What Patients and Partners Want in Interventions That Support Sexual Recovery After Prostate Cancer Treatment: An Exploratory Convergent Mixed Methods Study

Abstract

Introduction Men treated for prostate cancer suffer from treatment-related sexual side effects that adversely affect their relationships and quality of life. Aim To investigate what prostate cancer survivors and their partners want from a sexual recovery intervention, and whether they consider an online tool acceptable for use in promoting sexual recovery. Methods This mixed-methods study included focus groups and interviews with both heterosexual and gay cancer survivors, as well as their partners. Focus groups and interviews probed experiences with treatment, side effects, and support received/needed for sexual recovery. Participants responded to proposed web-based intervention content. Interviews were analyzed with thematic content analysis. Their sexual function was assessed with validated measures. Main Outcome Measures Acceptability of online tools for promoting sexual recovery was evaluated. Results Participants included 14 patients and 10 partners (2 male). Patient and partner median age was 62 and 62.5 years, respectively. Treatment ranged from surgery alone to combined radiation and hormonal therapy. Qualitative data analysis yielded 5 main intervention needs: (i) pretreatment discussion of sexual side effects, rehabilitation, emotional impact and realistic expectations, (ii) improved sexual communication within couples, (iii) strategies for promoting sexual intimacy beyond penetrative intercourse, (iv) attentiveness to partners' needs, and (v) access to peer support. Gay men specifically expressed the need for improved provider understanding of their sexuality and experiences. Most considered a web-based approach to be acceptable. Conclusion Patients and partners value both pretreatment preparation for sexual recovery and support for sexual recovery for both after treatment. A web-based approach may help mitigate barriers to access to these support services. Mehta A, Pollack CE, Gillespie T., et. al. What Patients and Partners Want in Interventions That Support Sexual Recovery After Prostate Cancer Treatment: An Exploratory Convergent Mixed Methods Study. Sex Med 2019;7:184–191.

Efficacy, Use, and Acceptability of a Web-Based Self-management Intervention Designed to Maximize Sexual Well-being in Men Living With Prostate Cancer: Single-Arm Experimental Study

“…The extent to which the participants agreed that they were comfortable when discussing sexual issues also did not change, but these scores were relatively high at baseline. This supports the findings from studies that have found that the level of comfort in men with prostate cancer is not a significant barrier to discussing sexual issues [ 21 , 48 ].…”

“…Despite these recommendations, the information provided varies greatly and is not routinely available across services [ 9 ]. Patients and their partners frequently report that they do not receive adequate support to manage these concerns [ 21 , 22 ]. In a study of prostate cancer follow-up at urology and radiotherapy clinics, the sexual aspects of recovery were not discussed in 46% and 48%, respectively, of the observed consultations [ 23 ].…”

Sexuality in Intimate Partners of People with Cancer: Information and Communication Needs: A Brief Communication

“…Patients with cancer reported to prefer their partners to be involved in communication regarding sexuality and intimacy and sexual recovery with a healthcare professional, and so do their partners (Mehta et al, 2019). In accordance with our study, in current medical practice, a discussion about sexuality and intimacy with a healthcare professional does not take place for most cancer patients and partners.…”

“…Current findings suggest that partners of patients with cancer are in need of practical advice regarding sexuality and intimacy and experiences from others. Suitable information with respect to sexuality and intimacy for partners can be helpful to prepare partners for sexual side effects and create realistic expectations about sexual function after cancer (Mehta et al, 2019). Lack of knowledge regarding sexual side effects can lead to unmet sexual needs, which can negatively influence quality of life and may result in lower levels of relationship satisfaction (Acquati et al, 2018;Dobinson et al, 2016;Park & Hwang 2012).…”

“…Existing studies highlight the importance of involvement of the partner in communication about sexuality and intimacy with healthcare professionals and providing them accurate information and include advice in supportive care for partners (Gilbert et al, 2009(Gilbert et al, , 2016Hawkins et al, 2009;Mehta et al, 2019;Vermeer, Bakker, Kenter, Stiggelbout, & Ter Kuile, 2016). Partners experience a lack of support, advice and information regarding sexuality and intimacy (Gilbert et al, 2016;Hautamaki-Lamminen, Lipiainen, Beaver, Lehto, & Kellokumpu-Lehtinen, 2013;Hawkins et al, 2009).…”