Sexual dysfunction and spousal communication in couples coping with prostate cancer. Psycho-Oncology, 18(7), 735-746

Department of Behavioral Science, The University of Texas M. D. Anderson Cancer Center, Houston, TX 77230-1439, USA.
Psycho-Oncology (Impact Factor: 2.44). 07/2009; 18(7):735-46. DOI: 10.1002/pon.1449
Source: PubMed


To characterize the sexual function of both prostate cancer patients and their partners, and to examine whether associations between sexual dysfunction and psychosocial adjustment vary depending on spousal communication patterns.
In this cross-sectional study, 116 prostate cancer patients and their partners completed psychosocial questionnaires.
Patients and partners reported high rates of sexual dysfunction. Within couples, patients' and their partners' sexual function was moderately to highly correlated (r=0.30-0.74). When patients had poor erectile function, their partners were more likely to report that the couple avoided open spousal discussions; this in turn was associated with partners' marital distress (Sobel's Z=12.47, p=0.001). Patients and partners who reported high levels (+1SD) of mutual constructive communication also reported greater marital adjustment, regardless of their own sexual satisfaction. In contrast, greater sexual dissatisfaction was associated with poorer marital adjustment in patients and partners who reported low levels (-1SD) of mutual constructive communication (p<0.05).
Our findings underscore the need for psychosocial interventions that facilitate healthy spousal communication and address the sexual rehabilitation needs of patients and their partners after prostate cancer treatment. Although some couples may be reluctant to engage in constructive cancer-related discussions about sexual problems, such discussions may help alleviate the negative impact that sexual problems have on prostate cancer patients' and their partners' marital adjustment.

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    • "A systematic review (Higano, 2012) stated that while trials has documented a broad range of physiologic effects, few studies had focus on the psychosocial effects of androgen deprivation therapy on sexuality, physical changes, intimacy, and how these treatments affect a couple's relationship. Badr and Taylor (2009) found in a cross-sectional study including 116 couples a need for psychosocial interventions to facilitate healthy spousal communication and to address the sexual rehabilitation needs of patients and their partners after prostate cancer treatment. Although the delayed sexual side effects after radiotherapy with androgen deprivation therapy have been identified in the literature, information about the lived experience of men and their partners is limited. "
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    ABSTRACT: Prostate cancer is the most frequent male cancer disease in the western world. Sexual dysfunction is common after prostate cancer with radiation therapy and androgen deprivation therapy, but further research is needed to determine the lived experience of couples struggling with sexual dysfunction after treatment. The purpose of this study was to explore the lived experience of men and their partners experiencing sexual side effects after radiation therapy and androgen deprivation therapy for prostate cancer. In addition, to understand the role of a structured rehabilitation program on the couple's experience. Couples with persistent sexual problems were recruited among patients treated with radiotherapy or/and androgen deprivation therapy. Descriptive statistics were collected including age, race, education and work. Focus groups with each gender were conducted using open ended questions to encourage participants to talk about their experiences. Data were analyzed using Giorgi's phenomenological method. A total of eight couples were recruited, men age 67 years [standard deviation (SD) 6·3], women 65 years (SD 7·2). Results from the focus group interviews regarding marital relations were grouped in three themes: negative impact of sexual dysfunction on the relationship; other physical and psychological consequences of late adverse effects; communication issues and partner feelings of frustration. Results regarding the rehabilitation program were grouped in four themes: importance of peer support; importance of time and space for reflection; improved communication; optimism after rehabilitation. The couples in this study reported that the sexual side effects of prostate cancer treatment impacted their relationship and were problematic for both the men and their partners. The rehabilitation program improved the couples communication concerning sexual intimacy and issues related to prostate cancer treatment. It also offered a chance for peer support from others going through similar experiences and increased hope for navigating through sexual and intimacy issues in the future.
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    • "Psycho-Oncology (2015 frame MCSs as limited by a 'code of silence' that inhibits emotional disclosure [5]. Consistent with the assertion that gender-based stereotypes often do not guide or explain behaviour [26,27], the majority of MCSs expressed the importance of effective sexual communication and willingness to initiate intimate conversations with partners. Challenge to such traditional scripts involves acknowledging variation in MCSs' ability to communicate about sexuality after cancer. "

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    • "However, it is well documented that intimate partners desire communication and information about post-cancer sexual changes to their own sexual selves and their relationship (Gilbert et al. 2009), with some evidence that partners have a greater need for information than people with cancer (Lavery & Clarke 1999; Rees & Bath 2000). In addition, people with cancer have reported that it is important for their intimate partner to be included in discussions about sexuality with health professionals (Ellingson & Buzzanell 1999; Flynn et al. 2012), with open communication between people with cancer and their partner key to managing changes to sexuality (Lavery & Clarke 1999; Badr & Carmack Taylor 2009). This open communication has been found to be easier if health professionals include both the person with cancer and the partner in discussions about sexuality (Rasmusson & Thome 2008). "
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    ABSTRACT: Changes to sexuality can be one of the most difficult aspects of life following cancer. This study examines the experience of discussing sexuality post cancer with health care professionals (HCPs), from the perspective of women and men with cancer (PWC), and their partners (PPWC), across a range of cancer types. A total of 657 PWC (535 women, 122 men) and 148 PPWC (87 women, 61 men) completed a survey containing closed and open-ended items, analysed by analysis of variance and thematic analysis. Discussions about sexuality with a HCP were more likely to be reported by men (68%) compared to women PWC (43%), and by women (47%) compared to men PPWC (28%), as well as by those with a sexual or reproductive cancer. Men PWC and women PPWC were most likely to want to discuss sexuality with a HCP, with men PWC and PPWC reporting highest levels of satisfaction with such discussions. Open-ended responses revealed dissatisfaction with the unwillingness of HCPs to discuss sexuality, unhappiness with the nature of such discussion, and positive accounts of discussions about sexuality with HCPs. These findings lend support to the notion that people with cancer and their partners may have unmet sexual information and support needs.
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