MP22-14 DEFINITIVE Therapy for Men with Newly-Diagnosed Oligometastatic Prostate Cancer: Initial Surgical Outcomes from a Phase II Study (original) (raw)
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Clinical Genitourinary Cancer, 2011
Patients submitted for prostatectomy were evaluated regarding their quality of life, behavioral problems, and marital adjustment. Thirty-two patients aged 54-76 years old were included. The results indicated that prostatectomy does not prevent normal psychological functioning, although there is a relationship between smoking and lower quality of life in these patients. Different types of monotherapy for prostate cancer leads to impairment in urinary and sexual functions, but prostatectomy seems to have worse results in physical functioning when compared with other treatments. Nevertheless, patients report high quality of life (QOL) levels, even when there are comments about the impact of sexual dysfunction on psychological health. The objectives of this work were to analyze levels of QOL, marital adjustment (MA), and behavioral problems (BP) of patients submitted to prostatectomy. Thirty-two patients from 54 to 76 years of age who underwent radical prostatectomy were evaluated during their follow-up appointments with the medical staff at the urology department of a private medical school. QOL scores were obtained from the World Health Organization Quality of Life instrument, short version. BP scores of patients younger than 60 years of age were assessed through the Adult Self-Report, whereas patients older than 60 years were assessed through the Older Adult Self-Report. MA scores were obtained by using the Locke-Wallace Marital Adjustment Test. The patients reported relatively high levels of QOL and MA, along with low BPs. Marital support was associated with higher levels of QOL. BPs were associated with lower physical and total QOL scores. Smoking habits were associated with lower levels of MA, psychological health, and QOL. Erectile dysfunction was related to lower MA levels and lower QOL scores. Overall, the patients had high self-reported QOL levels, which indicated that physical impairments related to surgery did not prevent patients to return to normal functioning.
Sexual, psychological and dyadic qualities of the prostate cancer 'couple
BJU International, 2005
To examine the levels of sexual, psychological and dyadic functioning of the prostate cancer 'couple' (as studies have shown that spouses/partners play an integral role in the patient's adjustment to prostate cancer treatment), to encourage the creation of innovative psychosexual interventions to be used in the outpatient setting, and to offer insights into a novel area of prostate cancer research. In all, 103 men newly diagnosed with prostate cancer, and their partners, were assessed in an academic outpatient setting using instruments measuring sexual function, depressed mood, psychological distress and dyadic adjustment. The partners' mean scores on sexual function questions were 55.75, significantly higher than those of the patients (51.7, P = 0.018), showing that partners perceived their sexual performance at a better level. Partners' mean scores on the depression and distress measures were also significantly higher. On those items that monitored the accuracy of the patients' perceptions of their sexual function, partners rated the patients significantly lower in ability to gain erections (patient/partner means 2.67/4.52; P < 0.001) and to perform sexually (patient/partner means 1.38/4.68; P < 0.001) than they rated themselves. Information from this study could be useful in constructing interventions that allow the physician and the prostate cancer 'couple' to reflect on issues of sexual function and psychological distress that might once have been considered taboo. The results characterize the disparities between patients with prostate cancer and their partners on self-reported questionnaires, and underscore how important it is to hear the voice of the 'couple'.
Marital relationship and health-related quality of life after prostate cancer diagnosis
International Journal of Urological Nursing, 2016
Prostate cancer has an impact on the health-related quality of life of patients and their spouses. However, the marital relationship at the time of prostate cancer diagnosis is not well known. The aim of the study was to describe and compare the marital relationship of patients with prostate cancer and their spouses and to identify factors associated with health-related quality of life at the time of diagnosis. The data of this cross-sectional study were collected with The Marital Questionnaire and RAND-36 Item Health Survey scales after the diagnosis of prostate cancer from 232 patients and 229 spouses at five Finnish central hospitals from October 2013-January 2016. Patients with prostate cancer rated their dyadic satisfaction better than their spouses. Respectively, spouses reported better dyadic cohesion. The marital relationship of the patients or spouses was not associated with demographic variables of the respondents. In patients, energy, emotional well-being and general health were associated with the marital relationship. In spouses, emotional role functioning, emotional well-being and social functioning were explained by the marital relationship. At the time of diagnosis, the marital relationship of patients with prostate cancer and their spouses was good. However, there were differences in associations between patients' and their spouses' marital relationship and health-related quality of life. Based on the results of this study, it is useful to take into account the spouses and the marital relationship in the nursing of patients with prostate cancer. The follow-up research on this subject is needed.
