My husband, Dean Skylar, bought me underwear after his prostate cancer diagnosis. It was a hopeful act that suggested he wanted to preserve our sex life in the challenging times ahead.
After skin cancer, prostate is the most common cancer in American men. The disease is diagnosed through a blood test to determine prostate-specific antigen (PSA) levels. If caught early, treatment may simply be active surveillance. If the cancer is contained in the prostate, a prostatectomy may be recommended to remove the prostate and surrounding tissue.
In Dean’s case, the cancer had spread and he was diagnosed with stage 4 metastatic cancer. His treatment was chemical castration and his life expectancy was five years.
Suddenly our lives changed dramatically. We had to deal with an obituary and a possible end to our sex life.
A diagnosis of prostate cancer has a profound impact on a couple’s life. Information about the impact of the disease on loss of sexuality associated with hormone therapy is not discussed in detail. Your oncologist will prescribe information about medications and treatments to combat the disease, but discussion of sex is uncomfortably sparse.
As the two of you fight for his life, he loses what he probably believes is vital – his sexuality. It’s not just that he loses the ability to have an erection; he loses his sex drive. And his partner may need more than a black silk nightgown to feel sexy again.
When Dean was diagnosed four years ago, maintaining our intimacy was critical to his well-being. We tried to plan for both physical and emotional changes. The medications he took eliminated his testosterone, which drives the cancer. Androgen deprivation therapy also reduced his muscle tone and caused weight gain, hot flashes, mental fogginess and fatigue.
My confident, weight-lifting, tennis-playing, sex-loving husband felt emasculated. The psychological stress this caused was initially debilitating. We researched the disease. We have changed our exercise, diet and intimacy patterns to accommodate physical limitations.
Dean and Christine on their anniversary in 2025
We found help from prostate self-help groups, cancer support organizations and therapists. We discovered online Facebook groups as well as in-person group therapies that offered useful tips. We already knew that intercourse wasn’t the only route to intimacy. Genitals are not the only way to have erotic experiences.
Some people in our groups have had success with vacuum erection devices, or penis pumps, which use suction to draw blood into the penis. This can be applied to medications such as Viagra. We ended up giggling at our failure as we tried, and I accused Dean of buying a cheap device. Others suggested penile implants, a surgical option that can be expensive and not necessarily covered by insurance.
There is also injectable penile therapy, which involves injecting medication into the penis using a syringe. Some of these options seemed daunting and kind of ouchy. We had already had to inject ourselves with medication to treat him, and given his life-threatening diagnosis, the operation seemed excessive.
We chose touch. We held hands, kissed, caressed and massaged. While he slept, I read next to him. I watched his favorite TV shows with him and ate whatever he was hungry for. I synced with him.
He kept an eye on our intimate moments. Since he no longer felt any sexual urges, he monitored a wall calendar in which I wrote a heart when he slept with me. I signaled desire by lighting candles, playing “our” songs on Sonos, or running a bath.
He was always a generous lover and responded to my invitations with a smile. As we navigated the stages of his illness, I wanted to ensure that he would never feel alone and hoped that we would become closer than ever before. We discussed everything.
As he grew weaker, I performed physical tasks for him that I had never done before. As soon as he had trouble reaching his toes, I clipped his nails. When he got tired of shaving, I trimmed his beard. I groomed his eyebrows and trimmed his nose hair. I stood next to the shower while he washed; I dried him with a towel when he came out.
His skin stayed smooth because I applied lotion every day. His doctors and nurses always commented on it.
We decided on home hospice because I wanted to look after him until the end. I slept on the couch next to his hospital bed. Sometimes I would bring my pillow and ask him to slide over so I could spoon next to him.
He kept telling me how sorry he was to have to do this to me. I insisted that I was lucky to have been his girlfriend, lover and wife throughout his life. I have told him repeatedly that I would miss him every second of the rest of my life and I know that will be true.
He died on July 20th. We were prepared for his last breaths.
I am forever grateful that I held him in my arms in his final moments. I whispered that I loved him. In the weeks that followed, I kept memories alive. I wear his wedding ring around my neck and put on his red terrycloth robe before bed. Photos of him appear on my electronic calendar, and sometimes I look at messages from him on my phone.
His ashes are in a silver urn on the coffee table with the initials DS and CL. It’s waiting for me to join its. Our children are instructed to drop them off at the Ponte Vecchio bridge in Florence, where we had a romantic vacation almost 20 years ago. But that trip decades ago is not what I remember most today. It’s the many small moments we’ve spent together over the last four years that have paved our way through a devastating illness. Our intimacy never ended; it grew just like our love.
This educational resource was created with support from Bayer.
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