Few men are willing to talk openly about issues such as cancer, family, fear, and sexuality. The philanthropist John Ingram is not one of those men, choosing to speak publicly about those issues and more in an interview with SurvivorNet. He did this with the intention of educating other men and helping them make hard decisions about their bodies when it comes to cancer risk.
Ingram is best known as the chairman of Ingram Content Group, Lightning Source and Digital Ingram, and Ingram Industries. He is largely responsible for taking the family business public and growing the manufacturing enterprise by spinning off into computer distribution ahead of the dot-com boom.Read More
What most do not realize however is that he is also a pragmatic “previvor” who decided to decrease his risk of cancer by undergoing prophylactic surgery to remove his prostate.
Previvor is the relatively new term that refers to someone who has undergone a significant medical procedure in the hope of warding off cancer, often because of genetic risk. The most famous of these previvors isAngelina Jolie, who following her mother’s cancer battle and the discovery of the BRCA1 gene mutation in her body underwent a double mastectomy.
Ingram, a father-of-four, made the decision to have his prostate removed after watching his father and brother both battle prostate cancer. His brother beat the disease, while his father passed away just six months after his diagnosis.
“You can beat a lot of things, but you really can’t outrun your genetic profile,” Ingraham told Survivor Net.
Ingram had his surgery at Vanderbilt, where the money donated and raised by his family over the years has helped to fund – among other things – research into the predictors, biomarkers, and inherited origins of prostate cancer.
“After my father died, we had the ability to take a business public, and a lot of the proceeds from taking it public over time, based on my father’s desires,” explained Ingram.
“We’re aimed at charitable things. Each one of us has had a chance to be really quite philanthropic. The whole thing’s pretty personal.”
And in yet another example of the lifelong philanthropist’s commitment to public health, he opted to share his story.
The benefits are clear, but he noted that there were undoubtedly risks that he had to be willing to accept.
“My doctor was very straight with me about the statistical chances of having sexual side effects,” said Ingram.
Ingram said that this was a side effect he discussed with his wife before arriving at his decision.
“I just knew enough about it and felt strongly enough about my family history, that I didn’t find it to be a hard decision, and my wife was supportive of it,” he explained.
“That’s a big deal, you know, because for the reasons I said before. My thoughts were, ‘let’s get rid of this cancer, and I’ll take my chances with the rest of it.’”
He now hopes to inspire other men to combat the disease by getting screened, learning their risk, and, when appropriate, having surgery to disease that took his father and threatened to take his brother.
“I’ve got some side effects, but I’m healthy as hell, and doing almost everything that I love,” pointed out Ingram .
“I think the message is, ‘look you could have some side effects, but you can also still do almost everything else you’re doing in your life and not have to worry about dying of something awful.’”
Sexual Function After Prostate Cancer
Most men will experience sexual dysfunction in some form after having prostate surgery.
This is because the nerves responsible for erections wrap around the prostate like a web, making it impossible to remove the gland without some damage to those nerves.
Men Can Still Get Erections After Prostate Surgery
Prostate surgery causes sexual dysfunction in most men by causing injury to the nerves responsible that allow men to have an erection. All of the operations listed above can damage these nerves.
In a radical prostatectomy, the most frequently performed surgery, doctors are often able to remove the prostate gland or a tumor without causing widespread inury to these nerves. The less injury to the nerves, the greater chance that a man will regain his ability to have an erection.
Those nerves that are injured need time to heal after surgery, and that process can take about two years. A man may be able to achieve an erection after just a year and in some cases been sooner, but the American Cancer Society puts the standard recovery time at around 24 months.
Age is also a key factor, with younger men more likely to regain full erections. Most men under 60 will be able to have full erections within two years if there is no widespread nerve damage.
Men who had strong erections prior to surgery are also more like to regain the ability to have erections.
Penile Rehabilitation After Prostate Surgery
Even tough they will not be able to maintain an erection without assistance, it it crucial that men who wish to regain this ability continue to have erections during the recovery period.
If a man does not have an erection until his nerves have healed, the tissues in his penis will weaken. Those men will then be unable to ever achieve a natural erection. Once this happens, he will not be able to get an erection naturally.
Doctors recommend penile rehabilitation in the weeks or months after surgery to make sure that the tissue retains its strength.
The best practice is for men to have an erection that is strong enough to achieve penetration two or three times a week.
In the event those drugs are not effective, a doctor might prescribe a penile injection or vacuum to help achieve an erection.
Preserving Sexual Function After Surgery
Who Should Get Genetic Tests
John Ingram made the decision to have prophylactic surgery after undergoing genetic testing, but even before that had good reason to believe his risk would be heightened given the diagnoses of his father and brother.
Dr. Ophira Ginsburg, the Senior Visiting Scientist, Cancer Surveillance at the World Health Organization, tells Survivor Net that individuals can reach out to a medical provider or genetic counselor if they do not know their family history well enough to determine their genetic risk.
This is the easy part explains Dr. Ginsburg. The hard part is determining what to do with that information.
“That’s the piece where it’s very important to have a well-informed healthcare provider to walk you through that information,” explains Dr. Ginsburg.
“What does it mean for me if my mother had cancer at 45 and my mother’s sister had cancer at 39? Maybe I have a BRCA mutation; well, maybe I have a mutation in another gene, and nowadays it’s getting complicated.”
It is crucial that a medical professional guides patients through this journey explains Dr.Ginsburg, and she discourages people from trying to make their own decision if they chose to use a direct-to-consumer test.
“We really feel it’s important that you get the best possible information to help interpret that test result for you and know what to do. Are you at risk, at an increased risk, or not? Does your risk lead us to think that you may consider high-risk screening?” points out Dr. Ginsburg.
She then cites just how serious some of these prophylactic surgeries are to drive home her point.
Men who have their prostate remove may suffer sexual dysfunction while women who removed parts of their reproductive system often enter into early menopause.
As Dr. Ginsburg points out: “You want to make sure that we give you those recommendations based on the best current available evidence, and that we are sensitive to your needs as an individual patient.”
The Pros and Cons of Prophylactic Surgery