Caveat: I’m not a doctor, and I don’t even play one on TV. This is all my opinion.

When that phone rang one dreary gray morning back in 2001, and it was my urologist calling with test results, I fully expected to be exonerated once again from a medical malady, as I’d always slipped by before, no matter what the test, usually with passing grades and a smile.

Not this time. The news as cloudy as the weather, the apologetic voice said that the biopsy results were positive for prostate cancer, and we needed to make an appointment to discuss what to do next.

I was in shock. Only 46 that year, my lucky personal experience with disease was limited to increasingly infrequent colds and flus, a broken collarbone at 6, and a nasty bout with Hep A. For me, the gold standard around which all health issues revolved was the yearly HIV test, and as long as I could keep passing that, nothing else would even come close.

As I did my research and discussed the options with the doctors, the more it occurred to me that prostate cancer (PC) was a numbers game. There was a number for the PSA (prostate specific antigen), a blood test you take, which when elevated, can be an indicator of PC. There was your age, also a number, a higher number (say, 75 vs. 46) being indicative of both the kind of treatment that would be recommended and the likelihood of surviving PC and dying of something else. Finally, there was the Gleason score, which was a numbering system indicating the aggressiveness of the cancer cells, a higher number being worse than a lower number.

There are also a number of treatment options recommended as a result of this cancer math. These range from watchful waiting, which means what it says, do nothing and see how the cancer progresses, to radical prostatectomy (RP, the surgical removal of the prostate gland and surrounding tissue) to a couple of different types of radiation, i.e., external beam radiation or brachytherapy (which is a method of implanting radioactive “seeds” in the prostate to kill the cancer).

In the years since I had my RP, a robotic prostatectomy procedure has become quite common, drastically reducing recovery times, though recent media reports cast some doubt on its being any more effective than RP for long-term incontinence or impotence issues.

My cancer was somewhat aggressive, and because of my relatively young age, all three urologists I consulted with recommended radical prostatectomy, with the option to undergo further treatment with radiation if there was still some cancer left over. I had my radical prostatectomy, and yes, there was cancer left over, and I underwent two months of external beam radiation a few months later.

One truth about all this is… Breasts Rule. Compared to the prostate cancer’s female equivalent, breast cancer, with its well-established foundations, fundraisers, celebrity spokeswomen, movies of the week, etc., PC keeps a low profile.

Increasingly, however, some well-known men have talked about their illness, including, as I write this, General Petraeus, Senator Christopher Dodd, composer Andrew Lloyd Weber and actor Dennis Hopper.

Prior to my diagnosis, whenever I read about PC, what I remembered most was that it was an extremely slow-growing cancer, and that it usually struck men who were much older than me.

In other words, no reason to worry.

Then there was that part about being gay, and that nothing could possibly be as bad as a positive HIV test.

Then there was the part about the side effects of PC treatment. No matter how you look at this, it’s not pretty. The statistics vary, again being a numbers game (which depends a lot on age), but the likelihood of some degree of impotence (or its more politically correct term, erectile dysfunction or ED) and urinary incontinence are side effects of both the prostatectomy and/or the radiation treatments.

My urologist told me that there were many ways to treat erectile dysfunction, from wonder drugs Viagra, Levitra and Cialis to penile injections to vacuum pumps, “but you have to be breathing for us to get you hard” – hence the medical community’s emphasis on cancer eradication first. Most, but not all, prostatectomy patients experience some degree of short-term urinary incontinence after the operation. Some are not so lucky and have permanent or intermittent problems with incontinence (which have their own surgical fixes).

Glaringly absent were the stories of gay men surviving PC, which is one of the reasons I’ve decided to tell that story in my novel “Benediction” (available on amazon.com) a darkly humorous fictional narrative based on the real life experience of having prostate cancer.

First of all, everyone in the medical establishment will assume you are heterosexual unless you tell them otherwise. Second, there’s very little support specifically targeted to gay men (though there are exceptions).

One man I talked to had checked out Us Too!, a national prostate cancer support organization, and found, like I had, that the group made the tacit assumption that every man was straight. After finding nothing in the way of gay support groups, he decided to organize his own group, which met once a month at his apartment.

He found out there were other gay men going through the same things, that he wasn’t isolated. Someone in the group encouraged him to go to the baths, to connect again with sensuality and sexuality – probably not the kind of advice to come out of a straight support group.