Contemporary nurse, 2018
Little is known about the influence of how patients with prostate cancer perceive emotional support from their spouses on their treatment-related symptoms. To explore the influence of marital intimacy on urinary and sexual symptoms. The research participants were 42 men diagnosed with prostate cancer recruited from a convenience sample from a university hospital in South Korea. The Expanded Prostate Cancer Index Composite, the Korean Marital Intimacy Scale, and the Hospital Anxiety and Depression Scale were used to measure variables of interest. In the hierarchical multiple regression analysis, higher marital intimacy was associated with more favorable symptom in the urinary domain. In the sexual domain, none of the models were significant, and no influence was found for marital intimacy. Marital intimacy, measured as perceived emotional support from spouses, was found to positively influence only the experience of urinary symptoms among South Korean men with prostate cancer.
Impact of Prostate Cancer Treatment on the Sexual Quality of Life for Men-Who-Have-Sex-with-Men
The Journal of Sexual Medicine, 2015
Introduction. With earlier prostate cancer (PCa) diagnosis and an increased focus on survivorship, post-treatment sexual quality of life (QoL) has become increasingly important. Research and validated instruments for sexual QoL assessment based on heterosexual samples have limited applicability for men-who-have-sex-with-men (MSM). Aim. We aimed to create a validated instrument for assessing sexual needs and concerns of MSM post-PCa treatment. Here we explore post-PCa treatment sexual concerns for a sample of MSM, as the first part of this multi-phase project. Methods. Individual semi-structured interviews were conducted with 16 MSM face-to-face or via Internet-based video conferencing. Participants were asked open-ended questions about their experiences of sexual QoL following PCa. Interviews were recorded, transcribed verbatim, uploaded to NVivo 8 TM , and analyzed using qualitative methodology. Main Outcome Measure. We have conducted semi-structure qualitative interviews on 16 MSM who were treated for PCa. Focus was on post-treatment sexual concerns. Results. The following themes were inductively derived: (i) erectile, urinary, ejaculation, and orgasmic dysfunctions; (ii) challenges to intimate relationships; and (iii) lack of MSM-specific oncological and psychosocial support for PCa survivorship. Sexual practices pre-treatment ranked in order of frequency were masturbation, oral sex, and anal sex, an ordering that prevailed post-treatment. Sexual QoL decreased with erectile, urinary, and ejaculation dysfunctions. Post-treatment orgasms were compromised. Some single men and men in non-monogamous relationships reported a loss of confidence or difficulty meeting other men post-treatment. Limited access to targeted oncological and psychosocial supports posed difficulties in coping with PCa for MSM. Conclusions. The negative impact on sexual QoL can be severe for MSM and requires targeted attention. Penilevaginal intercourse and erectile function have been the primary focus of sexual research and rehabilitation for men with PCa, and do not adequately reflect the sexual practices of MSM. Our findings suggest that future research dedicated to MSM with PCa is needed to incorporate their sexual practices and preferences specifically into treatment decisions, and that targeted oncological and psychosocial support services are also warranted. Lee TK, Handy AB, Kwan W, Oliffe JL, Brotto LA, Wassersug RJ, and Dowsett GW. The impact of prostate cancer treatment on the sexual quality of life for men-who-have-sex-with-men. J Sex Med **;**:**-**.
