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).
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.
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 8TM ,
and analyzed using qualitative methodology.
We have conducted semi-structure qualitative interviews on
16 MSM who were treated for PCa. Focus was on post-treatment sexual concerns.
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.
The negative impact on sexual QoL can be severe for MSM and
requires targeted attention. Penile-vaginal 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.
- 1British Columbia Cancer Agency, Fraser Valley Cancer Centre, Surrey, BC, Canada.
- 2Department of Obstetrics and Gynaecology, Diamond Health Care Centre, University of British Columbia, Vancouver, BC, Canada.
- 3Faculty of Applied Science, School of Nursing, University of British Columbia, Vancouver, BC, Canada.
- 4Department of Urologic Sciences, Gordon and Leslie Diamond Health Care Centre, University of British Columbia, Vancouver, BC, Canada.
- 5Australian Research Centre in Sex, Health and Society, La Trobe University, Melbourne, VIC, Australia.
