The sexual and other supportive care needs of Canadian prostate cancer patients and their partners: Defining the problem and developing interventions

Deborah L McLeod, Lauren M Walker, Richard J Wassersug, Andrew Matthew, John W Robinson

Abstract


Prostate cancer (PCa) treatments result in a wide range of short- and long-term survivorship issues not only for men, but also their partners. The effects of treatment vary from urinary incontinence and sexual dysfunction, to psychological, relational and social challenges. Androgen-deprivation therapy contributes as well to serious health risks (e.g., cardiovascular disease and osteoporosis), which must be effectively managed. 

Although there are a myriad of survivorship issues to manage, there are few survivorship programs in Canada to help patients and partners address the outcomes of PCa diagnosis and treatment. However, this is starting to change. Several sites across Canada are participating in developing a range of programs to address the supportive care needs of men with PCa and their partners. In this article, we discuss the issues and the programs that are now emerging to address them. 

Prostate cancer (PCa) patients face a myriad of issues associated with treatment that significantly impact quality of life. The primary localized and potentially curative PCa treatments are radical prostatectomy and radiation treatment (in the form of brachytherapy or external beam radiation). Systemic therapies such as androgen deprivation therapy (ADT) are also common. Although patients and their partners experience significant physical and psychosocial impacts from such treatments, support to address these issues is limited and inconsistently in Canadian cancer centres.

A number of Canadian cancer centres have been working diligently over the past six years to improve the supportive care offered to PCa patients and their partners. Two examples of these programs will be discussed, one focusing on sexual dysfunction arising from localized treatment for PCa and the second, addressing adaptation to androgen deprivation therapy.


Full Text:

PDF

References


Alibhai, S.M., Breunis, H., Timilshina, N., Johnston, C., Tomlinson, G., Tannock, I., ... & Naglie, G. (2010). Impact of androgen-deprivation therapy on physical function and quality of life in men with nonmetastatic prostate cancer. Journal of clinical oncology, 28(34), 5038–5045.

Alibhai, S.M., Gogov, S., & Allibhai, Z. (2006). Long-term side effects of androgen deprivation therapy in men with non-metastatic prostate cancer: a systematic literature review. Critical reviews in oncology/hematology, 60(3), 201–215.

Allan, C., Collins, V.R., Frydenberg, M., McLachlan, R.I., & Matthiesson, K.L. (2014). Androgen deprivation therapy complications. Endocrine-related cancer, ERC-13.

Armes, J., Crowe, M., Colbourne, L., Morgan, H., Murrells, T., Oakley, C., ... Richardson, A. (2009). Patients’ supportive care needs beyond the end of cancer treatment: a prospective, longitudinal survey. Journal of Clinical Oncology, 27(36), 6172–6179. doi:10.1200/JCO.2009.22.5151

Banthia, R., Malcarne, V.L., Varni, J.W., Ko, C.M., Sadler, G.R., & Greenbergs, H.L. (2003). The effects of dyadic strength and coping styles on psychological distress in couples faced with prostate cancer. Journal of Behavioral Medicine, 26, 31–52.

Boehmer, U., & Clark, J.A. (2001). Communication about prostate cancer between men and their wives. Journal of Family Practice, 50(3), 226–231.

Casey, R.G., Corcoran, N.M., & Goldenberg, S.L. (2012). Quality of life issues in men undergoing androgen deprivation therapy: A review. Asian journal of andrology, 14(2), 226–231. doi:10.1038/aja.2011.108; 10.1038/aja.2011.108

Charmaz, K. (1995). Identity dilemmas of chronically ill men. In D. Sabo, & D.F. Gordon (Eds.), Men’s health and illness: Gender, power and the body (pp. 266–291). Thousand Oaks, CA: Sage.

Cliff, A.M., & MacDonagh, R.P. (2000). Psychosocial morbidity in prostate cancer: II. A comparison of patients and partners. British Journal of Urology International, 86(7), 834–839.

Cooperberg, M.R., Koppie, T.M., Lubeck, D.P., Ye, J., Grossfeld, G.D., Mehta, S.S., & Carroll, P.R. (2003). How potent is potent? Evaluation of sexual function and bother in men who report potency after treatment for prostate cancer: Data from CaPSURE. Urology, 61(1), 190–196.

Cormie, P., Newton, R.U., Taaffe, D.R., Spry, N., & Galvão, D.A. (2013). Exercise therapy for sexual dysfunction after prostate cancer. Nature Reviews Urology, 10(12), 731–736.

