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A qualitative study exploring men’s experience of sexual dysfunction as a result of radiotherapy and androgen deprivation therapy to treat prostate cancer

Published online by Cambridge University Press:  17 February 2020

W. Kinnaird Open the ORCID record for W. Kinnaird [Opens in a new window]  and
A. Stewart-Lord
W. Kinnaird*
Affiliation:
University College London Hospitals, London, UK
A. Stewart-Lord
Affiliation:
London South Bank University, London, UK
*
Author for correspondence: William Kinnaird, UCLH Radiotherapy, Basement, 235 Euston Road, LondonNW1 2BU. Tel: +020 3447 3713. E-mail: william.kinnaird@nhs.net
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Abstract

Aim:

Sexual dysfunction is a common side effect of external beam radiotherapy (EBRT) and androgen deprivation therapy (ADT) to treat prostate cancer. Men are likely to experience erectile dysfunction, low libido, ejaculatory problems and penile shortening. This qualitative study explored men’s perceptions of sexual dysfunction, including factors such as self-perception, relationships and information and support needs.

Methods:

Semi-structured interviews were carried out with n = 8 men living 18–30 months after EBRT ± ADT. The interviews were transcribed and thematic analysis was carried out.

Results:

All men experienced sexual dysfunction following treatment. The main themes arising were: (i) priorities—sexual issues were not a priority when making treatment decisions, (ii) information and support—men described a lack of information and support about sexual dysfunction and (iii) impact—sexual dysfunction impacted on their self-perception and relationships.

Findings:

Men undergoing EBRT/ADT for prostate cancer may be affected by post-treatment changes in sexual function in a range of ways. This study suggests that they would benefit from early and wide-ranging information and support on sexual dysfunction, even if they do not consider it as a priority. Candid discussions about self-perception and relationships, as well as physical changes, may equip them to cope with post-treatment changes.

Keywords

erectile dysfunctionmasculinityoncologyquality of lifesexual health
Type
Original Article
Information
Journal of Radiotherapy in Practice , Volume 20 , Issue 1 , March 2021 , pp. 39 - 42
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Copyright
© The Author(s), 2020. Published by Cambridge University Press.

