Counseling patients about sexual health when considering post-prostatectomy radiation treatment

Wittmann, Daniela; Montie, James E.; Hamstra, Daniel A.; Sandler, Howard M.; Wood, David P.

doi:10.1038/ijir.2009.32

Cited by 12 publications

(9 citation statements)

References 81 publications

(75 reference statements)

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“…A multidisciplinary approach is important and effective for sexual recovery . Clinicians can prescribe medication to assist with erectile function.…”

Section: Assessment and Management Of Physical And Psychosocial Effecmentioning

confidence: 99%

American Cancer Society prostate cancer survivorship care guidelines

Skolarus

Wolf

Erb

et al. 2014

CA A Cancer J Clinicians

357

320

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https://www.wileyhealthlearning.com/acs.aspx Prostate cancer survivors approach 2.8 million in number and represent 1 in 5 of all cancer survivors in the United States. While guidelines exist for timely treatment and surveillance for recurrent disease, there is limited availability of guidelines that facilitate the provision of posttreatment clinical follow‐up care to address the myriad of long‐term and late effects that survivors may face. Based on recommendations set forth by a National Cancer Survivorship Resource Center expert panel, the American Cancer Society developed clinical follow‐up care guidelines to facilitate the provision of posttreatment care by primary care clinicians. These guidelines were developed using a combined approach of evidence synthesis and expert consensus. Existing guidelines for health promotion, surveillance, and screening for second primary cancers were referenced when available. To promote comprehensive follow‐up care and optimal health and quality of life for the posttreatment survivor, the guidelines address health promotion, surveillance for prostate cancer recurrence, screening for second primary cancers, long‐term and late effects assessment and management, psychosocial issues, and care coordination among the oncology team, primary care clinicians, and nononcology specialists. A key challenge to the development of these guidelines was the limited availability of published evidence for management of prostate cancer survivors after treatment. Much of the evidence relies on studies with small sample sizes and retrospective analyses of facility‐specific and population databases. CA Cancer J Clin 2014;64:225–249. © 2014 American Cancer Society.

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“…A multidisciplinary approach is important and effective for sexual recovery . Clinicians can prescribe medication to assist with erectile function.…”

Section: Assessment and Management Of Physical And Psychosocial Effecmentioning

confidence: 99%

American Cancer Society prostate cancer survivorship care guidelines

Skolarus

Wolf

Erb

et al. 2014

CA A Cancer J Clinicians

357

320

View full text Add to dashboard Cite

show abstract

“…Many clinicians are aware that both patient and partner‐related factors are important to sexual recovery following treatment for prostate cancer. Men and their partners want to be informed and involved in making decisions with regard to their cancer treatment and management of ED .…”

Section: Resultsmentioning

confidence: 99%

“…Erectile dysfunction prevalence after RT is estimated to be 67–85% and may take up to 24 months to develop . RT has an impact on vascular structures leading into and within the penis and radiation damage to these structures mediates the decline observed in erectile function (EF) . More specifically, endothelial cell damage and microvessel rupture lead to luminal stenosis and arterial insufficiency over a period of months or years after radiation exposure .…”

Section: Introductionmentioning

confidence: 99%

Development of UK guidance on the management of erectile dysfunction resulting from radical radiotherapy and androgen deprivation therapy for prostate cancer

et al. 2014

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AimTo develop a management strategy (rehabilitation programme) for erectile dysfunction (ED) after radiotherapy (RT) or androgen deprivation therapy (ADT) for prostate cancer that is suitable for use in a UK NHS healthcare context.MethodsPubMed literature searches of ED management in this patient group together with a survey of 28 experts in the management of treatment-induced ED from across the UK were conducted.ResultsData from 19 articles and completed questionnaires were collated. The findings discussed in this article confirm that RT/ADT for prostate cancer can significantly impair erectile function. While many men achieve erections through PDE5-I use, others need combined management incorporating exercise and lifestyle modifications, psychosexual counselling and other erectile aids. This article offers a comprehensive treatment algorithm to manage patients with ED associated with RT/ADT.ConclusionBased on published research literature and survey analysis, recommendations are proposed for the standardisation of management strategies employed for ED after RT/ADT. In addition to implementing the algorithm, understanding the rationale for the type and timing of ED management strategies is crucial for clinicians, men and their partners.

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“…Exploring such activities should be encouraged as a complement to ED therapies and as a pathway to sexual recovery when adequate erectile function cannot be restored ( Figure 1). 34,48,53,114,116 Even if a patient finds an ED treatment that is effective for him it might not always be reliable. Anticipating erectile failures as an inevitable part of the recovery process will reduce the chance of patients abandoning ED treatments and sexual activity al together.…”

Section: Promote Flexibilitymentioning

confidence: 98%

“…48,52 Preemptive ED education should allow for problems to be anticipated and addressed before they occur. 53 In addition, realistic information about the effort required to produce an acceptable erection can provide a buffer against a patient's personal sense of failure when ED treatments are ineffective. A sense of failure-once established-is hard to reverse.…”

Section: Foster Realistic Expectationsmentioning

confidence: 99%

Psychosocial perspectives on sexual recovery after prostate cancer treatment

Walker¹,

Wassersug

Robinson³

2015

Nat Rev Urol

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Many therapies for erectile dysfunction (ED) after prostate cancer treatment improve erectile firmness, yet, most couples stop using aids within 1-2 years. Patients and partners who expect immediate and complete success with their first ED treatment can be demoralized when they experience treatment failure, which contributes to reticence to explore other ED aids. Comprehensive patient education should improve sustainability and satisfaction with ED treatments. Pre-emptive and realistic information should be provided to couples about the probability of recovering natural erections. Beginning intervention early and using a couple-based approach is ideal. Recommendations are provided about the timing of ED treatment, the order of aid introduction, and combination therapies. Renegotiation of sexual activity is an essential part of sexual adaptation. From the outset of therapy, couples should be encouraged to broaden their sexual repertoire, incorporate erection-independent sexual activities, and continue to be sexual despite ED and reduced libido.

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Counseling patients about sexual health when considering post-prostatectomy radiation treatment

Cited by 12 publications

References 81 publications

American Cancer Society prostate cancer survivorship care guidelines

American Cancer Society prostate cancer survivorship care guidelines

Development of UK guidance on the management of erectile dysfunction resulting from radical radiotherapy and androgen deprivation therapy for prostate cancer

Psychosocial perspectives on sexual recovery after prostate cancer treatment

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