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Sexual satisfaction in prostate cancer: a multi-group comparison study of treated patients, patients under active surveillance, patients with negative biopsy, and controls

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Abstract

Purpose

Erectile function changes after prostate cancer (PCa) treatment are well documented, but less understood is the relative impact of prostate biopsy and active surveillance on sexual well-being. It is unknown whether potential negative impacts are exclusive to patients who have been treated for PCa, or whether the diagnosis itself or the experience of biopsy may also impact sexual well-being. Sexual satisfaction is an important yet understudied indicator of sexual well-being in this population. This study examines sexual satisfaction and its predictors across several comparison groups to explore relative impact.

Methods

At baseline and 12 months, questionnaire data was collected in four samples: (1) following PCa treatment, (2) active surveillance, (3) negative prostate biopsy result, and (4) controls receiving no biopsy or treatment. Predictors assessed included group, erectile function, communication style, and partner involvement.

Results

Sexual satisfaction declined in the active treatment group, no changes were observed in active surveillance or non-PCa control, and improvements were observed in the biopsy group. Predictors of sexual satisfaction over and above erectile function included restrictive communication (i.e. protective buffering) and perceived partner involvement. For higher levels of erectile function, a higher perceived degree of partner involvement was protective of sexual satisfaction.

Conclusion

Sexual satisfaction is an important indicator of sexual well-being and is negatively impacted following PCa treatment, but not active surveillance or prostate biopsy.

Implications for Cancer Survivors

Communication and partner involvement are potentially modifiable factors to be considered for intervention and may promote sexual satisfaction following PCa treatment. Patients experiencing negative biopsy, who note lower sexual satisfaction may experience improved satisfaction with time, and those under active surveillance who worry about sexual satisfaction may find reassurance from these results.

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Funding

Funding was provided for this study by a Rising Star independent investigator grant from Movember and Prostate Cancer Canada (now the Canadian Cancer Society) Grant # RS2015-03.

Author information

Authors and Affiliations

  1. Department of Oncology and Psychology, University of Calgary. Tom Baker Cancer Centre – Holy Cross Site, Psychosocial Resources, 2202 – 2nd St SW, Calgary, AB, T2S 3C1, Canada

    Lauren M. Walker

  2. Department of Psychology, Cape Breton University, Sydney, Canada

    Pablo Santos-Iglesias

Authors
  1. Lauren M. Walker
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  2. Pablo Santos-Iglesias
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Contributions

All authors contributed to the study design, data collection and analysis, and design and writing of the manuscript.

Corresponding author

Correspondence to Lauren M. Walker.

Ethics declarations

Ethics approval

Research Ethics Board approval was obtained for this study from the Research Ethics Board of Alberta – Cancer Committee.

Consent to participate

All participants provided informed consent.

Consent for publication

Consent to publish was obtained.

Competing interests

Dr. Lauren Walker’s work is supported unrestricted educational grants for the Androgen Deprivation Therapy Educational Program (www.LifeonADT.com). These grants are administered by the Prostate Cancer Centre in Calgary, Alberta for the Canadian Program (by Tolmar, Astellas, Novartis, Pfizer) and by the European Association of Urology for the Europe Programme (Bayer, Astellas).

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Walker, L.M., Santos-Iglesias, P. Sexual satisfaction in prostate cancer: a multi-group comparison study of treated patients, patients under active surveillance, patients with negative biopsy, and controls. J Cancer Surviv (2023). https://doi.org/10.1007/s11764-023-01420-2

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