Couper, J., Bloch, S., Love, A., Macvean, M., Duchesne, G.M., & Kissane, D. (2006a), Psychosocial adjustment of female partners of men with prostate cancer: A review of the literature. Psycho-Oncology,15, 937–953. doi:10.1002/pon.1031

Couper, J.W., Bloch, S., Love, A., Duchesne, G., Macvean, M., & Kissane, D.W. (2006b). The psychosocial impact of prostate cancer on patients and their partners. The Medical Journal of Australia, 185(8), 428–432.

Courtenay, W.H. (2000). Constructions of masculinity and their influence on men’s well-being: A theory of gender and health. Social Science & Medicine, 50, 1385–1401.

Coyne, J.C., Ellard, J.H., & Smith, D.A.F. (1990). Social support, interdependence, and the dilemmas of helping. In B.R. Sarason, I.G. Sarason, & G.R. Pierce (Eds.) Social support: An interactional view (pp. 129–149). New York: John Wiley & Sons

Crowe, H., & Costello, A.J. (2003). Prostate cancer: Perspectives on quality of life and impact of treatment on patients and their partners. Urologic Nursing, 23, 279–285.

Culos-Reed, S.N., Robinson, J.W., Lau, H., Stephenson, L., Keats, M., Norris, S., … Faris, P. (2010). Physical activity for men receiving androgen deprivation therapy for prostate cancer: Benefits from a 16-week intervention. Supportive Care in Cancer, 18(5), 591–599.

Elliott, S., Latini, D.M., Walker, L.M., Wassersug, R., & Robinson, J.W. (2010). Androgen deprivation therapy for prostate cancer: Recommendations to improve patient and partner quality of life. The journal of sexual medicine, 7(9), 2996–3010. doi:10.1111/j.1743-6109.2010.01902.x; 10.1111/j.1743-6109.2010.01902.x

Ervik, B., & Asplund, K. (2012). Dealing with a troublesome body: A qualitative interview study of men’s experiences living with prostate cancer treated with endocrine therapy. European Journal of Oncology Nursing, 16(2), 103–108. doi:10.1016/j.ejon.2011.04.005

Eton, D.T. (2005). Psychological distress in spouses of men treated for early-stage prostate carcinoma. Cancer, 103, 2412–2418.

Fergus, K.D. (2011). The rupture and repair of the couple’s communal body with prostate cancer. Families, Systems, & Health, 29(2), 95–113.

Fleshner, N., Keane, T.E., Lawton, C.A., Mulders, P.F., Payne, H., Taneja, S.S., & Morris, T. (2007). Adjuvant androgen deprivation therapy augments cure and long-term cancer control in men with poor prognosis, nonmetastatic prostate cancer. Prostate cancer and prostatic diseases, 11(1), 46–52. doi:10.1038/sj.pcan.4500982

Fode, M., Ohl, D.A., Ralph, D., & Sonksen, J. (2013). Penile rehabilitation after radical prostatectomy: What the evidence really says. BJU International, 112, 998–1008.

Freedland, S.J., Eastham, J., & Shore, N. (2009). Androgen deprivation therapy and estrogen deficiency induced adverse effects in the treatment of prostate cancer. Prostate cancer and prostatic diseases, 12(4), 333–338. doi:10.1038/pcan.2009.35

Garos, S., Kluck, A., & Aronoff, D. (2007). Prostate cancer patients and their partners: Differences in satisfaction indices and psychological variables. Journal of Sexual Medicine, 4, 1394–1403.

Hagedoorn, M., Buunk, B.P., Kuijer, R.G., Wobbes, T., & Sanderman, R. (2000). Couples dealing with cancer: Role and gender differences regarding psychological distress and quality of life. Psycho-Oncology, 9(3), 232–242.

Hanisch, L.J., Gooneratne, N.S., Soin, K., Gehrman, P.R., Vaughn, D.J., & Coyne, J.C. (2011). Sleep and daily functioning during androgen deprivation therapy for prostate cancer. European journal of cancer care, 20(4), 549–554. doi:10.1111/j.1365-2354.2010.01226.x; 10.1111/j.1365-2354.2010.01226.x

Harden, J., Schafenacker, A., Northouse, L., Mood, D., Smith, D., Pienta, K., … Baranowski, K. (2002). Couples’ experiences with prostate cancer: Focus group research. Oncology Nursing Forum, 29, 701–709.

Hawes, S., Malcarne, V., Ko, C., Sadler, G., Banthuia, R., Sherman, S., … Schmidt, J. (2006). Identifying problems faced by spouses and partners of patients with prostate cancer. Oncology Nursing Forum, 33(4), 807–814.

