emotional intimacy.”
He further advised, “Don’t lose sight of your relationship with your spouse through this. The doctors are not going to tell you that.
“They’re not asking you how you’re doing in your relationship.”
Hormone Therapy Side Effects Can Be Mitigated
Hormone Therapy & Side Effects: Blocking Testosterone To Fight Cancer
It’s important to understand that hormone therapy, also known as androgen deprivation therapy (ADT), is the foundation of treatment for advanced prostate cancer and works by reducing or blocking testosterone, which fuels cancer growth.
Common medications used in ADT include GnRH agonists and antagonists, androgen receptor blockers, and CYP17 inhibitors. Each drug has specific mechanisms and uses, especially in castration-resistant prostate cancer.
While it works well against cancer, hormone therapy can cause notable side effects—including tiredness, bone loss, and sexual challenges—so ongoing monitoring and supportive treatment are crucial.
With hormonal therapy, “you’re taking the testosterone from normal levels down to almost zero,” Dr. W Kevin Kelly, the chair of medical oncology at Thomas Jefferson University’s Sidney Kimmel Comprehensive Cancer Center, previously told SurvivorNet. This leads to side effects that can be difficult, but there are steps patients can take to make these changes easier to tolerate, such as adjusting their diet, implementing an exercise routine, and preparing for mood changes, he says.
Side Effects Of Hormone Therapy
Hormone therapy can greatly benefit men with prostate cancer, however, it comes with notable challenges. Many of its side effects stem from reduced testosterone and can have a major effect on daily life and a man’s overall well-being.
Potential side effects include:
- Hot flashes
- Loss of libido and erectile dysfunction
- Fatigue and decreased energy levels
- Weight gain and loss of muscle mass
- Bone thinning (osteopenia/osteoporosis)
- Mood changes and depression
- Cardiovascular risks
Although side effects can be arduous, patients must understand that a wide variety of treatments and supportive strategies exist to help manage and relieve many of these symptoms.
Sex After Cancer: The Mind-Body Connection
Sex After Prostate Cancer & Advice On Reclaiming Intimacy
Sex is something that’s often not spoken about when it comes to cancer treatment. Doctors are so determined on keeping patients alive, that the sexual side effects that come alongside cancer treatment aren’t often factored in as an important part of the journey.
When it comes to having a good sex life after prostate cancer treatment, Dr. James Brooks, Chief of Urologic Oncology at Stanford Medicine tells us there are ways men can get back to being sexually active.
“There are things we can do, treatments we can use, to get couples back to being sexually active,” Dr. Brooks says.
He also reminds us that if sexual function is not back to what it was before cancer, a sex therapist can assist in learning other ways to have sexual intimacy.
“There are ways to be sexually active even in the absence of an erection,” Brooks says. “It requires couples to think more broadly or creatively about their intimacy.”
Dr. James Brooks Talks Sex After Prostate Cancer.
From exploring new experiences in the bedroom to consulting a sex therapist or connecting with peers in a support group, there are many ways for both women and men to regain intimacy following a diagnosis.
Dr. Kimberly Resnick, a gynecologic oncologist at MetroHealth in Cleveland, previously told SurvivorNet that simply by having a partner, women can have better outcomes, saying, “And it likely has to do with being able to have some shared intimacy with someone and not feeling alone.”
It’s “ok that you don’t feel like having sex,” Dr. Resnick clarified.
She reassures patients that doctors can help you with solutions if you’re having trouble regarding sex after a diagnosis and treatment. Dr. Resnick suggests focusing on relaxation and creating a comfortable setting. The first time being intimate after a break isn’t the moment to experiment too much, though sex toys can open up safe and comfortable ways to experiment with intimacy.
Tools Couples Can Use to Discuss and Maintain Intimacy Amid Treatment
- Open communication with your partner.
- Recognizing that intimacy goes beyond the physical—found in simple acts of emotional closeness, like holding hands, cuddling, or sharing meaningful moments together.
- Understand the value of verbal affirmations or daily check-ins to strengthen your emotional connection.
- Learn about the side effects of treatments—such as hormone therapy, surgery, and radiation—and how they can impact sexual desire and physical function.
- Consider consulting a sex therapist or counselor experienced in addressing sexual changes related to cancer.
- Ask your doctor or urologist about treatments or strategies that may help sexual function.
- Spend quality time together without pressure.
- Try using meditation or guided exercises to empower connection.
RELATED: Counseling Options for Cancer Patients
It’s important to note that protecting mental health is an essential part of cancer care. When it comes to counselors and psychotherapists, Dr. Daynelle Dedmond, a gynecologic oncologist with Centura Health in Colorado Springs, previously told SurvivorNet, “Patients often ask what the difference is between psychotherapy and counseling.
“Counseling can sometimes be more like a conversation between the patient and the counselor. But psychotherapy uses different modalities and techniques to help patients through their trauma and through their emotional concerns.”
RELATED: Sex Is Possible After Prostate Cancer and 5 Other Facts You Should Know
Meanwhile, men should feel at ease discussing intimacy with their wives, even if it involves sex. True connection isn’t just about intercourse—romance and closeness come in countless forms.
Keep in mind: even if the body or mind isn’t drawn to physical intimacy, there are other ways to nuture connection and emotional closeness.
The American Cancer Society (ACS) emphasizes the importance of finding a qualified mental health professional. Patients can turn to psychiatrists, psychologists, social workers, marriage and family counselors, as well as, psychiatric nurse specialists or nurse practitioners.
The ACS recommends starting by consulting professional organizations to find specialists in sex therapy.
Two useful resources are:
- American Association of Sex Educators, Counselors, and Therapists (AASECT) – www.aasect.org
- National Association of Social Workers (NASW) – www.helpstartshere.org
Content independently created by SurvivorNet with support from Novartis Pharmaceutical Corp
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