1
|
High Neuroticism Is Related to More Overall Functional Problems and Lower Function Scores in Men Who Had Surgery for Non-Relapsing Prostate Cancer. Curr Oncol 2022; 29:5823-5832. [PMID: 36005197 PMCID: PMC9406934 DOI: 10.3390/curroncol29080459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 08/10/2022] [Accepted: 08/15/2022] [Indexed: 11/23/2022] Open
Abstract
The personality trait of neuroticism is associated with adverse health outcomes after cancer treatment, but few studies concern men treated for prostate cancer. We examined men with high and low neuroticism treated with radical prostatectomy for curable prostate cancer without relapse. We compared overall problems and domain summary scores (DSSs) between these groups, and if high neuroticism at pre-treatment was a significant predictor of overall problems and DSSs at follow-up. A sample of 462 relapse-free Norwegian men self-rated neuroticism, overall problems, and DSSs by the EPIC-26 before surgery and at three years’ follow-up. Twenty-one percent of the sample had high neuroticism. Patients with high neuroticism reported significantly more overall problems and DSSs at pre-treatment. At follow-up, only overall bowel problems and urinary irritation/obstruction and bowel DSSs were different. High neuroticism was a significant predictor of overall bowel problems and bowel and irritation/obstruction DSSs at follow-up. High neuroticism at pre-treatment was significantly associated with a higher rate of overall problems both at pre-treatment and follow-up and had some significant predictions concerning bowel problems and urinary obstruction at follow-up. Screening for neuroticism at pre-treatment could identify patients in need of more counseling concerning later adverse health outcomes.
Collapse
|
2
|
Kohada Y, Ito J, Kaiho Y, Kusumoto H, Kukimoto T, Mikami J, Hinata N, Sato M. Importance of considering interest in sex when evaluating satisfaction after robot-assisted radical prostatectomy. Int J Urol 2022; 29:446-454. [PMID: 35133043 DOI: 10.1111/iju.14813] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 01/04/2022] [Accepted: 01/21/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To assess the impact of patients' interest in sex on the satisfaction after robot-assisted radical prostatectomy, longitudinal changes of urinary and sexual functions and bothers were evaluated. METHODS A total of 101 patients underwent robot-assisted radical prostatectomy in our institution. Based on sexual interest, they were divided into the high-interest and low-interest groups. Overall satisfaction, urinary function, urinary bother, sexual function, and sexual bother were evaluated using the expanded prostate cancer index composite questionnaire preoperatively and at 1, 3, 6, and 12 months after robot-assisted radical prostatectomy. We investigated the associations between the overall satisfaction and urinary function/urinary bother/sexual function/sexual bother scores (with higher score indicating better function and less impairment). RESULTS In the high-interest group (n = 45), satisfaction correlated with high urinary function and urinary bother scores early after robot-assisted radical prostatectomy (urinary function: 1 and 3 months, urinary bother: 3 months postoperatively; P < 0.05) and then with high sexual bother score thereafter (sexual bother at 6 and 12 months after surgery; P < 0.05). Sexual function score did not correlate with satisfaction. In the low-interest group (n = 56), satisfaction correlated with high urinary function and urinary bother scores over time (urinary function: 3 and 6 months, urinary bother: at 3, 6 and 12 months postoperatively; P < 0.05). Neither sexual function nor sexual bother correlated with satisfaction postoperatively in the low-interest group. CONCLUSIONS The impact of urinary and sexual functions and bothers on patients' overall satisfaction differed between patients with high- and low-interest in sex. The patient's interest in sex should be considered when assessing satisfaction after robot-assisted radical prostatectomy.