Journal of Sexual Medicine, 2009
Introduction. Few studies have looked at prevalence estimates for female sexual dysfunctions in combination with personal distress, although existing diagnostic criteria for sexual disorders include both aspects. Further, the variation in female sexual function has been shown to be largely explained by unique nongenetic factors. Such factors may include partner sexual function and perception of sexual compatibility with a partner, factors which may also be associated with sexual distress. Aim. We investigated the association between female sexual dysfunction and distress as well as their association with partner compatibility. Methods. In order to assess sexual function and distress, the Female Sexual Function Index and seven items from the Female Sexual Distress Scale were used in a population-based sample of 5,463 women, aged 18-49 years. The women were, based on cutoff points, classified as either having neither dysfunction nor distress, one of them, or both, separately for each dysfunction. Further, the associations between partner compatibility, distress, and sexual dysfunctions were analyzed. Sexual compatibility with partner was investigated by using several items exploring, for example, amount of foreplay, interest in sex, and communication about sexual matters. Main Outcome Measures. Associations between partner compatibility and female sexual function and sexual distress. Results. The proportion of women reporting both sexual dysfunction and distress ranged from 7% to 23%, depending on the dysfunction. Desire disorders followed by orgasmic disorders were most common. All compatibility variables were significantly associated with distress and with most of the sexual dysfunctions. The main complaints of the women were "too little foreplay" (42%) and "partner is more interested" (35%). The women feeling distress or having a sexual dysfunction reported more incompatibility with partner compared with functional women. Conclusions. The findings highlight the importance of addressing partner compatibility for successful treatment and counseling of female sexual dysfunctions. Witting K, Santtila P, Varjonen M, Jern P, Johansson A, von der Pahlen B, and Sandnabba K. Female sexual dysfunction, sexual distress, and compatibility with partner. J
Sexual Medicine, 2022
Background: Prostate cancer (PCa) is often diagnosed early with prolonged survival, which makes sexual quality of life (QoL) an increasingly important treatment consideration, but existing QoL questionnaires have limited applicability for men who-have-sex-with-men (MSM) beyond penile erections and penetrative sex. Aim: We aimed to create a validated survey instrument for assessing a variety of sexual activities beyond penile insertive sex for MSM after PCa treatment. Methods: Based on our previously published survey findings, we have generated a prototype questionnaire with 13 different domains, reviewed by both healthy MSM and pilot-tested by MSM treated for PCa. Outcomes: We report here on progress in developing the questionnaire and demonstrate the complexity of MSM sexual side effects resulting from PCa treatment(s). Results: Statistical analysis of 204 responses from MSM treated for PCa showed that each domain performed well individually (Cronbach's alpha coefficients ranged from 0.80 to 0.95; item-total correlations ranged from 0.16 to 0.89), with many significant intercorrelations between the domains (ranged from-0.048 to 0.93). Clinical Implications: The questionnaire can contribute to clinical diagnosis and treatment decisions that best fit the preferred sexual practices of individual MSM. Strengths & Limitations: The current questionnaire considers a much broader repertoire of MSM's sexual practices and preferences than other currently available questionnaires. The high intercorrelations between the many parameters demonstrate that problems in one domain can affect other domains. This preliminary analysis warrants further exploration with a larger sample size. Conclusions: Once validated our questionnaire should help develop tailored psychosocial supports for MSM experiencing sexual dysfunction after PCa treatment and help newly diagnosed MSM with PCa make treatment decisions informed by their preferred sexual practices. Wibowo E, Dowsett GW, Nelson CJ, et al. Development of a Sexual Quality of Life Questionnaire for Men-Who-Have-Sex-With-Men With Prostate Cancer.
Journal of Sexual Medicine, 2007
Introduction. Prostate cancer is the most common type of cancer found in American men. Patient adjustment to prostate cancer is not limited to attempts to restore sexual function, a process that can pose significant challenges to couples following most surgical and nonsurgical treatments. Patients often struggle with depression and other relational stressors. Partners also undergo psychosocial, relational, sexual, and quality-of-life changes and their responses to these changes may relate to patient adjustment.Aim. To evaluate to what extent partners' psychosocial and relational adjustment relates to prostate cancer patient adjustment.Main Outcome Measures. Partner and patient general and sexual depression; patient relationship satisfaction, quality of sexual communication, sexual satisfaction, and life satisfaction.Method. A total of 77 patients and 57 partners responded to a mail survey that included demographic information, the Beck Depression Inventory, Life Satisfaction Index, Index of Sexual Satisfaction, Relationship Assessment Scale, Dyadic Sexual Communication Scale, Sexuality Scale, and Client Satisfaction Questionnaire.Results. Patients and their partners differed in their sexual self-esteem, sexual depression, sexual preoccupation, and life satisfaction. Both had greater levels of depression, poorer quality of sexual communication, and more sexual dissatisfaction than the general population. Partners' level of general depression and depression concerning their sex lives were significant predictors of patients' relationship satisfaction, perceived quality of communication about the sexual relationship, and sexual satisfaction after controlling for patients' general and sexual depression.Conclusion. Partners often serve as primary caregivers, thus partner adjustment can be critical to the health of the patient and to his primary relationship. Results suggest the importance of including partners' adjustment in assessing patient adjustment post-treatment. We suggest that physicians working with these patients partner with mental health professionals who can help couples address the challenges they encounter and extend the continuity of care when the need for medical intervention has passed. Garos S, Kluck A, and Aronoff D. Prostate cancer patients and their partners: Differences in satisfaction indices and psychological variables. J Sex Med 2007;4:1394–1403.