[AlaskaAngel]

Bill,

It is fascinating to try to unravel the nature and reasons for the diminishment of sexuality with the use of therapies that are intended to permanently drop natural hormonal production as much as possible (not just while doing chemotherapy) as a protection against recurrence.

For example, one effect is the sharp reduction in testosterone. Testosterone is not just a hormone that acts to provide sensuality and sexuality in males. Another effect is the lowered level of the pheromones that act in humans to attract other humans for possible relations. How does one put that back by "not being told what the possible effects are just in case negative thinking might be discouraging"? Those losses are not imaginary, but genuine.

Even for those whose therapy helps them avoid recurrence, it is no small sacrifice to make. But all the more terrible is it for someone who has gone through the therapy and is dealing with recurrence AND the loss of that precious expression of intimacy in helping them get through such a difficult time together with someone they love. The violation of trust by not discussing it in advance of therapy to me truly is a form of rape.

While it might seem at first thought that it is more important to avoid the impression that therapy might result in significant loss of sensuality and sexuality than it is to take the time and effort to explain ahead of time what the risks and benefits are, there is no other way to ensure that the person considering treatment is being trusted to make an intelligent choice among therapies that are known to have absolutely no garantee of working at all for any particular individual.

Lying by omission is still lying. This is a shotgun therapy that is being prescribed, with variable benefit (including none) and many support drugs, all of which can result in their own effects on sensuality and sexuality.

It is important to realize that each physician providing the prescription has a personal bias about therapy, and therefore has a reason to avoid allowing the patient to be fully informed prior to making the choice.

As a male, if you were going to choose whether or not to be chemically castrated to avoid recurrence (and there was no garantee that you would not still have recurrence anyway), would you appreciate not being trusted with the information that your sex life stands a considerable chance of being diminished?

AlaskaAngel