Collapse
Affiliation(s)
- Yuki Kohada
- Division of Urology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Japan.,Department of Urology, Hiroshima University Graduate School of Biomedical Sciences, Hiroshima, Japan
| | - Jun Ito
- Division of Urology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | - Yasuhiro Kaiho
- Division of Urology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | - Hiroki Kusumoto
- Division of Urology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | - Takashi Kukimoto
- Division of Urology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | - Jotaro Mikami
- Division of Urology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | - Nobuyuki Hinata
- Department of Urology, Hiroshima University Graduate School of Biomedical Sciences, Hiroshima, Japan
| | - Makoto Sato
- Division of Urology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| |
Collapse
|
3
|
Wibowo E, Wassersug RJ, Robinson JW, Santos-Iglesias P, Matthew A, McLeod DL, Walker LM. An Educational Program to Help Patients Manage Androgen Deprivation Therapy Side Effects: Feasibility, Acceptability, and Preliminary Outcomes. Am J Mens Health 2021; 14:1557988319898991. [PMID: 32024430 PMCID: PMC7005977 DOI: 10.1177/1557988319898991] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Androgen deprivation therapy (ADT), a common treatment for prostate cancer, is associated with physical, psychological, and sexual side effects that reduce patients' quality of life. The authors designed an educational program to prepare patients for managing these side effects. This paper describes an implementation model for national dissemination of the program, testing its feasibility and acceptability at the institutional and patient level. Postprogram changes in patients' self-efficacy to manage side effects and side effect bother are also explored. Patients on or anticipating ADT enrolled in the educational program. Pre and post intervention questionnaires measured patient satisfaction with the program, side effect bother, and self-efficacy to manage ADT side effects. The ADT Educational Program was deemed feasible and acceptable. Five of six targeted sites successfully launched the program with sufficient patient enrolment. Patient attendees were highly satisfied. Self-efficacy, bother, and use of management strategies were interrelated. Lower bother was associated with increased self-efficacy and more use of management strategies, and increased bother was associated with lower self-efficacy and less use of management strategies. Based on pre-post scores, improvements in patients' self-efficacy to manage ADT side effects were also observed. Results demonstrate that this brief educational program is feasible and acceptable to patients and cancer care institutions. The program appears to promote self-efficacy and the uptake of ADT management strategies for ADT side effects. The results of this study support the program implementation and suggest that improvements in self-efficacy after program participation may help patients adapt to ADT side effects.
Collapse
Affiliation(s)
| | | | | | | | | | - Deborah L McLeod
- Nova Scotia Health Authority, Halifax, Canada.,Dalhousie University, Halifax, NS, Canada
| | - Lauren M Walker
- University of Calgary, Alberta, Canada.,Arnie Charbonneau Cancer Institute, Calgary, AB, Canada
| |
Collapse
|
4
|
Walker LM. Psychosocial contributors to patients' and partners' postprostate cancer sexual recovery: 10 evidence-based and practical considerations. Int J Impot Res 2020; 33:464-472. [PMID: 33204005 DOI: 10.1038/s41443-020-00369-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 10/09/2020] [Accepted: 10/27/2020] [Indexed: 11/09/2022]
Abstract
Sexual recovery after prostate cancer (PCa) treatment is challenging. When expectations are that erectile response will quickly return to baseline, patients can often struggle when this does not happen. Further difficulty is experienced when patients encounter physical, psychological, and relational barriers to sexual adjustment. Drawing on the psychosocial research literature and on 15 years of clinical experience counseling PCa patients about sexual recovery, this paper outlines considerations for clinical practice. Suggestions include broadening the target for successful outcomes after Pca treatment beyond erectile function to include sexual distress and other sources of sexual concern. Clinicians are urged to consider individual differences such as the larger context of the patient, including their values and preferences, their treatment goals, and their relationship situation and status, in order to promote successful sexual adaptation. When introducing treatment approaches, the role of grief and loss should be assessed, and patients should be supported to foster realistic expectations about the recovery process. Suggestions for how to introduce various sexual strategies to patients are also offered, including ways to support patients in making and sustaining behavioral changes associated with sexual intervention. Clinicians are offered suggestions to promote patients' sexual flexibility, prevent long periods of sexual inactivity, and help patients to identify various sexual motivators. Consideration of these psychological, relational, and social factors are all likely to help facilitate better sexual outcomes for PCa patients.