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References

Cancer Research UK, https://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/prostate-cancer#heading-Zero. Accessed on October 2019.Google Scholar
Gore, J, Kwan, L, Lee, SP, Reiter, RE, Litwin, MS. Survivorship beyond convalescence: 48-month quality-of-life outcomes after treatment for prostate cancer. J Natl Cancer Inst 2009; 101: 888–892.CrossRefGoogle ScholarPubMed
Ream, E, Quennell, A, Fincham, L et al. Supportive care needs of men living with prostate cancer in England: a survey. Br J Cancer 2008; 98; 1903–1909.CrossRefGoogle ScholarPubMed
Miles, C, Candy, B, Jones, L, Williams, R, Tookman, A, King, M. Interventions for sexual dysfunction following treatments for cancer. Cochrane Database Syst Rev 2007; 4. https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD005540.pub2/abstract. Accessed on October 2019.CrossRefGoogle Scholar
Candy, B, Jones, L, Williams, R, Tookman, A, King, M. Phosphodiesterase type 5 inhibitors in the management of erectile dysfunction secondary to treatments for prostate cancer: findings from a Cochrane systematic review. BJU International 2008; 102 (4): 426–431.CrossRefGoogle ScholarPubMed
Potosky, AL, Davis, WW, Hoffman, RM, Stanford, RA, Penson, DF, Harlan, LC. Five-year outcomes after prostatectomy or radiotherapy for prostate cancer: the prostate cancer outcomes study. J Natl Cancer Inst 2004; 96: 1358–1367.CrossRefGoogle ScholarPubMed
Stephenson, RA, Mori, M, Hsieh, YC et al. Treatment of erectile dysfunction following therapy for clinically localized prostate cancer: patient reported use and outcomes from the surveillance, epidemiology, and end results prostate cancer outcomes study. J Urol 2005; 174 (2): 646–650.CrossRefGoogle ScholarPubMed
Katz, A. What happened? Sexual consequences of prostate cancer and its treatment. Can Fam Physician 2005; 51: 977–972.Google ScholarPubMed
White, I, Wilson, J, Aslet, P et al. Development of UK guidance on the management of erectile dysfunction resulting from radical radiotherapy and androgen deprivation therapy for prostate cancer. Int J Clin Pract 2015; 69 (1): 106–123 CrossRefGoogle ScholarPubMed
Hanly, N, Mireskandari, S, Juraskova, I. The struggle towards ‘the new normal’: a qualitative insight into psychosexual adjustment to prostate cancer. BMC Urol 2014; 14: 56. doi: 10.1186/1471-2490-14-56 CrossRefGoogle ScholarPubMed
Bokhour, B, Clark, JA, Inui, TS, Silliman, RA, Talcott, JA. Sexuality after treatment for early prostate cancer: exploring the meanings of ‘Erectile Dysfunction’. J Gen Intern Med 2001; 16 (10): 649–655.CrossRefGoogle Scholar
Nicolaisen, M, Muller, S, Patel, HRH, Hanssen, TA. Quality of life and satisfaction with information after radical prostatectomy, radical external beam radiotherapy and postoperative radiotherapy: a long-term follow-up study. J Clin Nurs 2014; 23: 3403–3414.CrossRefGoogle ScholarPubMed
Galbraith, ME, Hays, L, Tanner, T. What men say about surviving prostate cancer: complexities represented in a decade of comments. Clin J Oncol Nurs 2012; 16(1): 65–72.10.1188/12.CJON.65-72CrossRefGoogle Scholar
Snow, SL, Panton, RL, Butler, LJ et al. Incomplete and inconsistent information provided to men making decisions for treatment of early-stage prostate cancer. Urology 2007; 69 (5): 941–945.10.1016/j.urology.2007.01.027CrossRefGoogle ScholarPubMed
National Institute for Health and Care Excellence. Prostate cancer: diagnosis and management, London: National Institute for Health and Care Excellence (2019). https://www.nice.org.uk/guidance/ng131/chapter/Recommendations#localised-and-locally-advanced-prostate-cancer. Accessed on July 2019.Google Scholar
Downing, A, Wright, P, Hounsome, L et al, Quality of life in men living with advanced and localised prostate cancer in the UK: a population-based study. Lancet Oncol 2019; 20: 436–447 CrossRefGoogle ScholarPubMed
Donovan, JL, Hamdy, FC, Lane, JA, et al. Patient-reported outcomes after monitoring, surgery, or radiotherapy for prostate cancer. N Engl J Med 2016; 375:1425–37.CrossRefGoogle ScholarPubMed
Maliski, SL, Connor, S, Fink, A and Litwin, MS. Information desired and acquired by men with prostate cancer: data from ethnic focus groups, Health Educ Behav, 2006; 33 (3), 393–409.CrossRefGoogle ScholarPubMed
Braun, V, Clarke, V. Using thematic analysis in psychology. Qual Res Psychol 2006; 3 (2): 77–101.CrossRefGoogle Scholar
Ballinger, C. Demonstrating rigour and quality? In: Finlay, L, Ballinger, C (eds). Qualitative Research for Allied Health Professionals: Challenging Choices, West Sussex: John Wiley and Sons 2006: 235–246.Google Scholar
Wittmann, D, Northouse, L, Foley, S et al. The psychosocial aspects of sexual recovery after prostate cancer treatment. Int J Impot Res 2009; 21: 99–106.CrossRefGoogle ScholarPubMed
Forbat, L, White, I, Marshall-Lucette, S, Kelly, D. Discussing the sexual consequences of treatment in radiotherapy and urology consultations with couples affected by prostate cancer. BJU Int 2001; 109 (1): 98–103.CrossRefGoogle Scholar
Flynn, KE, Barksy Reese, J, Jeffrey, DD et al. Patient experiences with communication about sex during and after treatment for cancer. Psychooncology 2012; 21: 594–601.10.1002/pon.1947CrossRefGoogle ScholarPubMed
Feldman-Stewart, D, Brundage, MD, Hayter, C et al. What questions do patients with curable prostate cancer want answered? Med Decis Making 2000; 20 (1): 7–19.CrossRefGoogle ScholarPubMed
King, MT, Viney, R, Smith, DP et al. Survival gains needed to offset persistent adverse treatment effects in localised prostate cancer. Br J Cancer 2012; 106: 638–645.10.1038/bjc.2011.552CrossRefGoogle ScholarPubMed