The Prostate Cancer Rehabilitation Clinic: A Biopsychosocial Clinic for Sexual Dysfunction after Radical Prostatectomy

Abstract

Purpose The most prevalent intervention for localized prostate cancer (pca) is radical prostatectomy (rp), which has a 10-year relative survival rate of more than 90%. The improved survival rate has led to a focus on reducing the burden of treatment-related morbidity and improving the patient and partner survivorship experience. Post-rp sexual dysfunction (sdf) has received significant attention, given its substantial effect on patient and partner health-related quality of life. Accordingly, there is a need for sdf treatment to be a fundamental component of pca survivorship programming.Methods Most research about the treatment of post-rp sdf involves biomedical interventions for erectile dysfunction (ed). Although findings support the effectiveness of pro-erectile agents and devices, most patients discontinue use of such aids within 1 year after their rp. Because side effects of pro-erectile treatment have proved to be inadequate in explaining the gap between efficacy and ongoing use, current research focuses on a biopsychosocial perspective of ed. Unfortunately, there is a dearth of literature describing the components of a biopsychosocial program designed for the post-rp population and their partners.Results In this paper, we detail the development of the Prostate Cancer Rehabilitation Clinic (pcrc), which emphasizes multidisciplinary intervention teams, active participation by the partner, and a broad-spectrum medical, psychological, and interpersonal approach.Conclusions The goal of the pcrc is to help patients and their partners achieve optimal sexual health and couple intimacy after rp, and to help design cost-effective and beneficial rehabilitation programs.

An online Sexual Health and Rehabilitation eClinic (TrueNTH SHAReClinic) for prostate cancer patients: a feasibility study

“…Consequently, the data is inadequate to support any specific penile rehabilitation regimen [ 22 ]. Biopsychosocial interventions have been developed that take a more holistic approach to addressing SD following PC treatment [ 23 ]. The biopsychosocial approach encompasses both a biomedical and a psychosocial component.…”

“…The TrueNTH SHAReClinic is based on a broad definition of penile rehabilitation focused on applying a systematic pro-erectile aid regimen to assist patients in achieving long-term return of erectile functioning, firm enough for penetration, with or without the use of pro-erectile agents/devices. We have termed this biomedical rehabilitation approach, erectile rehabilitation [ 23 ]. TrueNTH SHAReClinic helps patients find and adapt to the least invasive pro-erectile agent/device that is successful in achieving desired erections.…”

“…To evaluate the effectiveness of the TrueNTH SHAReClinic sexual health and rehabilitation intervention, we plan to compare it to (1) best-practice for parallel outcomes for the face-to-face program at the Princess Margaret Cancer Centre’s Prostate Cancer Rehabilitation Clinic [ 23 ]; (2) empirical evidence extracted from a systematic literature review; and (3) pre-post data at 1 year follow-up versus baseline data. The overall aim, however, of the present study was to evaluate the feasibility of undertaking a single arm, prospective comparative study of the TrueNTH SHAReClinic as a web-based, pan-Canadian, sexual health and rehabilitation intervention for men treated for PC.…”

Virtual care models for cancer survivorship

“…Improvements in cancer screening and therapy have increased survival rates in Canada to 95% for prostate cancer, and 87% for breast cancer, with the number of surviving patients increasing correspondingly 4,5 . However, survivors are often left with myriad post-treatment functional impairments and psychosocial and mental health challenges that negatively impact their quality of life 6,7 .…”

Clinic Utilization and Characteristics of Patients Accessing a Prostate Cancer Supportive Care Program’s Sexual Rehabilitation Clinic

“…This model of survivorship care allows cancer survivors and their partners to enter a multidisciplinary program that provides disease and patient-specific care plans. Despite increased interest in this treatment model, there is scant literature surrounding these programs with regard to efficacy [ 12 ].…”