Collapse
Affiliation(s)
- Lauren M Walker
- Arnie Charbonneau Cancer Institute, University of Calgary, Calgary, AB, Canada. .,Division of PsychoOncology, Department of Oncology, University of Calgary, Calgary, AB, Canada. .,Department of Psychology, University of Calgary, Calgary, AB, Canada.
| |
Collapse
|
5
|
Jeong CW, Herlemann A, Cowan JE, Broering JM, Ten Ham RMT, Wilson LS, Carroll PR, Cooperberg MR. The Relative Impact of Urinary and Sexual Function vs Bother on Health Utility for Men With Prostate Cancer. JNCI Cancer Spectr 2020; 4:pkaa044. [PMID: 33134826 PMCID: PMC7583149 DOI: 10.1093/jncics/pkaa044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2019] [Revised: 03/28/2020] [Accepted: 05/20/2020] [Indexed: 11/24/2022] Open
Abstract
Function and bother are related but distinct aspects of health-related quality of life. The objective of this study was to compare quantitatively the relative impacts of function and bother in urinary, sexual, and bowel outcomes on health utility as a reflection of health-related quality of life in men with prostate cancer. Our analysis included participants in the Cancer of the Prostate Strategic Urologic Research Endeavor utility supplementary study, with a final cohort of 1617 men. Linear regression on the patients’ function and bother summary scores (0-100) from the University of California, Los Angeles Prostate Cancer Index was performed to predict bias-corrected health utilities. Urinary and sexual bother were associated with each health utility, and their coefficients were 3.7 and 20.8 times greater, respectively, than those of the corresponding function. To our knowledge, our study provides the first quantitative and direct comparison of the impacts of function vs bother on health utility.
Collapse
Affiliation(s)
- Chang Wook Jeong
- Diller Family Comprehensive Cancer Center, Department of Urology, University of California, San Francisco, CA, USA.,Department of Urology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Annika Herlemann
- Diller Family Comprehensive Cancer Center, Department of Urology, University of California, San Francisco, CA, USA.,Department of Urology, Ludwig-Maximilians-University of Munich, Munich, Germany
| | - Janet E Cowan
- Diller Family Comprehensive Cancer Center, Department of Urology, University of California, San Francisco, CA, USA
| | - Jeanette M Broering
- Diller Family Comprehensive Cancer Center, Department of Urology, University of California, San Francisco, CA, USA
| | - Renske M T Ten Ham
- Health Policy and Economics, Department of Clinical Pharmacy, University of California, San Francisco, CA, USA.,Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, the Netherlands
| | - Leslie S Wilson
- Health Policy and Economics, Department of Clinical Pharmacy, University of California, San Francisco, CA, USA
| | - Peter R Carroll
- Diller Family Comprehensive Cancer Center, Department of Urology, University of California, San Francisco, CA, USA
| | - Matthew R Cooperberg
- Diller Family Comprehensive Cancer Center, Department of Urology, University of California, San Francisco, CA, USA.,Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| |
Collapse
|
6
|
Walker LM, Santos-Iglesias P. On the Relationship Between Erectile Function and Sexual Distress in Men with Prostate Cancer. ARCHIVES OF SEXUAL BEHAVIOR 2020; 49:1575-1588. [PMID: 32072396 DOI: 10.1007/s10508-019-01603-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 11/26/2019] [Accepted: 11/28/2019] [Indexed: 06/10/2023]
Abstract
Erectile difficulties are common after prostate cancer (PCa) treatment and are associated with sexual distress. However, the relationship between erectile function and sexual distress has yet to be carefully examined. This study had three goals: (1) examine the relationship between erectile function and sexual distress; (2) determine groups of men based on erectile function and sexual distress; and (3) examine the psychosexual characteristics of these groups. A cross section of 233 sexually active men after PCa treatment (age M = 64.90 years, SD = 7.50) completed an online survey containing demographic, health, and sexuality and relationship questionnaires. The relationship between erectile function and sexual distress was curvilinear. Four groups of men were found: good erectile function and low sexual distress, poor erectile function and high sexual distress, but also good erectile function yet high sexual distress, and poor erectile function and low sexual distress. Regardless of erectile function, men with greater sexual distress were more depressed, reported additional sexual concerns, placed less value on sex, were less sexually satisfied, and used protective buffering communication more frequently. They were also less likely to be satisfied with their adaptation to sexual changes and less likely to have found a solution to those changes. The relationship between erectile function and sexual distress is complex, characterized by a wide array of responses to erectile function (high and low distress) and multiple correlates of sexual distress. These results broaden the concept of sexual recovery after PCa treatment, which may assist clinicians and researchers to better address sexual problems after PCa treatment.
