Cassie Becknell's boyfriend, Anthony Jones, was intimately familiar with her body years before they started dating. Becknell, 37, was an artist, but she was also a nude life model. For five years, the pair exchanged glances and quick chats after class before she worked up the courage to ask him on a date. The chemistry—and desire—was palpable from the start. But Jones, 62, had a problem.
"We met up. Sparks flew. And then he had to tell me, 'Hey, by the way, it doesn't work the way you're used to,'" Becknell said.
Jones is a prostate cancer survivor who had undergone a radical prostatectomy a year and a half prior. There are different treatment options for prostate cancer, but a radical prostatectomy involves removing the entire prostate and surrounding tissues. The procedure can add 10 or more years to a person's life but it isn’t without side effects.
Most people who have a prostatectomy experience some nerve damage, which can disrupt what Becknell called the "brain-boner connection." About 85 percent of men who have the surgery experience erectile dysfunction (ED) according to the National Library of Medicine.
For some, issues resolve within a year. But many men, including Jones, have persistent problems. He feared the disclosure could be a deal breaker, but it wasn't an issue for Becknell. She had expected things might work differently given Jones' age; she knew that about 60 percent of men in their 60s have some form of ED.
Plus, having experienced extreme vaginal dryness after the birth of her son, she could empathize to some degree.
"I was like, 'No problem, I'll do whatever we need to do. I'm game,'" Becknell said, recalling that both she and Jones became emotional during the conversation. "You're just fine, and we're going to do whatever we need to do to be intimate together."
As Jones and Becknell discovered, sex after prostatectomy can be challenging. But with patience and the right accommodations, it can be equally fulfilling.
Sex after prostate cancer
Having sex as a survivor of prostate cancer can look and feel very different. In addition to erectile difficulties, men who undergo radical prostatectomies experience "dry orgasms" because the seminal vesicle glands are removed with the prostate. As a result, the testicles continue producing sperm, but it is reabsorbed instead of being ejected.
"It's very hard on a man because the relationship to the boner is like, way different then," Becknell said. "You don't even know. It's all brand new."
Jones was single at the time of his surgery, having just gotten out of a long-term relationship.
"He's like, 'Well, go figure. I'm just getting out of a failed relationship. Might as well take my boner away too,'" Becknell said. "And then a year and a half later we get together."
Part of the recovery process included physical therapy, which entails exercises to strengthen the pelvic floor and masturbation with the help of medication and wearable devices. Although Jones was familiar with the changes in his body, being with a partner was a learning experience for both.
The couple initially tried other forms of intimacy without intercourse and then began experimenting with penis rings, along with Jones' prescribed medication. Although the rings helped, Becknell said they could be cumbersome and uncomfortable. Moreover, while she was quite happy and satisfied, she knew Jones was still struggling to climax.
"He was very frustrated by it. To remember all the things that he used to do but not be able to do those with me, that's awful. And then realizing that he's not having the same experience that he wants. That's terrible. So, I reinforce how happy I am all the time," she said. "I actually sometimes jokingly say, 'You're like a high school girl—like you're participating, but you're getting nothing out of it, you know?' Of course, he loves to participate. It's not that. But a lot of times he's not coming all the way to climax. And that's just the reality of our lives."
Prostate cancer and sex: Facing reality
Embracing that reality was a cornerstone of the couple's relationship and part of what helped to keep their spark alive. Rather than viewing their sexual difficulties as such, Becknell interpreted them as a function of their relationship.
"What happens is you don't lose sex, but you lose all the spontaneity of it. You can't just roll out, 'Hey, I'm ready. Let's go,'" she said. "You have to take the pill and then you have to use the device. And that's not always the most fun and sexy thing. But when you want to have sex with your partner, you're like, 'Yeah this is what we do. This is our life.'"
Spontaneous intercourse might not be in the cards for Jones and Becknell, but the Eddie device from Giddy has helped their intimacy flow more organically, Becknell said.
Eddie, with its horseshoe shape and removable constriction band, emulates the natural physiology of an erection by preventing blood from flowing out, while allowing blood to flow in. Penis rings, by contrast, are circular and constrict the penis on all sides, which can cause discomfort or pain.
Because the device complements the penis' natural shape and physiology, Becknell said it's also helped Jones achieve better and more frequent orgasms when used in conjunction with prescription medication.
"Having sex in combination with drugs, it's wonderful," she said. "It's been working beautifully for us."
The bottom line
Adjusting to life after prostate cancer can be difficult. But reframing perceptions around intimacy—and finding creative ways to overcome hurdles—can make sex and sensual encounters just as pleasurable as those before your diagnosis.
"You're still a man. You're still able to connect with a woman. And if you're doing it a little differently, so what? You're still doing it, you know?" Becknell said.
Becknell echoed that she is very happy with her sex life, which amplifies her and Jones' love for each other. And although grappling with the effects of prostate cancer has been challenging, she said the experience has only strengthened their relationship.
"It really did bring us closer together," she said.