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Sheppard S, Culliford D, Glen T, Lee S, Sheppard ZA, Porter S. Care for sexual health in oncology survey: Discussions about sexual health with people with cancer in the context of the obligation to provide informed consent. Eur J Oncol Nurs 2024; 72:102669. [PMID: 39216309 DOI: 10.1016/j.ejon.2024.102669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 03/30/2024] [Accepted: 07/12/2024] [Indexed: 09/04/2024]
Abstract
PURPOSE The purpose of this paper is to describe the impacts of cancer treatment on sexual health in a sample of people who had been treated for mixed types of cancer; to describe discussions they had with professionals about sexual health that occurred during cancer care; and to consider the extent to which these discussions were sufficient to enable participants to give informed consent for the sexual side effect of cancer treatment. METHOD A cross-sectional, online survey using a convenience sample of people with cancer was recruited via UK cancer charities. Eligibility criteria included having received treatment and follow-up care for any type of cancer in the UK during the previous 10 years. Univariate analysis was conducted using SPSS. RESULTS 136 people with cancer participated in this survey. The majority of participants reported having experienced a worsening of their sexual lives, which bothered them. Whilst 33.6% of the sample (n = 125) reported having discussed sexual health during their cancer care, only 5.4% reported that a healthcare professional initiated a pre-treatment discussion about the sexual side effects of cancer treatment. CONCLUSIONS These results suggest that the proportion of participants who were provided with sufficient information to give informed consent for the sexual side effects of cancer treatment was very low. This indicates that healthcare professionals may require specific advice on how to include this topic during the informed consent process.
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Affiliation(s)
| | - David Culliford
- National Institute of Health and Care Research, Applied Research Collaboration Wessex. Southampton Science Park, Innovation Centre, 2 Venture Road, Chilworth, Southampton, SO16 7NP, UK; University of Southampton, School of Health Sciences, Southampton, SO17 1BJ, UK
| | - Tracy Glen
- Dorset County Hospital NHS Foundation Trust, Williams Avenue, Dorchester, Dorset, DT1 2JY, UK
| | | | - Zoë A Sheppard
- Dorset County Hospital NHS Foundation Trust, Williams Avenue, Dorchester, Dorset, DT1 2JY, UK
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Adequacy of sexual care information given to prostate cancer patients receiving radical external beam radiotherapy. JOURNAL OF RADIOTHERAPY IN PRACTICE 2022. [DOI: 10.1017/s1460396922000310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Abstract
Background:
Despite the acknowledged value of providing prostate radiotherapy patients with sexual dysfunction (SD) information, there is little evidence related to patient perceptions of this or the extent to which information is provided to them. This study aimed to critically evaluate the quality and format of SD information given to patients before, during and after radical EBRT to treat prostate cancer.
Method:
Members of UK prostate cancer support groups were asked to complete an anonymous online survey tool seeking opinions of the SD information they were given before, during and after external beam radiotherapy (EBRT).
Results:
There were 56 responses to the survey with over 42% of respondents reporting that they had not received any SD information. Of those who did, 78·1% (25/32) received information before the start of EBRT. Physicians were the most involved in the provision of SD information, with nurses and therapeutic radiographers being underutilised. Responses were mostly negative, or neutral regarding the quality of SD information and the information received about impact on relationships, psychological and emotional health. Many participants wanted more information and support.
Conclusion:
This study demonstrates that prostate cancer patients who have undergone radical EBRT have not received adequate information relating to potential sexual function side effects and the psychological and emotional effects of SD. This information should be included in verbal and written information provided at all stages of the radiotherapy pathway.