Collapse
Affiliation(s)
- Lauren M Walker
- Tom Baker Cancer Centre-Holy Cross Site, Division of Psychosocial Oncology, Department of Oncology, University of Calgary, 2202 2nd Street SW, Calgary, AB, T2S 3C1, Canada.
- Arnie Charbonneau Cancer Institute, University of Calgary, Calgary, AB, Canada.
| | | |
Collapse
|
7
|
Santos-Iglesias P, Walker LM. Psychometric Validation of the Sexual Distress Scale in Men with Prostate Cancer. J Sex Med 2019; 15:1010-1020. [PMID: 29960626 DOI: 10.1016/j.jsxm.2018.05.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Revised: 05/23/2018] [Accepted: 05/28/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Different scales exist for the assessment of sexual distress in men with prostate cancer (PCa); however, these measures narrowly focus on distress associated with sexual function. AIM To validate and examine the psychometric properties of the Sexual Distress Scale (SDS) and Sexual Distress Scale-Revised (SDS-R), which were recently validated for use within men, in samples of sexually functional and sexually dysfunctional men with PCa. METHODS A sample of 538 men (with and without PCa and with and without sexual dysfunction) were used to examine the psychometric properties of the SDS. Confirmatory factor analysis followed by tests of measurement bias, calculations of reliability, and estimation of receiver operating characteristic (ROC) curves were used to examine the psychometric properties of the SDS and SDS-R. A subsample of 321 men completed the survey again 1 month later, and their responses were used to examine test-retest reliability. OUTCOMES Participants completed the SDS and SDS-R, as well as measures of sexual bother and sexual concerns, sexual function, sexual attitudes, and mood states. RESULTS The SDS and SDS-R assess 1 general domain of sexual distress; 1 violation of measurement invariance was found between men with and men without PCa, which limits the comparability of scores between these 2 groups. Internal consistency and test-retest reliabilities were above 0.93 and 0.82, respectively. Evidences of validity based on relations with other variables supported our predictions because sexual distress was associated with other measures of distress, sexual function, satisfaction, and mood and not correlated to sexual attitudes. Although the SDS and SDS-R discriminated between sexually functional and dysfunctional men, the accuracy of the cutoff scores was only moderate. CLINICAL TRANSLATION This instrument can be used by researchers and clinicians to examine sexual distress and can be used to elucidate how sexual distress relates to sexual function, well-being, and quality of life. STRENGTHS AND LIMITATIONS The SDS and SDS-R assess sexual distress independently of sexual function; however, with the current evidence, they should not be used to compare men with and men without PCa and to classify men with and men without sexual dysfunction. CONCLUSION This study provides a validation of the SDS and SDS-R that can be used in samples of men with PCa and with and without sexual dysfunction for the assessment of distress. Santos-Iglesias P, Walker LM. Psychometric Validation of the Sexual Distress Scale in Men with Prostate Cancer. J Sex Med 2018;15:1010-1020.
