University of British Columbia, Vancouver, BC, Canada
Jennifer Bossio , Christine Zarowski , Stacy Elliott , Lindsay Hedden , Phil Pollock , Maria Spillane , Eugenia Wu , Natalie Nunez , Anna Branch , Larry Goldenberg , Celestia S. Higano
Background: Sexual dysfunction and psychological distress are two of the most important unmet supportive care needs of prostate cancer (PC) patients (pts). The Sexual Health Service (SHS) from the Prostate Cancer Supportive Care Program at the Vancouver Prostate Centre addresses the sexual recovery needs of PC pts and their partners via education and clinical service. This study explores patient characteristics and needs to better understand SHS utilization. Methods: Data was obtained from patient charts, semi-structured interviews, and patient-reported outcome measures from July 2013-June 2017. Analyses include descriptive statistics and pre-post comparisons via parametric (paired t-tests) or non-parametric (Wilcoxon) tests. Results: Data from 667 pts was analysed. Average age was 65yrs (SD= 7.3, 43-88yrs) and most were in a relationship (79.6%; mean length = 30.5 yrs, SD= 15.2yrs, 9 mos–68yrs). Appointments were attended with partners (42.3%) or alone (56%) and most pts had undergone surgery for their PC (81.8%). Other treatments included radiation (18.2%), androgen deprivation therapy (13.3%), chemotherapy (1.0%), some had multiple treatments. Average time since end of PC treatment to first SHS appointment was 18 mos (SD= 25.7mos; range, 0-17yrs). At the first SHS appointment, mean self-reported erectile functioning indicated severe dysfunction (IIEF scores: M =6.39, SD= 5.22). Pts reported significant decreases following PC treatment in: quality of erections, orgasm intensity, sexual desire, partner’s sexual desire, men’s sexual self-view, sexual body image and overall sexual satisfaction (p’s < .01). Patients also reported lower levels of partner intimacy (p= .003). At first SHS appointment, 34.5% of patients reported one significant ongoing life stressor, and 23.8% reported more than one. Most common life stressors were health (29.4%), family (23.8%), work (15.3%), relationship (8.8%) and financial (6.9%). Conclusions: Analyses support the need for the SHS, as pts report declines in all realms of sexual wellbeing and ongoing life stressors. Findings improve our understanding of the long-term impacts of PC treatment and guide future treatment offerings.
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