Gary, thanks for your question. I know a lot of men treated for prostate cancer who have similar feelings when their sexual lives have become so disrupted.
I’m wondering what you may have tried as a means of restoring your erections. For many men treated for prostate cancer, the oral medications simply don’t work or don’t work consistently. In addition, the oral medications aren’t really designed to produce an erection firm enough for anal penetration.
I’d suggest you consider a few different options. First, I’d have a long talk with your partner(s) about the kind of sexual activities you’re engaging in. Many times we can get a little set in our ways in a lot of areas of our lives, including sex. Your partner(s) may be willing to expand the types of things you do in bed to give each other pleasure.
I’m not sure exactly what you mean by “anal active” but if you mean you’re the receptive partner for anal sex, then you may be able to still receive pleasure from stimulation of the anal opening. For many men (including straight guys), anal pleasure may come from having their prostate stimulated. But you also have a lot of nerve endings around the anal opening and many men (and women) receive pleasure from having those nerves stimulated with a finger or toy. A great book for you to look at is Jack Morin’s Anal Pleasure & Health: A guide for men and women. It’s a little hard to find but you can get used copies on the internet. It can give you some ideas for fun, safe play that can help you rejuvenate your sense of anal pleasure.
Third, I’d have a talk with your urologist about other options for regaining your erections. While you can have a satisfying sex life without an erection, many men feel they need to have an erection. For most men, being able to get an erection is an important part of what makes them feel like a man. There are a number of options available to you, from the vacuum pump to intracavernosal injections to a penile prosthesis that you may not have considered yet. Your urologist can help you decide if any of these options are right for you.
My last suggestion is to consider talking with someone about how you feel about your sex life. The American Psychosocial Oncology Society has a toll-free referral number that may be able to help you find a counselor in your area with experience in working with cancer survivors. Their number is 1-866-276-7443. You also might consider joining a support group in your area. The Malecare website can help locate a group near you – www.malecare.com. If there isn’t a Malecare group in your area, you can try the American Cancer Society - 1-800-227-2345 or US Too – 1- 800-808-7866.

Best wishes.