Tuesday, October 11, 2011

Cancer patient prized sex more than life

He prized his love life more than his life. To his detriment.

He had prostate cancer and could have been cured if he had had the cancer surgically removed at an early stage.

But because that carries a risk of his losing his ability to have sexual intercourse, he decided to gamble with his life.

He had been married only recently.

Impotence would have meant an end to sex with his 28-year-old wife and the possibility of children.
So he ignored his doctor's advice.

He died six months later at 30.

Prostate cancer is the third most common cancer among men in Singapore. It develops in the prostate, a gland in the male reproductive system.

On average, there are 534 new cases a year and 105 deaths from prostate cancer.

Speaking to The New Paper on Sunday, leading urologist Peter Lim recalled his youngest patient: "His prostate cancer was detected by biopsy and it was still at an early stage.

"I told him to remove it urgently or he will die. He asked me, 'Any danger?' I said, 'Yes, you have a high chance of impotency.' And he ran away.

"At that time, we did not have the robots and it was an open operation. The chance of his being impotent was high, at 80 per cent," Professor Lim explained.

Death preferable to impotency?

He said 10 to 15 per cent of his patients "disappeared" at the very mention of "impotence".

"Sex is very important to most men. Even though they can still have a penile implant to get back their erections, many do not want to take the risk.

"They would run away and it is usually their wives who would encourage them and get them to return to the hospital for treatments."

Last month, The Journal Of The American Medical Association published a study that found that a high percentage of men could not have a normal sex life after being treated for prostate cancer.

Fewer than half of the 1,027 patients involved in the study and who had reported good sexual function before cancer had managed to regain it two years after treatment.

Those involved in the study were aged between 38 and 84. Overall, just 35 per cent of men in the surgery group, 37 per cent who were in the radiation group and 43 per cent of those in the brachytherapy group could have sexual intercourse two years after treatment.

Sex life still possible after surgery

Still, it is possible for men who have had surgery to experience an improved sex life two years later.
Alternative treatments like radiotherapy may not necessarily lower the risk of impotency. It's just that the effect could be delayed, said Dr Lewis Liew, a urologist and laparoscopic surgeon.

Prostate cancer tends to develop in men older than 50. But Prof Lim has treated patients as young as 41. In the last 10 years, he had two patients, both aged 30, hit by prostate cancer.

He said: "The younger you are, the more aggressive the tumour will be. You must remove the tumour urgently or you will die.

"The minute you know that you have cancer, you cannot be so stupid to go shopping around for another doctor. They are going to say the same thing to you."

He added: "Some patients hope to find one doctor who would say to them, 'Oh, don't worry! I can give you this medicine and you will be okay.'

"Men should know that if you are not that young and you get prostate cancer, it is not a bad cancer to have, provided you quickly treat it."

He recalled another patient, a 52-year-old Caucasian, who refused to have the tumour surgically removed because he was newly married.

Prof Lim said: "He told me, 'Why should I go for the operation and be impotent?' I told him, 'It's about your life, you know'."

Within 18 months, the cancer spread to his liver and, even though he started chemotheraphy, he died three months later.

Best chance for recovery

Prof Lim, who sees five times more foreigners than Singaporeans seeking treatment for prostate cancer, added: "We have the best treatment in Asia.

"We have a few robots here that can perform the surgery accurately. With robotic surgery, the risk of impotency is low, at 25 per cent.

"In fact, I just operated on a patient from Mauritius. He was in hospital for three to four days and after he returned to Mauritius, he called to tell me that he had an erection!"

What women say... 
"Most men define their masculinity through sex and to some, especially those still in their prime, sex is a big part of their lives. Losing the ability to perform is like losing sight of who they are, thus the feeling that life is not worth living." - Miss Cheryl Lim, 27, business owner

"While sex may be crucial in a marriage, it is not the only thing. When you lose your life, you lose everything, not just sex." - Ms Shino Yee, 37, a beautician

"Men need to know that women want more than just sex. If they can't even take care of themselves, how are they capable of taking care of their loved ones?" - Miss Fei Wong, 32, regional assistant director of sales

"While I can understand how men value their 'manhood', it is stupid to put health and life at such a risk." - Miss Deborah Dayani Nanayakara, 26, public relations manager

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