Heathcote, P.S., Mactaggart, P.N., Boston, R.J., James, A.N., Thompson, L.C., & Nicol, D.L. (1998). Health-related quality of life in Australian men remaining disease-free after radical prostatectomy. The Medical journal of Australia, 168(10), 483–486.

Helgason, A.R., Adolfsson, J., Dickman, P., Arver, S., Fredrikson, M., & Steineck, G. (1997). Factors associated with waning sexual function among elderly men and prostate cancer patients. The Journal of urology, 158(1), 155–159. doi:10.1097/00005392-199707000-00050 (1997)

Hovey, R.B., Cuthbertson, K.E.S., Birnie, K.A., Robinson, J.W., Thomas, B.C., Massfeller, H.F., ... Scott, C. (2012). The influence of distress on knowledge transfer for men newly diagnosed with prostate cancer. Journal of Cancer Education, 27(3), 540–545. doi:10.1007/s13187-012-0343-2

Kukula, K.C., Jackowich, R.A., & Wassersug, R.J. (2014). Eroticization as a factor influencing erectile dysfunction treatment effectiveness. International journal of impotence research. 26(1),1–6.

Lee, M., Jim, H.S., Fishman, M., Zachariah, B., Heysek, R., Biagioli, M., & Jacobsen, P.B. (2014). Depressive symptomatology in men receiving androgen deprivation therapy for prostate cancer: A controlled comparison. Psycho‐Oncology. [Epub ahead of print]

Lilleby, W., Fosså, S.D., Wæhre, H.R., & Olsen, D.R. (1999). Long-term morbidity and quality of life in patients with localized prostate cancer undergoing definitive radiotherapy or radical prostatectomy. International Journal of Radiation Oncology, Biology, Physics, 43(4), 735–743.

Lundahl, B., & Burke, B.L. (2009). The effectiveness and applicability of motivational interviewing: A practice‐friendly review of four meta-analyses. Journal of Clinical Psychology, 65(11), 1232–1245.

Lundahl, B., Moleni, T., Burke, B.L., Butters, R., Tollefson, D., Butler, C., & Rollnick, S. (2013). Motivational interviewing in medical care settings: A systematic review and meta-analysis of randomized controlled trials. Patient education and counselling, 93(2), 157–168. doi:http://dx.doi.org/10.1016/j.pec.2013.07.012

Manne, S.L. (1999). Intrusive thoughts and psychological distress among cancer patients: the role of spouse avoidance and criticism. Journal of Consulting and Clinical Psychology, 67, 539–546.

Manne, S., Badr, H., Zaider, T., Nelson, C., & Kissane, D. (2010). Cancer-related communication, relationship intimacy, and psychological distress among couples coping with localized prostate cancer. Journal of Cancer Survivorship, 4(1), 74–85.

Manne, S.L., Kissane, D.W., Nelson, C.J., Mulhall, J.P., Winkel, G., & Zaider, T. (2011). Intimacy‐enhancing psychological intervention for men diagnosed with prostate cancer and their partners: A pilot study. The Journal of Sexual Medicine, 8(4), 1197–1209. doi:10.1111/j.1743-6109.2010.02163.x

Matthew, A.G., Goldman, A., Trachtenberg, J., Robinson, J., Horsburgh, S., Currie, K., & Ritvo, P. (2005). Sexual dysfunction after radical prostatectomy: Prevalence, treatments, restricted use of treatments and distress. The Journal of urology, 174(6), 2105–2110. doi:10.1097/01.ju.0000181206.16447.e2 (2005)

McGinty, H.L., Phillips, K.M., Jim, H.S., Cessna, J.M., Asvat, Y., Cases, M.G., ... Jacobsen, P.B. (2014). Cognitive functioning in men receiving androgen deprivation therapy for prostate cancer: A systematic review and meta-analysis. Supportive Care in Cancer, 1–10.

McLeod, D., Curran, J., Dumont, S., White, M., & Charles, G. (2013). The Interprofessional Psychosocial Oncology Distance Education (IPODE) project: perceived outcomes of an approach to healthcare professional education. Journal of Interprofessional Care, 28(3), 254–259.

McLeod, D.L., Curran, J., & White, M. (2011). Interprofessional psychosocial oncology education: Nurse outcomes of the IPODE project. Psycho-oncologie, 5(2), 109–115.

Meyer, J.P., Gillatt, D.A., Lockyer, R., & Macdonagh, R. (2003). The effect of erectile dysfunction on the quality of life of men after radical prostatectomy. BJU international, 92(9), 929–931.

