“Changing a Man’s Diet After
a Prostate Cancer Diagnosis” A cancer diagnosis is seen
as a teachable moment in medicine where we can try to get
people to eat healthier, but research suggests that
male cancer patients in particular may be reluctant to
introduce dietary modifications. This has been attributed
to dietary changes often being viewed as mimicking
“feminine” eating behaviors, such as emphasizing an
increase in fruit and vegetables. Although healthy eating
might enhance long-term survival, few men with prostate cancer
make dietary changes to advance their
well-being. Many of the cancer
survival trials for example, required adherence to strict,
plant-based diets, and though researchers tried
providing extensive nutrition education and counseling
programs, dietary adherence was
still a challenge. The way Dean Ornish
was apparently able to reverse the progression of prostate
cancer with a plant-based diet was home delivering prepared
meals to their door, figuring men
are so lazy they’ll just eat whatever’s
put in front of them. After all, male culture tends
to encourage men to go for convenience food,
meat, and beer. Take Men’s Health
magazine, for example. Included in their
list of things men should never
apologize for: liking McDonald’s, not offering
a vegetarian alternative, and laughing at people
who eat trail mix. It featured articles
with titles like, “Vegetables Are for Girls,” and sections like “Men and Meat: There’s Only One
Kind of Flesh We Like Better, and Even Then, She’d Better
Know How to Grill!” To appeal to male
sensibilities, doctors are advised to use
‘body as machine’ metaphors, framing men’s health in
terms of mechanical objects, such as cars
requiring tuning. But if men are so concerned
about their masculinity and manhood, maybe we should instead
share a bit about what prostate cancer
treatment entails. The prostate is situated at
the base of the penis, and so when you
core it out with a radical
prostatectomy, you lose about an inch
off your penis, IF… it gets
erect at all. Only 16% of men
undergoing the procedure will regain their
pre-surgery level of erectile functioning. Patients are typically quoted
erectile dysfunction rates around 60% or 70%, but studies have generally
considered erectile function recovery as just the ability to
maintain an erection hard enough for
penetration about 50% of the time. So getting it up occasionally
is considered recovery. But when a surgeon tells a patient
he will recover function, the patient probably assumes
that means the kind of function they had prior
to surgery. And that only happens
16% of the time, and only 4% of the time
in men over 60. Only 1 in 25 get their baseline
sexual function back. And it’s not
just erections, but other problems like OAP,
orgasm-associated pain even years later,
and urinary incontinence during foreplay,
stimulation, or orgasm. The vast majority of
couples overestimate how much function
they’re going to recover. Couples reported feeling
loss and grief. Having cancer
is bad enough without the
additional losses. You’d think that
would be enough to motivate men to
improve their diets, but almost a fourth
of men newly diagnosed with prostate cancer state
that they would prefer to have their lives cut
short rather than living with a diet that prohibits
beef and pork. More men would
rather be impotent than improve
their diet. It appears pleasures
of the flesh may sometimes
even trump… pleasures of the flesh.