Five‐year outcomes from a randomised controlled trial of a couples‐based intervention for men with localised prostate cancer

Abstract

Objective Psychosexual morbidity is common after prostate cancer treatment, however, long‐term prospective research is limited. We report 5‐year outcomes from a couples‐based intervention in dyads with men treated for localised prostate cancer with surgery. Methods A randomised controlled trial was conducted involving 189 heterosexual couples, where the man received a radical prostatectomy for prostate cancer. The trial groups were peer support vs. nurse counselling versus usual care. Primary outcomes were sexual adjustment, unmet sexual supportive care needs, masculine self‐esteem, marital satisfaction, and utilisation of erectile aids at 2‐, 3‐, 4‐ and 5‐year follow‐up. Results The effects of the interventions varied across the primary outcomes. Partners in the peer group had higher sexual adjustment than those in the usual care and nurses group at 2 and 3 years (P = 0.002‐0.035). Men in usual care had lower unmet sexual supportive care needs than men in the peer and nurse groups (P = 0.001; P = 0.01) at 3 years. Women in usual care had lower sexual supportive care needs than women in the peer group at 2 and 3 years (P = 0.038; P = 0.001). Men in the peer and nurse group utilised sexual aids more than men in usual care; at 5 years 54% of usual care men versus 87% of men in peer support and 80% of men in the nurse group. Conclusion Peer and nurse‐administered psychosexual interventions have potential for increasing men's adherence to treatments for erectile dysfunction. Optimal effects may be achieved through an integrated approach applying these modes of support.

Contemporary consumer perspectives on prostate cancer survivorship: Fifty voices

“…The persistence of these problems despite decades of both descriptive and intervention research for men with prostate cancer speaks to a lack of translation of research into practice that is greatly concerning. [20][21][22][23][24][25] Men with prostate cancer in Australia have historically provided community-based care when action by the health system lagged. 8 As health systems adjust and work to catch up there is a risk that this voice will be lost or overridden by the health professional perspective.…”

Prostate cancer survivorship priorities for men and their partners: Delphi consensus from a nurse specialist cohort

“…Noting of the need for partners to be involved in this stage of care is a timely reminder that person‐centred care for men who are partnered ideally takes a dyadic focus where the supportive role of the partner is crucial. This is especially important in the setting where treatment causes sexual dysfunction for many men and so will have an equally traumatic impact on the man's partner (Chambers et al, ).…”

Practical Approaches to Treat ED in PDE5i Nonresponders

“…As one type of psychological intervention, sexual counseling can not only improve erectile function and sexual satisfaction but also increase treatment compliance in patients with ED caused by RP and penile prosthesis implantation, extended device application or hypospadias repair performed in childhood [69][70][71][72][73]. A meta-analysis has demonstrated that taking PDE5is to improve erectile function requires other comprehensive management, including sexual counseling, exercise and lifestyle changes [74].…”