Miller, W.R., & Rollnick, S. (2013). Motivational Interviewing: Helping People Change (3rd ed.). New York: Guilford.

Mirone, V., Imbimbo, C., Palmieri, A., Longo, N., & Fusco, F. (2003). Erectile dysfunction after surgical treatment. International Journal of Andrology, 26(3), 137–140.

Navon, L., & Morag, A. (2003). Advanced prostate cancer patients’ ways of coping with the hormonal therapy’s effect on body, sexuality and spousal ties. Qualitative Health Research, 13(10), 1378–1392.

Neese, L.E., Schover, L.R., Klein, E.A., Zippe, C., & Kupelian, P.A. (2003). Finding help for sexual problems after prostate cancer treatment: A phone survey of men’s and women’s perspectives. Psycho-Oncology, 12, 463–473.

Northouse, L.L., Mood, D.W., Montie, J.E., Sandler, H.M., Forman, J.D., Hussain, M., … Kershaw, T. (2007). Living with prostate cancer: Patients’ and spouses’ psychosocial status and quality of life. Journal of Clinical Oncology, 25(27), 4171–4177.

Ng, E., Corica, T., Turner, S., Lim. A., & Spry, N. (2014). Sexual function in men with castrate levels of testosterone: Observations of a subgroup of sexually active men with prostate cancer undergoing androgen deprivation. Open Journal of Urology, 4, 98–103. doi:10.4236/oju.2014.47017

Ogah, I., & Wassersug, R.J. (2013, November). How reliable are “reputable sources” for medical information on the Internet? The case of hormonal therapy to treat prostate cancer. In Urologic Oncology: Seminars and Original Investigations (Vol. 31, No. 8, pp. 1546–1552). NY: Elsevier.

Oliffe, J. (2002). In search of a social model of prostate cancer: Finding out about Bronch. In S. Pearce, & V. Muller (Eds.). Manning the next millennium: Studies in masculinities (pp. 69–84). Perth, WA: Black Swan.

Pedersen, K.V., Carlsson, P., Rahmquist, M., & Varenhorst, E. (1993). Quality of life after radical retropubic prostatectomy for carcinoma of the prostate. European Urology, 24, 7–11.

Perczek, R.E., Burke, M.A., Carver, C.S., Krongard, A., & Terris, M.K. (2002). Facing a prostate cancer diagnosis. Who is at risk for increased distress? Cancer, 94, 2923–2928.

Perez, M.A., Skinner, E.C., & Meyerowitz, B.E. (2002). Sexuality and intimacy following radical prostatectomy: Patient and partner perspectives. Health Psychology, 21, 288–293.

Pitceathly, C., & Maguire, P. (2003). The psychological impact of cancer on patients’ partners and other key relatives: A review. European Journal of Cancer, 39(11), 1517–1524.

Resendes, L.A., & McCorkle, R. (2006). Spousal responses to prostate cancer: An integrative review. Cancer Investigation, 24, 192–198.

Roesch, S.C., Adams, L., Hines, A., Palmores, A., Vyas, P., Tran, C., … Vaughn, A. (2005). Coping with prostate cancer: A meta-analytic review. Journal of Behavioral Medicine, 8(3), 281–293.

Ross, R.W., & Small, E.J. (2002). Osteoporosis in men treated with androgen deprivation therapy for prostate cancer. The Journal of urology, 167(5), 1952–1956.

Rubak, S., Sandbæk, A., Lauritzen, T., & Christensen, B. (2005). Motivational interviewing: A systematic review and meta-analysis. The British Journal of General Practice, 55(513), 305–312.

Saylor, P.J., & Smith, M.R. (2009). Prostate cancer: How can we improve the health of men who receive ADT?. Nature Reviews Urology, 6(10), 529–531.

Schover, L.R. (2001). Sexuality and cancer: For the man who has cancer and his partner. New York: American Cancer Society.

Sharpley, C.F., Bitsika, V., Wootten, A.C., & Christie, D.R. (2014). Differences in major depressive disorder and generalised anxiety disorder symptomatology between prostate cancer patients receiving hormone therapy and those who are not. Psycho‐Oncology. Apr 30. doi:10.1002/pon.3566 [Epub ahead of print]

Skerrett, K. (2010). “Good enough stories”: Helping couples invest in one another’s growth. Family Process, 49, 503–516.

