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Men’s sexual help-seeking and care needs after radical prostatectomy or other non-hormonal, active prostate cancer treatments

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Abstract

Objective

To examine prostate cancer (PCa) survivors’ sexual help-seeking intentions, behaviours, and unmet needs.

Methods

In this prospective cohort study, men who underwent active, non-hormonal treatment completed baseline (N = 558) and 6-month follow-up (N = 387) questionnaires. Theory of planned behaviour (TPB) constructs (sexual help-seeking intention, perceived behavioural control (PBC), subjective norm, attitude), masculine values (e.g., sexual importance/priority, emotional self-reliance), sex life and functioning, sexual supportive care needs, distress (anxiety, depression), and sexual help-seeking behaviour were assessed.

Results

Most men (M age = 64.6 years; M years post-diagnosis = 4.0) received prostatectomy (93%), reported severe erectile dysfunction (52%), ≥ 1 unmet sexual care need (66%), and sought help from a doctor (baseline 52%, follow-up 42%). Sexual care needs were significantly associated with poorer erectile function, reduced satisfaction with sex-life, valuing sex as important/integral to identity (masculine values), and increased depression (p ≤ 0.001). Sexual help-seeking intentions were significantly associated with valuing sex as important/integral to identity, recent help-seeking, greater confidence/control, perceiving support from important others, and positive attitudes, for sexual help-seeking (p < 0.001). Significant predictors of sexual help-seeking (follow-up) were baseline intentions, recent help-seeking (p < 0.001), and increased anxiety (p < 0.05).

Conclusions

Men’s unmet sexual care needs, sexual help-seeking intentions, and behaviour appear driven by the importance/value attributed to sex, distress, positive feelings, support from others, and confidence for help-seeking. Psychosocial providers are well-placed to address men’s concerns, yet few sought their assistance. Interventions to improve men’s access to effective sexual care are needed, particularly focused on reframing masculine values about the importance of sex and leveraging TPB-based predictors of help-seeking.

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Acknowledgements

We thank Leah Zajdlewicz, Dr John Yaxley, Ms Mary Cremin, Mr Graham Woodside, and Dr Anthony Lowe for their assistance on the project.

Funding

This study was funded by the Centre for Research Excellence in Prostate Cancer Survivorship (CRE-PCS), National Health and Medical Research Council Centre for Research Excellence 2016–2020 APP1098042. John Oliffe is supported by a Canada Research Chair (Tier 1) in Men’s Health Promotion.

Author information

Authors and Affiliations

  1. School of Psychology, The University of Queensland, Brisbane, Queensland, Australia

    Melissa K. Hyde

  2. Menzies Health Institute Queensland, Griffith University, Southport, Queensland, Australia

    Melissa K. Hyde, Kirstyn Laurie, Jeff Dunn & Suzanne K. Chambers

  3. Freemasons Foundation Centre for Men’s Health, Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia

    Melissa Opozda, Andrew D. Vincent & Gary Wittert

  4. Centre for Nutrition and Gastrointestinal Research, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia

    Melissa Opozda, Andrew D. Vincent & Gary Wittert

  5. School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada

    John L. Oliffe

  6. Department of Nursing, University of Melbourne, Melbourne, Victoria, Australia

    John L. Oliffe

  7. Department of Psychiatry and Behavioural Sciences, Memorial Sloane Kettering Cancer Centre, New York, NY, USA

    Christian J. Nelson

  8. Cancer Research Centre, Cancer Council Queensland, Brisbane, Queensland, Australia

    Jeff Dunn

  9. Institute for Resilient Regions, University of Southern Queensland, Toowoomba, Queensland, Australia

    Jeff Dunn & Suzanne K. Chambers

  10. Prostate Cancer Foundation of Australia, Sydney, New South Wales, Australia

    Jeff Dunn

  11. University of Technology Sydney, Sydney, New South Wales, Australia

    Jeff Dunn & Suzanne K. Chambers

  12. Department of Urology, Princess Alexandra Hospital, University of Queensland, Brisbane, Queensland, Australia

    Eric Chung

  13. AndroUrology Centre, Brisbane, Queensland, Australia

    Eric Chung

  14. St Andrew’s War Memorial Hospital, Brisbane, Queensland, Australia

    Michael Gillman

  15. Department of Urology, St James’s Hospital, Dublin, Ireland

    Rustom P. Manecksha

  16. Department of Urology, Tallaght University Hospital, Dublin, Ireland

    Rustom P. Manecksha

  17. Department of Surgery, Trinity College Dublin, Dublin, Ireland

    Rustom P. Manecksha

  18. Exercise Medicine Research Institute, Edith Cowan University, Perth, Western Australia, Australia

    Suzanne K. Chambers

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  1. Melissa K. Hyde
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Correspondence to Melissa K. Hyde.

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Conflict of interest

Melissa Hyde, Melissa Opozda, Kirstyn Laurie, Andrew Vincent, John Oliffe, Christian Nelson, Jeff Dunn, Eric Chung, Michael Gillman, Rustom Manecksha, and Suzanne Chambers have nothing to disclose. Gary Wittert reports grants and non-financial support from Bayer Schering and personal fees from Besins Health Care, outside the submitted work.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institution and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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A presentation based on this paper was presented at Cancer Survivorship 2019, Sydney, Australia.

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Hyde, M.K., Opozda, M., Laurie, K. et al. Men’s sexual help-seeking and care needs after radical prostatectomy or other non-hormonal, active prostate cancer treatments. Support Care Cancer 29, 2699–2711 (2021). https://doi.org/10.1007/s00520-020-05775-5

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