Table 2 Extracted data from original studies with quality rating scores

Allensworth-Davies et al. (2016) (USA)

To identify factors associated with masculine self-esteem in gay men following treatment for localized PCa and to determine the association between masculine self-esteem, PCa-specific factors, and mental health factors in these patients

A quantitative cross-sectional survey of gay PCa survivors (n = 111) with questionnaire

Stigma experienced by GBM as part of their sexual orientation, magnified the risk associated with poor mental health among gay elders. This finding suggests that open communication with one’s PCa physician may be an important factor in a gay man’s recovery from PCa. Given that few PCa support groups exist specifically for gay men, increased opportunities for speaking openly and in a safe environment about treatment concerns and changes in sexual function could benefit post-treatment QoL for GBM

Amarasekera et al. (2020) (USA)

To determine if there are sexual function domains relevant to gay men that are not captured by the Expanded Prostate Cancer Index Composite (EPIC) sexual function assessment

Quantitative online survey regarding the applicability of the sexual function domain in the validated EPIC question with Gay men (n = 53) diagnosed with PCa

Sexual function in gay men relating to receptive anal intercourse is measured incompletely when assessing sexual function after PCa treatment. There is a decline in health-related quality of life after PCa treatment in GBM and increased rates of psychological distress from erectile dysfunction

Capistrant et al. (2016) (USA)

To investigate the availability and provision of social support for gay and bisexual men with prostate cancer (GBMPCa)

A qualitative data from in‐depth, semi structured, one‐on‐one telephone interviews of GBM (n = 30) with PCa. Inductive and deductive codes were used to identify themes about social support provided to GBMPCa during diagnosis and treatment

Participants expressed wanting more in‐person support groups specifically for GBMPCa to make them feel more at ease when talking with other gay men. The participants also expressed the need of having people attend appointments with them. They wanted to hear directly from first hand experiences and to aid in their own decision-making process regarding treatment. Men were selective as to whom they talked to regarding sexual side effects

Doran et al. (2018) (UK)

To highlight the needs of gay men with prostate cancer, and their experiences of healthcare provision

A phenomenological research method was used to collect and analyse data. In‐depth interviews were conducted with gay men (n = 12) who had been diagnosed with prostate cancer

Participants wanted, and expected, candid discussions with HCPs, about how prostate cancer could affect their lives, sexual function, and how to access culturally relevant support before and after treatment. Information provided to GBM was perceived as being misplaced or informed by heteronormative assumptions. Information concerning medication and devices to aid or enhance sexual function was frequently sought using the internet as participants were reluctant to discuss their concerns with their healthcare provider. Participants described the need for male health professionals to show sensitivity and understanding by offering information and advice

Dowsett et al. (2014) (Australia)

To explore forms of sexual practice engaged in by men following treatment for PCa

An international online survey was conducted in 2010–2011 of men treated for PCa, where participants (n = 558) were asked explicitly about their sexual practices before and after PCa treatment

The number of males practicing being the insertive partner declined with PCa treatment due to erectile dysfunction. Many nonheterosexual men continued to be sexually active by switching from insertive to receptive

Jägervall et al. (2019) (Sweden)

To determine specific concerns of gay men’s post-prostate cancer treatment sexual practices

A qualitative study design was deployed using semi-structured interviews. self-identifying gay men (n = 11) aged 58–81 years and treated for PCa were interviewed

The need to emphasise the value of distinguishing between sexual identity and sexual practice when designing rehabilitation programmes for GBM with PCa should be considered by healthcare professionals. Men diagnosed with PCa identifying as gay or bisexual experience lacking sexual communication in interactions with health professionals

Lee et al. (2015) (Canada)

To explore post-PCa treatment sexual concerns for a sample of men-who-have-sex-with-men (MSM)

Qualitative methodology with individual semi-structured interviews of MSM (n = 16) either face-to-face or via Internet-based video conferencing. Participants were asked open-ended questions about their experiences of sexual QoL following PCa

The need to incorporate GBM sexual practices and preferences specifically into treatment decisions. The need for psychosocial support, information pamphlets and support groups targeted to or inclusively for MSM. Some men were also uncomfortable disclosing their sexual orientation in PCa support group settings

Lee et al. (2013) (Canada)