Collapse
Affiliation(s)
| | - Lauren M Walker
- Department of Oncology, University of Calgary and Department of Psychosocial Resources, Tom Baker Cancer Centre, Calgary, Canada
| |
Collapse
|
8
|
Walker LM, Santos-Iglesias P, Robinson J. Mood, sexuality, and relational intimacy after starting androgen deprivation therapy: implications for couples. Support Care Cancer 2018; 26:3835-3842. [PMID: 29777382 DOI: 10.1007/s00520-018-4251-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Accepted: 05/06/2018] [Indexed: 10/16/2022]
Abstract
BACKGROUND Patients on androgen deprivation therapy (ADT), a common treatment for prostate cancer, report significant declines in quality of life and detrimental impact on their intimate relationships. ADT depresses a man's testosterone to castrate levels, leading to declines in sexual function, and changes in mood. These changes can have profound impact on couples' intimate relationships. METHOD Patients undergoing ADT, and their consenting partners, were followed on a variety of outcomes relating to mood, sexual changes, and relational intimacy. Participants were assessed at baseline, 3 months, and 6 months. Changes in these three domains are documented. A dyadic analysis was conducted on the primary outcome of relational intimacy in order to assess the role of changes in mood and various aspects of sexuality on couples' intimate relationships. RESULTS Declines were observed in the first 6 months on ADT for sexual function, sexual frequency, and relational intimacy. Sexual bother increased within the first 3 months on ADT. No changes in mood were observed. Dyadic analysis revealed important effects on couples' reports of relational intimacy. (A) Patient and partner ratings of emotional intimacy were higher when partners better understood the patients' mood state. (B) Patient and partner ratings of sexual intimacy were higher when couples were more sexually active. CONCLUSIONS The current study confirms that patients experience reduced sexuality and relational intimacy during the first 6 months on ADT. Specific facets of relational intimacy are improved with increased sexual activity and also when partners recognize the emotional changes that patients are experiencing.
Collapse
Affiliation(s)
- Lauren M Walker
- Department of Oncology, Division of Psychosocial Oncology, University of Calgary, 2202 2 St SW, Calgary, AB, T2S 3C1, Canada.
| | - Pablo Santos-Iglesias
- Department of Oncology, Division of Psychosocial Oncology, University of Calgary, 2202 2 St SW, Calgary, AB, T2S 3C1, Canada
| | - John Robinson
- Department of Oncology, Division of Psychosocial Oncology, University of Calgary, 2202 2 St SW, Calgary, AB, T2S 3C1, Canada.,Department of Psychosocial Resources, Tom Baker Cancer Centre, Alberta Health Services, Calgary, Canada
| |
Collapse
|
9
|
Donovan KA, Gonzalez BD, Nelson AM, Fishman MN, Zachariah B, Jacobsen PB. Effect of androgen deprivation therapy on sexual function and bother in men with prostate cancer: A controlled comparison. Psychooncology 2017; 27:316-324. [PMID: 28557112 DOI: 10.1002/pon.4463] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Revised: 03/31/2017] [Accepted: 05/22/2017] [Indexed: 11/06/2022]
Abstract
OBJECTIVES The adverse sexual effects of androgen deprivation therapy (ADT) on men with prostate cancer have been well described. Less well known is the relative degree of sexual dysfunction and bother associated with ADT compared to other primary treatment modalities such as radical prostatectomy. We sought to describe the trajectory and relative magnitude of changes in sexual function and bother in men on ADT and to examine demographic and clinical predictors of ADT's adverse sexual effects. METHODS Prostate cancer patients treated with ADT (n = 60) completed assessments of sexual function and sexual bother 3 times during a 1-year period after the initiation of ADT. Prostate cancer patients treated with radical prostatectomy only and not receiving ADT (n = 85) and men with no history of cancer (n = 86) matched on age and education completed assessments at similar intervals. RESULTS Androgen deprivation therapy recipients reported worsening sexual function and increasing bother over time compared to controls. Effect sizes for the differences in sexual function were large to very large, and for bother were small to very large. Age younger than 83 years predicted relatively poorer sexual function, and age younger than 78 years predicted greater sexual bother at 12 months in men on ADT compared to men not on ADT. CONCLUSIONS Most men on ADT for prostate cancer will never return to baseline levels of sexual function. Interventions focused on sexual bother over function and designed to help couples build and maintain satisfying relationship intimacy are likely to more positively affect men's psychological well-being while on ADT than medical or sexual aids targeting sexual dysfunction.
