Experiences of support for sexual dysfunction in men with prostate cancer: findings from a UK-wide mixed methods study

Eilis McCaughan, Eila Watson, Jo Brett, Sarah Wilding, Lauren Matheson, Amy Downing, William R Cross, Peter Selby, Hugh Butcher, Adam Glaser, Anna Gavin

    Research output: Contribution to journalArticlepeer-review

    Abstract

    Background: Men with prostate cancer (PCa) often experience sexual dysfunction following diagnosis
    and treatment, yet little is known about the support they receive to deal with this.
    Aim: To explore men’s experiences of support for sexual dysfunction following PCa diagnosis.
    Methods: A UK-wide survey of men 18-42 months post-diagnosis of PCa, identified through cancer
    registries. The survey measured sexual function and the extent to which men perceived sexual
    dysfunction to be a problem (EPIC-26), access to and experience of medications, devices and specialist
    services for sexual dysfunction, and included a free-text question for further comments. Analysis
    focussed on men who reported poor sexual function, which they considered a moderate/big problem.
    Descriptive statistics explored the characteristics of men offered intervention and those that found
    this helpful. Free-text responses were analysed using thematic analysis.
    Outcome: Access to and experience of medications, devices and specialist services for sexual
    dysfunction.
    Results: 39.0% of all survey respondents (13,978/35,823) reported poor sexual function, which they
    considered a moderate/big problem. 51.7% of these men were not offered any intervention to aid
    sexual functioning. 71.9% of those offered an intervention reported trying it, of whom 48.7% found
    the intervention helpful. Men treated with surgery or brachytherapy were most likely to be offered
    an intervention. Medication was the most commonly offered intervention and 39.3% of those who
    tried medication, found this helpful. Although offered less often, approximately half of the men who
    tried devices or attended specialist services found this helpful.
    Free text responses indicated that barriers to accessing support included: inadequate information
    and support from health care professionals; embarrassment; negative views about treatment
    options; concerns about side-effects and safety; and inconsistencies between secondary and
    primary care . Barriers to continuing use included: limited effectiveness of treatments; inadequate
    ongoing support; and funding constraints. Drivers of sexual recovery included: patient proactivity
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    and persistence with trying different treatment options; ongoing support from health professionals.
    Clinical Implications: There is an urgent need to ensure all men are offered, and have equal access
    to, sexual care support, with referral to specialist services when required.
    Strengths and limitations: This study presents data from a large, UK-wide, population based study of
    men with prostate cancer and includes quantitative and qualitative findings. The possibility of nonresponse bias should, however, be considered.
    Conclusion: There are significant shortcomings in the support offered to UK men with sexual
    dysfunction following diagnosis and treatment for PCa which need to be addressed.
    Original languageEnglish
    JournalJournal of Sexual Medicine
    Publication statusAccepted/In press - 28 Dec 2020

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