Movember is an Australian charity that dedicates the month of November to raising awareness about men’s health issues such as prostate cancer, testicular cancer, and men’s mental health.
As part of an initiative dedicated to providing reliable information and support to prostate cancer survivors and their partners, Movember supported the creation of Guidelines for Sexual Health Care for Prostate Cancer Patients: Recommendations of an International Panel. The guidelines were endorsed by the Sexual Medicine Society of North America (SMSNA), the International Society for Sexual Medicine (ISSM), and other relevant organizations.
Prostate cancer patients often experience sexual problems after getting treatment for their cancer. While these treatments are very effective when the cancer is detected early, the sexual side effects of treatment can dramatically change a person’s quality of life. This is why it is helpful to have guidelines from experts in the field to help prostate cancer survivors and their partners live healthier, happier lives after treatment that include maintenance of their sexual relationships.
The following is a short summary of the statements from these clinical guidelines. (The full guidelines can be found here: https://programs.movember.com/clinical-guideline-sexual-health-prostate-cancer/). These guidelines focus on both the impact of prostate cancer treatment on men’s sexuality and relationships, as well as on strategies that can help men and their partners recover their sex lives.
How should clinicians counsel patients and partners about the sexual impact of prostate cancer treatment?
Clinicians should proactively initiate conversations with patients and their partners about sexual health, addressing patients’ diverse backgrounds while doing so. They should offer realistic expectations, rehabilitation strategies, and emotional support to patients and their partners dealing with prostate cancer treatment-related sexual changes.
What should patients and partners know about the impact of individual prostate cancer therapies on sexual function?
The guideline recommends that clinicians inform prostate cancer patients about all potential sexual side effects, such as erectile dysfunction (ED), changes in (or the absence of) ejaculation, changes in orgasm, loss of penile length and girth, possible infertility, and other penile issues such Peyronie’s disease (penile curvature). Fertility preservation options like sperm banking should be discussed if a man wishes to father a child after treatment.
Why is it important to assess sexual function and sexual distress in patients and partners?
Screening and assessing patient and partner sexual function, concerns, and distress before, during, and after treatment aids in personalized care and issue identification.
Counseling patients and partners about the importance of psychosocial treatment.
Clinicians should inform patients and their partners about psychosocial treatment and explain how it can help them. Psychosocial treatment can help educate patients and partners about the sexual side effects of treatment, their emotional impact, and a couple’s unique needs, while considering diverse orientations, cultures, and values. Encouragement for help-seeking is essential, including referrals to specialists in sex therapy when necessary.
Counseling patients and partners about biomedical treatment.
Patients and their partners should be informed about tailored ED treatments, including pills, injections, suppositories, vacuum pumps, and penile implants. Urologists specializing in sexual medicine can provide this assistance most effectively. Techniques to manage other side effects such as urine leakage during sexual excitement and/or orgasm are also important for patients to know. Lastly, clinicians should share strategies or provide referrals for managing psychological symptoms.
What kinds of lifestyle changes can help?
Making lifestyle changes may help support better erectile functioning. Quitting smoking, keeping moderate to low alcohol consumption, maintaining a heart-healthy diet, and getting regular exercise are habits that not only promote overall well-being, but may also improve a person’s sexual function.
Conclusion
Prostate cancer treatments can affect both patients and their partners, impacting their sexual relationships and quality of life. Using comprehensive rehabilitation strategies and discussing these guidelines with a trusted health care provider can help you find personalized care and can support sexual intimacy with your partner.
For more information on this topic, please read these publications from the ISSM Journals: The Journal of Sexual Medicine, Sexual Medicine Reviews, and Sexual Medicine Open Access:
References:
Wittmann, D., Mehta, A., McCaughan, E., Faraday, M., Duby, A., Matthew, A., Incrocci, L., Burnett, A., Nelson, C.J., Elliott, S., & Koontz, B.F. (2022). Guidelines for Sexual Health Care for Prostate Cancer Patients: Recommendations of an International Panel. The Journal of Sexual Medicine, 19(11), 1655-1669. https://doi.org/10.1016/j.jsxm.2022.08.197
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