Soeyonggo, T., Locke, J., Del Giudice, M.E., Alibhai, S., Fleshner, N.E., & Warde, P. (2014). National survey addressing the information needs of primary care physicians: Side effect management of patients on androgen deprivation therapy. Canadian Urological Association Journal, 8(3–4), E227.

Soloway, C.T., Soloway, M.S., Kim, S.S., & Kava, B.R. (2005). Sexual, psychological and dyadic qualities of the prostate cancer ‘couple’. British Journal of Urology International, 95(6), 780–785.

Steginga, S.K., Occhipinti, S., Dunn, J., Gardiner, R.A., Heathcote, P., & Yaxley, J. (2001). The supportive care needs of men with prostate cancer. Psycho-Oncology, 10(1), 66–75.

Tanner, T., Galbraith, M., & Hays, L. (2011). From a woman’s perspective: Life as a partner of a prostate cancer survivor. Journal of Midwifery & Women’s Health, 56(2), 154–160. doi:10.1111/j.1542-2011.2010.00017.x (2011)

Tran, S., Walker, L.M., Wassersug, R.J., Matthew, A.G., McLeod, D.L., & Robinson, J.W. (2014). What do Canadian uro-oncologists believe patients should know about androgen deprivation therapy?. Journal of Oncology Pharmacy Practice, 20(3), 199–209. doi:10.1177/1078155213495285

van der Wielen, G.J., Mulhall, J.P., & Incrocci, L. (2007). Erectile dysfunction after radiotherapy for prostate cancer and radiation dose to the penile structures: A critical review. Radiotherapy and Oncology, 84(2), 107–113, doi:10.1016/j.radonc.2007.07.018

Walker, L.M., & Robinson, J.W. (2011). A description of heterosexual couples’ sexual adjustment to androgen deprivation therapy for prostate cancer. Psycho‐Oncology, 20(8), 880–888.

Walker, L.M., & Robinson, J.W. (2012). Sexual adjustment to androgen deprivation therapy struggles and strategies. Qualitative health research, 22(4), 452–465. doi:10.1177/1049732311422706

Walker, L.M., Tran, S., & Robinson, J.W. (2013). Luteinizing hormone–releasing hormone agonists: A quick reference for prevalence rates of potential adverse effects. Clinical Genitourinary Cancer, 11(4), 375–384.

Walker, L.M., Tran, S., Wassersug, R.J., Thomas, B., & Robinson, J.W. (2013, October). Patients and partners lack knowledge of androgen deprivation therapy side effects. In Urologic Oncology: Seminars and Original Investigations (Vol. 31, No. 7, pp. 1098–1105). Elsevier. doi:10.1016/j.urolonc.2011.12.015

Wall, B.A., Galvão, D.A., Fatehee, N., Taaffe, D.R., Spry, N., Joseph, D., & Newton, R.U. (2014). Maximal exercise testing of men with prostate cancer being treated with ADT. Medicine and science in sports and exercise.

Wibowo, E., Wassersug, R., Warkentin, K., Walker, L., Robinson, J., Brotto, L., & Johnson, T. (2012). Impact of androgen deprivation therapy on sexual function: A response. Asian Journal of Andrology, 14(5), 793. doi:10.1038/aja.2012.60;10.1038/aja.2012.60

Wolin, K.Y., Colditz, G.A., & Proctor, E.K. (2011). Maximizing benefits for effective cancer survivorship programming: Defining a dissemination and implementation plan. The oncologist, 16(8), 1189–1196. doi:10.1634/theoncologist.2011-0054

Wooten, A., Burney, S., Frydenberg, M., & Foroudi, F. (2007). Psychological adjustment of survivors of localised prostate cancer: The need for sexual rehabilitation. Psycho-Oncology, 16, S54–S55

Wu, L.M., Diefenbach, M.A., Gordon, W.A., Cantor, J.B., & Cherrier, M.M. (2013, November). Cognitive problems in patients on androgen deprivation therapy: A qualitative pilot study. In Urologic Oncology: Seminars and Original Investigations (Vol. 31, No. 8, pp. 1533–1538). Elsevier. doi:10.1016/j.urolonc.2012.07.003; 10.1016/j.urolonc.2012.07.003

Zaider, T., Manne, S., Nelson, C., Mulhall, J., & Kissane, D. (2012). Loss of masculine identity, marital affection, and sexual bother in men with localized prostate cancer. The journal of sexual medicine, 9(10), 2724–2732. doi:10.1111/j.1743-6109.2012.02897.x; 10.1111/j.1743-6109.2012.02897.x


Refbacks

  • There are currently no refbacks.