Making love again after prostate cancer surgery or treatment takes a dedicated partnership in understanding and communication, say Keith and Virginia Laken.

They should know. The Laken's commitment to a continued physical and emotional bonding — despite impotency and incontinence — resulted in a richer, deeper, more intimate relationship than they could ever have imagined before cancer.

But that's the wisdom of hindsight. Foresight was a lot more blurred and riddled with anxiety, fears, and frustration.

Seven years ago, Keith was ready to choose a shorter life with no surgery than have a longer one with a presumed lessened sex life.

He and his wife, Virginia, had enjoyed a loving marriage of 28 years, and he was young, only 49 at the time. So he balked at the potential side effect of impotency, feeling like he'd be less powerful, less respected at work, less of a man and husband, less human.

Virginia's assurances that it wouldn't matter if they ever made love again, that she just wanted him to live, only fanned the flames of argument. She came to learn that this treated Keith's despair as a kind of male vanity rather than a true loss to them both.

He discovered he wasn't alone.

According to the American Cancer Society, prostate cancer is the second leading cause of cancer death in men. This year, an estimated 30,200 men will die of the disease and nearly 189,000 new cases will be diagnosed.

By the third biopsy in 1995, which proved positive for cancer, they had experienced a roller-coaster ride of emotions. And Keith was reluctant to be treated at all.

Keith was finally convinced when his doctor at the Mayo Clinic had him speak to other prostate cancer patients who had recovered from their operations and were enjoying a love life.

Before the surgery, Keith and Virginia started keeping separate journals to aid their understanding. It served as a frank chronicle of the hard-won healing process following Keith's radical prostatectomy, and the basis for their book, Making Love Again.

The surgery was successful, and after seven weeks Keith returned to work at his job as a vice-president of an electronics division of his company in Minnesota. Now, Keith and Virginia assumed that he would have a quick return to sexual functioning.

"No such luck," they said.

"Four months without sex made me begin to appreciate the integral role sex played in our marriage," said Virginia. "Making love was what we did to reconnect when things weren't going well and how we celebrated when they were. Without sex, we had felt isolated from each other."

But they learned that Keith could have an orgasm without an erection, and they began to enjoy making love again. And they returned to other pleasures they had put on hold, like walking and talking together.

But frustration would re-appear, and silence would sneak in as a way of avoiding conflict.

Five months after surgery, Keith started penile injections to get an erection. Their "love potion," took them from exhilaration to discouragement in three months, as they faced the reality of lifelong impotency.

Although the injections worked well, they had to get used to the lack of spontaneity, and they struggled to find the right dosage.

Worse, Keith had lost all sense of physical desire. His drive was gone. It affected more than their lovemaking. Keith was unhappy, and his outlook on life, his attitude at work and at home, seemed negative and angry.

The turning point came when they could both cry over all they had lost. Then they could voice their feelings and truly listen without judgment to how the other one felt. With this openness, they could turn to each other for comfort. They were determined to seek help.

Help came in the form of a psychologist, a specialist in male sexual dysfunction, recommended by their doctor. He listened to both of them and let them know that they were well on their way to recovery because of one primary reason: they were talking to each other and sorting out their feelings together.

The psychologist pointed out the things they were doing right: they had realized that their love-making needs had changed — frequency had lessened and they were actively creative in their love-making.

He encouraged them to keep making love by focusing on pleasure, not intercourse.

He then helped Keith understand that his lack of desire was physical, not mental. He explained that a man in his condition "has to become more attentive to what his brain is saying versus what his body is saying."

They began and continue to approach love making more deliberately with scheduled sex days. "We make sure our love making takes place, even though our bodies are not driving us to make love — our minds are," said Virginia. "We realize that love making is so important to our marriage, that we set aside a time."

It took them three years to reach that understanding. A big motivator for writing their book was so other couples wouldn't have to go through this much uncertainty.

"Touching is such an important part of communication," said Virginia.

And it's therapeutic. "When someone is sick, it's easy to become hesitant and lessen our touch. At one point I didn't want to touch Keith for fear of hurting him," said Virginia. "In hindsight, it's just the opposite, we should be touching more."

"With persistence and redefining intimacy, you can have a wonderful relationship," said Keith. "But keep touching, keep being intimate, keep making love, in whatever form love-making takes."

Their experience could read like a blue print for any deeply committed and loving relationship that continues to communicate and grow on many levels. As shown through the Lakens, the process itself is the act of rediscovery and renewal. This transformed their relationship to a new level that continues to be more impassioned and intimate than they believed possible.