Collapse
Affiliation(s)
- Kristine A Donovan
- Health Outcomes and Behavior Program, Moffitt Cancer Center, Tampa, FL, USA
| | - Brian D Gonzalez
- Health Outcomes and Behavior Program, Moffitt Cancer Center, Tampa, FL, USA
| | - Ashley M Nelson
- Department of Psychology, University of South Florida, Tampa, FL, USA
| | - Mayer N Fishman
- Department of Genitourinary Oncology, Moffitt Cancer Center, Tampa, FL, USA
| | - Babu Zachariah
- Department of Radiation Oncology, James A. Haley Veterans' Hospital, Tampa, FL, USA
| | - Paul B Jacobsen
- Health Outcomes and Behavior Program, Moffitt Cancer Center, Tampa, FL, USA
| |
Collapse
|
10
|
Storås AH, Sanda MG, Boronat OG, Chang P, Patil D, Crociani C, Suarez JF, Cvancarova M, Loge JH, Fosså SD. Erectile Dysfunction and Sexual Problems Two to Three Years After Prostatectomy Among American, Norwegian, and Spanish Patients. Clin Genitourin Cancer 2016; 14:e265-73. [DOI: 10.1016/j.clgc.2015.10.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Revised: 10/10/2015] [Accepted: 10/17/2015] [Indexed: 11/25/2022]
|
11
|
Fosså SD, Storås AH, Steinsvik EA, Myklebust TA, Eri LM, Loge JH, Dahl AA. Psychometric testing of the Norwegian version of the Expanded Prostate Cancer Index Composite 26-item version (EPIC-26). Scand J Urol 2016; 50:280-5. [DOI: 10.3109/21681805.2016.1163617] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Sophie D. Fosså
- National Advisory Unit on Late Effects after Cancer Treatment, The Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway
- Cancer Registry of Norway, Oslo, Norway
- Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Anne Holck Storås
- National Advisory Unit on Late Effects after Cancer Treatment, The Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway
| | - Eivind A. Steinsvik
- Division of Surgery, Department of Otorhinolaryngology, Akershus University Hospital, Lørenskog, Norway
| | | | - Lars M. Eri
- Faculty of Medicine, University of Oslo, Oslo, Norway
- Division of Urology, Oslo University Hospital, Oslo, Norway
| | - Jon H. Loge
- Faculty of Medicine, University of Oslo, Oslo, Norway
- Regional Centre for Excellence in Palliative Care, Oslo University Hospital, Oslo, Norway
| | - Alv A. Dahl
- National Advisory Unit on Late Effects after Cancer Treatment, The Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway
- Faculty of Medicine, University of Oslo, Oslo, Norway
| |
Collapse
|
12
|
Goonewardene SS, Persad R. Psychosexual care in prostate cancer survivorship: a systematic review. Transl Androl Urol 2015; 4:413-20. [PMID: 26816840 PMCID: PMC4708596 DOI: 10.3978/j.issn.2223-4683.2015.08.04] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2015] [Accepted: 08/05/2015] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Prostate cancer (PC) is the most common cancer in men. Due to improvements in medical care, the number of PC survivors is increasing. Current literature demonstrates survivors have significant unmet needs including psychosexual care. We assess patients psychosexual needs by systematic review of literature over the past 20 years up to May 2015 in order to see what issues need to be addressed within psychosexual care. METHODS A systematic review was conducted on PC survivorship and psychosexual care. The search strategy aimed to identify all references related to PC survivorship programme components (parts of survivorship programmes) AND survivorship AND psychosexual concerns. Search terms used were as follows: (PC OR prostate neoplasms) AND (survivorship OR survivor*) OR [psychosexual impairment or sexual dysfunction or erectile dysfunction (ED)] AND [comorbidity or quality of life (QoL)]. RESULTS The systematic review identified 17 papers, examining unmet needs in psychosexual care post PC therapy. CONCLUSIONS These findings of this review may change psychosexual care of PC survivors, as national and international guidance is needed.
