Masculinity has different meaning to different people, but often, men view masculinity in terms of how they can use the power within to provide. This may mean working to support their families or simply building or fixing things around the house. Masculinity, for most, is also tied to sexual health.
Before receiving a prostate cancer diagnosis, David Bentley of Taylorsville, North Carolina, viewed himself as a provider, family-man, and athlete. “Pre-diagnosis, I was active riding my bike, enjoying time with my family, especially my grandson, but working way too hard and long. My wife and I were in a real good place in our relationship. Everyone was happy, and life was good,” he says.
In the summer of 2014, he was enjoying spending time with his family and gearing up for 24 Hours of Booty, a cycling event that raised money for cancer research. But just three weeks after the event, he learned he had metastatic prostate cancer.
Bentley sought treatment at Cancer Treatment Centers of America® (CTCA), Atlanta, where he had a radical prostatectomy. In January 2015, he underwent seven weeks of radiation. Then, in January 2016, he started hormone therapy, which has kept his PSA at an undetectable level.
“Because my initial scans showed evidence of the cancer possibly escaping my prostate, I was not lucky enough to have nerve sparing surgery. This meant that I could no longer have a natural erection, the one thing that makes you uniquely a man,” says Bentley. “Also, I was met with incontinence, which was hard to comes to grips with at first. Later, the introduction of Lupron (hormone therapy) had the most impact as it basically destroyed the natural urges for sex.”
Before his cancer diagnosis, Bentley logged 150 to 200 miles per week on his bicycle and was luckily able to return to his bike to complete the 24 Hours of Booty cycling event after surgery and radiation. However, after he began hormone therapy, his physical recovery progressed slowly.
“It affected my energy level and promoted weight gain,” he recalls. “Last year was tough trying to find the energy to ride and my mileage was almost nonexistent. This year, I am determined to make a comeback.”
After cancer treatment, recovery can be a slow process, as Bentley experienced. According to Sean Cavanaugh, MD, Chief of Radiation Oncology, Medical Director, Prostate Center at CTCA Atlanta, physical recovery is a test of patience and resilience. He explains:
I tell men to think about the process of rehab like it would be for rotator cuff surgery. That’s something to which many men can relate. The rehab is a slow process and expectations are kept low at first. Gradually, slowly, little by little a patient can strengthen and use their shoulder again. Whether we are talking about muscle strength, recovery from surgery, or libido and erectile function, my experience is that men want their recovery to be fast, complete and free from uncomfortable situations or embarrassment. Unfortunately, that likely isn’t going to happen. Whether from needing help showering or help getting an erection, the reality is that men are going to need some help and there will likely be some awkward moments.
Mental and emotional recovery
Like Bentley, many men define their masculinity by their work. When cancer and its treatments keep men from working, the role of provider may be reassigned to another family member, which can be difficult to accept.
Dr. Cavanaugh also notes that for many men, their cancer diagnoses may be their first experience with a major medical issue. Unlike women who often have imaging, frequent appointments and a hospitalization associated with pregnancy, men may be facing these things for the first time, which can feel overwhelming.
“It’s not uncommon for a man to ask which treatment option would allow him to continue to work,” Dr. Cavanaugh says. “The diagnosis may cause them to be away from work for an extended time, something women may have experienced with maternity leave, but most men will find foreign and unsettling.”
Bentley turned to his experience as a coach to harness the strength to fight cancer. “My years of coaching sports kicked in. I needed to find out all I could about my opponent, searching out its weaknesses and assembling the best team I could to help me win.”
Bentley also turned to a support group, which reminded him, “No one fights alone.”
Opening up to others in a support group can be one of the best coping mechanisms, suggests Dr. Cavanaugh.
“If a support group isn’t your cup of tea, then I’d suggest talking with a male family member, priest or pastor. The reality is that many of my male patients tend to not be very talkative about their illness. For those who don’t want to talk, prayer, and meditation can be valuable tools,” Dr. Cavanaugh explains.
In addition to his support group, Bentley found solace in painting, which he discovered through an Art Expression class at CTCA. “My first night I almost walked out as I didn’t feel like painting a red bike with a flower basket. Then the instructor said paint whatever you want to. I channeled my inner Bob Ross and painted a mountain scene, and from then on, I did whatever landscape came to mind,” he recalls.
Before his diagnosis, he would never have guessed that painting would become a passion: “Painting was proof to me that God chose what could’ve been a very dark time in my life to show me that I had something more to offer the world.”
Physical, emotional and mental recovery may require more time than expected, but with patience, support, and self-reflection, you can achieve your health and life goals.
“Cancer is not a journey, it is an all-out war with the ultimate stakes: survival. After my diagnosis, I made a conscious decision that I was going fight to my limit every day and if I reached that limit then I would take a deep breath and push on,” Bentley says. “I found a sign right before my surgery that says ‘Pain is temporary, quitting is forever.’ I have it over my front door so that I see it every day before I step out into the world and try to make a difference.”
“If a patient tries, he can find some aspect of his masculinity that has not been harmed by his disease or treatments,” Dr. Cavanaugh encourages. “Focus on that aspect while working on recovering the rest. You may want to talk to your partner, your sister or a different woman with whom you feel comfortable. Ask them what they think masculinity is and you might be surprised how much you still resemble their answer.”