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Wittmann D, Mehta A, Bober SL, Zhu Z, Daignault-Newton S, Dunn RL, Braun TM, Carter C, Duby A, Northouse LL, Koontz BF, Glodé LM, Brandon J, Bangs R, McPhail J, McPhail S, Arab L, Paich K, Skolarus TA, An LC, Nelson CJ, Saigal CS, Chen RC, Mulhall JP, Hawley ST, Hearn JWD, Spratt DE, Pollack CE. TrueNTH Sexual Recovery Intervention for couples coping with prostate cancer: Randomized controlled trial results. Cancer 2022; 128:1513-1522. [PMID: 34985771 DOI: 10.1002/cncr.34076] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 11/22/2021] [Accepted: 11/30/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND Despite significant sexual dysfunction and distress after localized prostate cancer treatment, patients typically receive only physiologic erectile dysfunction management. The authors performed a randomized controlled trial of an online intervention supporting couples' posttreatment recovery of sexual intimacy. METHODS Patients treated with surgery, radiation, or combined radiation and androgen deprivation therapy who had partners were recruited and randomized to an online intervention or a control group. The intervention, tailored to treatment type and sexual orientation, comprised 6 modules addressing expectations for sexual and emotional sequelae of treatment, rehabilitation, and guidance toward sexual intimacy recovery. Couples, recruited from 6 sites nationally, completed validated measures at the baseline and 3 and 6 months after treatment. Primary outcome group differences were assessed with t tests for individual outcomes. RESULTS Among 142 randomized couples, 105 patients (mostly surgery) and 87 partners completed the 6-month survey; this reflected challenges with recruitment and attrition. There were no differences between the intervention and control arms in Patient-Reported Outcomes Measurement Information System Global Satisfaction With Sex Life scores 6 months after treatment (the primary outcome). Three months after treatment, intervention patients and partners reported more engagement in penetrative and nonpenetrative sexual activities than controls. More than 73% of the intervention participants reported high or moderate satisfaction with module content; more than 85% would recommend the intervention to other couples. CONCLUSIONS Online psychosexual support for couples can help couples to connect and experience sexual pleasure early after treatment despite patients' sexual dysfunction. Participants' high endorsement of the intervention reflects the importance of sexual health support to couples after prostate cancer treatment. LAY SUMMARY This study tested a web-based program supporting couples' sexual recovery of sexual intimacy after prostate cancer treatment. One hundred forty-two couples were recruited and randomly assigned to the program (n = 60) or to a control group (n = 82). The program did not result in improvements in participants' satisfaction with their sex life 6 months after treatment, but couples in the intervention group engaged in sexual activity sooner after treatment than couples in the control group. Couples evaluated the program positively and would recommend it to others facing prostate cancer treatment.
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Affiliation(s)
- Daniela Wittmann
- Department of Urology, University of Michigan, Ann Arbor, Michigan
| | - Akanksha Mehta
- Department of Urology, Emory University, Atlanta, Georgia
| | - Sharon L Bober
- Sexual Health Program, Dana-Farber Cancer Institute, Boston, Massachusetts
- Department of Psychiatry, Harvard University, Boston, Massachusetts
| | - Ziwei Zhu
- Department of Urology, University of Michigan, Ann Arbor, Michigan
| | | | - Rodney L Dunn
- Department of Urology, University of Michigan, Ann Arbor, Michigan
| | - Thomas M Braun
- Department of Urology, University of Michigan, Ann Arbor, Michigan
| | - Caroline Carter
- Department of Urology, University of Michigan, Ann Arbor, Michigan
| | - Ashley Duby
- Department of Urology, University of Michigan, Ann Arbor, Michigan
| | | | - Bridget F Koontz
- Department of Radiation Oncology, Duke University, Durham, North Carolina
| | - L Michael Glodé
- School of Medicine, Medical Oncology, University of Colorado, Aurora, Colorado
| | | | | | | | | | - Lenore Arab
- Department of Urology, University of California Los Angeles, Los Angeles, California
| | | | - Ted A Skolarus
- Department of Urology, University of Michigan, Ann Arbor, Michigan
- VA Health Services Research & Development, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan
| | - Lawrence C An
- Department of Urology, University of Michigan, Ann Arbor, Michigan
| | - Christian J Nelson
- Male Sexual and Reproductive Medicine Program, Memorial Sloan Kettering, New York, New York
- Psychiatry Service, New York, New York
| | - Christopher S Saigal
- Department of Urology, University of California Los Angeles, Los Angeles, California
| | - Ronald C Chen
- Department of Urology, University of California Los Angeles, Los Angeles, California
| | - John P Mulhall
- Center for Sexual and Reproductive Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Sarah T Hawley
- Department of Urology, University of Michigan, Ann Arbor, Michigan
| | - Jason W D Hearn
- Department of Urology, University of Michigan, Ann Arbor, Michigan
- Department of Radiation Oncology, Duke University, Durham, North Carolina
| | - Daniel E Spratt
- Department of Urology, University of Michigan, Ann Arbor, Michigan
- Department of Radiation Oncology, Duke University, Durham, North Carolina
| | - Craig E Pollack
- Department of Health Policy and Management I School of Medicine, Johns Hopkins University, Baltimore, Maryland
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