There are similarities between PC patients and HIV-positive men, in the sense that both have to overcome the feeling of being “damaged goods” – “there is personal information about yourself that could have sexual ramifications. Some men will act differently when they know…so how to act, what to say, is a big question.

But I think what gay men in particular really want to know, when you finally get past those questions of mortality, is exactly what’s going to happen with those nasty side effects and how are they going to affect my cock, what’s anal sex like without a prostate, and for pete’s sake, this incontinence stuff?

These are things your urologist won’t tell you, even if you ask, because they really don’t know – because for the most part, the patients they deal with are older straight men, who, in my experience, don’t talk about this sort of thing anyway.

Your 81-year-old uncle in Cincy is probably not going to ask the doctor about the pros/cons of getting fucked by his college-aged hustler “friend” post-op while your aunt wrings her hands out in the waiting room.

(I did ask that question. Luckily I was a patient in San Francisco, where all my straight urologist said was “it’s OK, just don’t go hog wild” – really, he said that.)

I can tell you that I thought I was lucky to not be a straight man, where the sexual imperative is vaginal intercourse, and the focus for the man is always on his cock. I could experiment more with being a bottom, with using my mouth, my ass – we gay men have so many options when it comes to sex.

And it still feels great getting fucked, even without a prostate gland. I’m never sure how much of that originates in my ass or how much of it comes from my head and my heart, but it doesn’t matter.

Funny thing: Because of that added openness (so to speak), I have a broader range of sexuality now than before I had prostate cancer.

Now about the cock: The facts about ED – and I refuse to call it impotence because that makes you sound like you have no power, that you’re not a force to be reckoned with anymore, and I just don’t buy that – are really glossed over.

You’re most likely to hear something on the order of, “you will get your erections back, but it will be gradual over a couple of years.”

The truth is, there is so much trauma done down there with either the RP or the radiation that the nature of erectile response is changed forever.

The old reliable head-cock connection, say, when you saw something hot walking down the street or a scene in a video that got to you and sprouted your wood – is pretty much gone. Manual stroking is needed most of the time, and with that little bit of help, and those great ED drugs, it’s pretty much like old times.

And there’s no semen any more. The prostate makes almost all the fluid that transports the sperm out of the body so without it nothing comes out, nothing. I spoke to a guy recently who’s about to undergo a RP and this little fact hadn’t been communicated to him by his doctor.

Despite the fact that there is no jizz, the orgasm feels the same as it always did. In fact, if I didn’t see my cock actually not shooting out white stuff, I would believe that it had – because that’s what it feels like and I’m grateful for it.

The doctors will also tell you that depression over these changes followed by sexual inactivity will just make matters worse. In other words, “use it or lose it” applies here. My own doctor told me to masturbate daily, even if there was no erection at first. I didn’t realize that an orgasm was possible without an erection – but it is.

After the operation, I had to wear incontinence “shields” for about six months until I stopped leaking, and now that is pretty much a thing of the past, except during a few strenuous activities – sometimes in the weight room, sometimes when dancing – which is called stress incontinence and it’s helpful to wear something additional down there.

Also, curiously, there can be some incontinence during sex, which is usually solved (for me, anyway) by convincing my partner to lie down, as it’s affected by body position. Either that, or to just join me in the shower!

My advice? For any man facing PC I’d say go to support groups, gay, if available, and straight as well. Also, in getting additional medical opinions, to talk to radiologists as well as surgeons, to get their take on treatment. The more you know, the less scared you will be.

As there are no current universally accepted screening guidelines (and they’ve become controversial yet again), my doctor recommended checking the PSA level and having a digital rectal examination once per year for most men over 50, but to start at age 40 for men of African-American descent (who have a higher risk of prostate cancer, for unknown reasons) or for men with first-order relatives (a father or brother) with a history of prostate cancer.

What to tell your sex partners? I still struggle with this, but I have found out that it’s always been more a concern for me than for anybody I’ve had sex with in the years since PC. Most of the time, guys don’t notice anything (are we all that self-centered?) and if they do, you can always have the “conversation” – but I’ve discovered that nothing puts the damper on sexual desire quite as fast as a discussion about cancer does. So beware.

Every year when the holidays roll around I’m reminded to make my appointment for my annual PSA test – which in my case would indicate if the cancer was active again. So far so good, and they tell me the longer it goes on like this the less likely it will be for it to come back.

I’m cautiously optimistic, both about my future with cancer and as a sexual being – and grateful for the opportunity in my life to define what it is that really makes a man.