Impact of Prostate Cancer on Sexual Relationships: A Longitudinal Perspective on Intimate Partners' Experiences
ABSTRACT In this prospective study of localized prostate cancer patients and their partners, we analyzed how partner issues evolve over time, focusing on satisfaction with care, influence of cancer treatment, and its impact on relationship with patient, cancer worry, and personal activities.
Our study aims were twofold: (i) to determine whether the impact of treatment on patients and partners moderate over time and (ii) if receiving surgery (i.e., radical prostatectomy) influences partner issues more than other treatments.
Patients newly diagnosed with localized prostate cancer and their female partners were recruited from three states to complete surveys by mail at three time points over 12 months.
The four primary outcomes assessed in the partner analysis included satisfaction with treatment, cancer worry, and the influence of cancer and its treatment on their relationship (both general relationship and sexual relationship).
This analysis included 88 patient-partner pairs. At 6 months, partners reported that cancer had a negative impact on their sexual relationship (39%-somewhat negative and 12%-very negative). At 12 months, this proportion increased substantially (42%-somewhat negative and 29%-very negative). Partners were significantly more likely to report that their sexual relationship was worse when the patient reported having surgery (P = 0.0045, odds ratio = 9.8025, 95% confidence interval 2.076-46.296). A minority of partners reported significant negative impacts in other areas involving their personal activities (16% at 6 months and 25% at 12 months) or work life (6% at 6 months, which increased to 12% at 12 months).
From partners' perspectives, prostate cancer therapy has negative impact on sexual relationships and appears to worsen over time. Ramsey SD, Zeliadt SB, Blough DK, Moinpour CM, Hall IJ, Smith JL, Ekwueme DU, Fedorenko CR, Fairweather ME, Koepl LM, Thompson IM, Keane TE, and Penson DF. Impact of prostate cancer on sexual relationships: A longitudinal perspective on intimate partners' experiences. J Sex Med **;**:**-**.
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ABSTRACT: Prostate cancer survivors' post-surgery sexual problems are well documented and long lasting. Partners' distress in this context leads to psychological morbidity which is poorly understood. Given the prevalence of prostate cancer diagnoses in older men, partners' distress represents a public health concern. This study elucidates an important aspect of partners' distress which has hitherto been undocumented. It can lead to further research and health-care provisions that will support couples in prostate cancer survivorship towards improved mental health and health outcomes. Partner sexual function has been viewed as a factor in men's erectile function recovery after prostatectomy for prostate cancer. However, patients' and partners' perceptions on the role of the partner in couples' sexual recovery has not been studied. We wanted to understand those perceptions and to see whether their perceptions were congruent. Men and partners were recruited from a previous study and interviewed separately about the role of the partner. Interview transcripts were analyzed using grounded theory with the help of NVivo software. Ten men and nine partners participated; most were more than 1 year past surgery. Men were 62, and partners were 58 years old on average. Nine men had erectile dysfunction. Six female partners were post-menopausal, and a participating male partner had post-prostatectomy erectile dysfunction. Men and partners agreed that partners provide emotional and logistical support. Both perceived the partner's own sexual interest, not function, as critical to the couple's sexual recovery. Some men felt pressured by partners' initiative, feeling insecure about sexual performance. Men were unaware of partners' sexual needs or needs for support. Partners expressed those needs but were unsure of what kind of support they needed. Partners' sexual and support needs during couples' sexual recovery after prostatectomy should be acknowledged and addressed as a legitimate aspect of research and care for men recovering from prostatectomy.Supportive Care in Cancer 04/2014; 22(9). DOI:10.1007/s00520-014-2244-x · 2.50 Impact Factor
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ABSTRACT: We performed a systematic review to evaluate evidence regarding factors that influence patient preferences for management options for localized prostate cancer. We followed a prespecified search protocol (PROSPERO identifier CRD42014009173) to identify studies that evaluated patient preferences for prostate cancer management options for localized prostate cancer. We queried PubMed, the Cochrane Database of Systematic Reviews, Embase, Cumulative Index to Nursing & Allied Health Literature (CINAHL) Plus, and Econ-Lit databases. Two separate reviewers completed the article selection process and review, including coding of study characteristics. Study quality was scored according to the PREFS checklist, which consists of five criteria: Purpose, Respondents, Explanation, Findings, and Significance. Reviewers summarized the primary findings of each article included in the analysis. Of the 606 citations identified in the literature search, there were a total of 21 articles that met all selection criteria, reporting results for a total of 4,131 subjects. Themes identified in the studies included: the importance of patient perceptions of treatment efficacy and side effects; the influence of physician recommendations on patient decision-making; and the prioritization of concerns regarding treatment side effects among those men who prefer radiation therapy or active surveillance. The articles had an average PREFS score of 3.4 (standard deviation [SD] 1.0), which is similar to a recent study for breast cancer treatment preferences. This systematic review of factors that influence patient preferences for prostate cancer management options identified a small, but high quality, group of articles that satisfied the selection criteria. The available evidence suggests that interventions aimed at informing patients regarding the comparative effectiveness of prostate cancer management alternatives should include the influence of physician recommendations and family members' desires on patient decision-making.Patient Preference and Adherence 07/2015; 9:899-911. DOI:10.2147/PPA.S83333 · 1.49 Impact Factor
Article: CE: Early Localized Prostate Cancer.[Show abstract] [Hide abstract]
ABSTRACT: : A review of diagnostic tests and treatment options. As many as 233,000 men in the United States are diagnosed with prostate cancer each year. Most diagnoses are of low-grade, localized disease, which tends to be slow growing and is rarely lethal, even in the absence of intervention. The amount and complexity of the information men receive at diagnosis may be overwhelming and difficult to process, particularly given the weight of a new cancer diagnosis and the potential for long-term, life-altering adverse effects from treatment. This review examines the multiple options available for men with newly diagnosed, low-risk, localized prostate cancer and explains how nurses can help these men and their partners make treatment decisions that are appropriate for their particular circumstances.The American Journal of Nursing 02/2015; 115(3). DOI:10.1097/01.NAJ.0000461809.26978.cd · 1.32 Impact Factor