Collapse
Affiliation(s)
- Sanchia Shanika Goonewardene
- 1 Guys and St Thomas Hospitals London, Kings College London, London, UK ; 2 North Bristol NHS Trust, Bristol, UK
| | - Raj Persad
- 1 Guys and St Thomas Hospitals London, Kings College London, London, UK ; 2 North Bristol NHS Trust, Bristol, UK
| |
Collapse
|
13
|
Fosså SD, Dahl AA. Global Quality of Life After Curative Treatment for Prostate Cancer: What Matters? A Study Among Members of the Norwegian Prostate Cancer Patient Association. Clin Genitourin Cancer 2015; 13:518-24. [PMID: 26303590 DOI: 10.1016/j.clgc.2015.07.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Revised: 07/17/2015] [Accepted: 07/18/2015] [Indexed: 12/31/2022]
Abstract
INTRODUCTION The purpose of this study was to identify factors that are associated with quality of life (QoL) in relapse-free patients after radical prostatectomy or high-dose radiotherapy with or without hormone treatment. PATIENTS AND METHODS A cross-sectional postal survey among members of the Norwegian Prostate Cancer Patient Association was used. We analyzed associations between QoL and general health, "typical" adverse effects (sexual, urinary, and bowel assessed using the Expanded Prostate Cancer Composite items) and psychosocial variables (work ability, family life, social life and/or leisure activities) in univariate and multivariate regression analyses. Statistical significance was defined as P < .01. RESULTS Among 612 responders (approximately 50% compliance; median age, 70 years), in univariate analyses QoL was significantly associated with functional aspects and the level of bother within the sexual, urinary, and bowel domains and with general health and psychosocial aspects of daily life. In the multivariate analysis only general health and social life and/or leisure activities remained associated with QoL, with work ability being a third factor in patients younger than 65 years old. Posttreatment worsening of partnership was reported by 12% of the patients. CONCLUSION Prostate cancer patients who are to undergo curative treatment should be informed about the risk of reduced function within the sexual, urinary, and bowel domains, but also about these dysfunctions' relation to bother and QoL, considered together with the patients' general health and their preferences as to their social life activities.
Collapse
Affiliation(s)
- Sophie D Fosså
- Department of Oncology, Oslo University Hospital, The Norwegian Radium Hospital Oslo, Oslo, Norway.
| | - Alv A Dahl
- Department of Oncology, Oslo University Hospital, The Norwegian Radium Hospital Oslo, Oslo, Norway
| |
Collapse
|
14
|
Dowsett GW, Lyons A, Duncan D, Wassersug RJ. Flexibility in Men's Sexual Practices in Response to Iatrogenic Erectile Dysfunction after Prostate Cancer Treatment. Sex Med 2014; 2:115-20. [PMID: 25356308 PMCID: PMC4184491 DOI: 10.1002/sm2.32] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
INTRODUCTION Prostate cancer (PCa) treatments are associated with a high incidence of erectile dysfunction (ED). Interventions to help men with iatrogenic ED have largely focused on penile tumescence adequate for vaginal penetration. Less research has been undertaken on sex practices other than penile/vaginal intercourse. AIM The aim of this study was to explore forms of sexual practice engaged in by men following treatment for PCa. We focused in particular on anal intercourse (AI) as practiced by both nonheterosexual (i.e., gay-identified men and other men who have sex with men) and heterosexual men. We sought to determine how common AI was subsequent to PCa treatment and how flexible AI practitioners were in their modes (e.g., from insertive to receptive) when faced with iatrogenic ED. METHODS An international online survey was conducted in 2010-2011 of men treated for PCa, where participants (N = 558) were asked explicitly about their sexual practices before and after PCa treatment. MAIN OUTCOME MEASURES The outcome measures were the numbers and percentages of men who practiced AI before and after PCa treatment as well as the percentage who changed AI practice after PCa treatment. RESULTS Five hundred twenty-six men (90 nonheterosexual men; 436 heterosexual men) answered questions on AI practices. A proportion of nonheterosexual (47%) and heterosexual men (7%) practiced AI following PCa treatment, and did so in all modes (insertive, receptive, and "versatile"). Many nonheterosexual men continued to be sexually active in the face of iatrogenic ED by shifting from the insertive to receptive modes. A few men, both heterosexual and nonheterosexual, adopted AI for the first time post-PCa treatment. CONCLUSIONS Flexibility in sexual practice is possible for some men, both nonheterosexual and heterosexual, in the face of iatrogenic ED. Advising PCa patients of the possibilities of sexual strategies that include AI may help them in reestablishing a sex life that is not erection dependent. Dowsett GW, Lyons A, Duncan D, and Wassersug RJ. Flexibility in men's sexual practices in response to iatrogenic erectile dysfunction after prostate cancer treatment. Sex Med 2014;2:115-120.
Collapse
Affiliation(s)
- Gary W Dowsett
- Australian Research Centre in Sex, Health and Society, La Trobe University Melbourne, Victoria, Australia
| | - Anthony Lyons
- Australian Research Centre in Sex, Health and Society, La Trobe University Melbourne, Victoria, Australia
| | - Duane Duncan
- Australian Research Centre in Sex, Health and Society, La Trobe University Melbourne, Victoria, Australia
| | - Richard J Wassersug
- Australian Research Centre in Sex, Health and Society, La Trobe University Melbourne, Victoria, Australia
| |
Collapse
|
15
|
Bhattasali O, Chen LN, Woo J, Park JW, Kim JS, Moures R, Yung T, Lei S, Collins BT, Kowalczyk K, Suy S, Dritschilo A, Lynch JH, Collins SP. Patient-reported outcomes following stereotactic body radiation therapy for clinically localized prostate cancer. Radiat Oncol 2014; 9:52. [PMID: 24512837 PMCID: PMC3931491 DOI: 10.1186/1748-717x-9-52] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2013] [Accepted: 02/06/2014] [Indexed: 02/07/2023] Open
Abstract
Background Stereotactic body radiation therapy (SBRT) delivers high doses of radiation to the prostate while minimizing radiation to adjacent normal tissues. Large fraction sizes may increase the risk of functional decrements. Treatment-related bother may be more important to a patient than treatment-related dysfunction. This study reports on patient-reported outcomes following SBRT for clinically localized prostate cancer. Methods Between August 2007 and July 2011, 228 consecutive hormone-naïve patients with clinically localized prostate cancer were treated with 35–36.25 Gy SBRT delivered using the CyberKnife Radiosurgical System (Accuray) in 5 fractions. Quality of life was assessed using the American Urological Association Symptom Score (AUA) and the Expanded Prostate Cancer Index Composite (EPIC)-26. Urinary symptom flare was defined as an AUA score 15 or more with an increase of 5 or more points above baseline 6 months after treatment. Results 228 patients (88 low-, 126 intermediate- and 14 high-risk) at a median age of 69 (44–90) years received SBRT with a minimum follow-up of 24 months. EPIC urinary and bowel summary scores declined transiently at 1 month and experienced a second, more protracted decline between 9 months and 18 months before returning to near baseline 2 years post-SBRT. 14.5% of patients experienced late urinary symptom flare following treatment. Patients who experienced urinary symptom flare had poorer bowel quality of life following SBRT. EPIC scores for urinary bother declined transiently, first at 1 month and again at 12 months, before approaching pre-treatment scores by 2 years. Bowel bother showed a similar pattern, but the second decline was smaller and lasted 9 months to 18 months. EPIC sexual summary and bother scores progressively declined over the 2 years following SBRT without recovery. Conclusions In the first 2 years, the impact of SBRT on urination and defecation was minimal. Transient late increases in urinary and bowel dysfunction and bother were observed. However, urinary and bowel function and bother recovered to near baseline by 2 years post-SBRT. Sexual dysfunction and bother steadily increased following treatment without recovery. SBRT for clinically localized prostate cancer was well tolerated with treatment-related dysfunction and bother comparable to conventionally fractionated radiation therapy or brachytherapy.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | - Sean P Collins
- Department of Radiation Medicine, Georgetown University Hospital, 3800 Reservoir Road, N,W,, Washington, D,C 20007, USA.
| |
Collapse
|