To evaluate post-treatment QoL in PCa patients who are MSM, and to investigate the utility of current QoL assessment tool

Qualitative study involving PCa patients treated with surgery and/or radiation were recruited from the local MSM community. Each participant completed the Expanded Prostate Cancer Index Composite (EPIC) questionnaire, Male Sexual Health Questionnaire (MSHQ), and a questionnaire focused on insertive and receptive roles of anal intercourse

The need for validated questionnaires targeted to GBM population as current instruments assessing sexual QoL may not be applicable or valid for PCa patients who have sex with men. Some medical professionals may continue to feel uncomfortable treating MSM. The lack of historical acceptance, continued perceptions in the medical community, and psychosocial barriers in the MSM community are challenges that have contributed to the current knowledge gap

Mehta et al. (2019) (USA)

To investigate what prostate cancer survivors and their partners want from a sexual recovery intervention, and whether they consider an online tool acceptable for use in promoting sexual recovery

A mixed-methods study with focus groups and interviews. Participants included both heterosexual and gay cancer survivors, as well as their partners

Lack of knowledge about the sexual side effects of PCa treatments, due to their healthcare provider focusing on cancer control only, rather than the impact of cancer therapies on long-term quality of life. physicians may be unwilling to discuss the sexual side effects of treatment for fear that patients would be unwilling to undergo cancer treatment due to the potential side effects. The need for better pretreatment counseling and emotional preparation about side effects and realistic expectations for recovery

McConkeya and Holbor, (2018) (UK)

To explore the lived experience of gay men with PCa

A qualitative methodological approach employing phenomenological method was used to collect and analyse data from eight (8) gay men treated for PCa

Gay men with PCa have unmet information and supportive care needs. The need for information related to the impact of sexual dysfunction and associated rehabilitation, negatively impacting their quality of life. Some men were uncomfortable with their healthcare providers due to issues associated with heteronormativity, minority stress, and stigma. There is the need for healthcare providers to update PCa education programmes to cater for the needs of GBM

Rose et al., (2016) (USA, Canada, UK, and New Zealand)

To examine GBM’s experiences of sexual communication with HCPs since the onset of PCa

A mixed method study comprising of a survey of GBM (n = 124) with PCa and male partners (n = 21), and interviewed a sub-sample of GBM (n = 46) and male partners (n = 7)

GBM perceived their communication with HCPs as challenging. Medical support was prioritised over sexual and psychological support. HCPs assumed; heterosexuality of GB patients making it difficult for the patients to disclose their sexual orientation. GBM perceived rejection or lack of interest and knowledge from a majority of HCPs with regard to gay sexuality and the impact of PCa on GBM

Rosser et al. (2019) (USA)

To assess the effects of treatment of PCa on GBM’s sexual behaviour

An online survey of gay and bisexual men with prostate cancer (n = 193) were recruited from North America's largest online cancer support group. Sexual functioning was measured using the Expanded Prostate Cancer Index Composite (EPIC) and a tailored Gay Sexual Functioning Inventory (GSFI)

GBM participants scored significantly worse on overall mental health compared to published results for other PCa survivors. The risk of HIV and STI after PCa treatment was a major concern for those GBM who received surgery as few GBM who engaged in insertive anal sex reported using condoms, with most citing erection difficulties as the underlying reason for non-condom use. Clinicians asking about sexual orientation could improve clinical practice

Ussher et al. (2016) (Australia)

To examine the meaning and consequences of erectile dysfunction and other sexual changes in GBM with PCa and male partners

A combination of on-line survey and one-to-one interviews was used to examine the meaning and consequences of sexual changes after PCa for GBM (n = 124) and male partners (n = 21)

Erectial dysfunction associated with reports of emotional distress, negative impact on gay identities, and feelings of sexual disqualification was reported by the participants. Feelings of exclusion from a sexual community central to GBM’s lives due to sexual challenges associated with their treatment of PCa

Wassersug et al. (2013) (USA, Australia, Canada, UK, and New Zealand)

To determine if heterosexual and nonheterosexual men treated for PCa differ in diagnostic and treatment outcomes and in various measures of physical health, sexual function, and wellbeing, before and after the treatment

Self-identified heterosexual (n = 460) and self-identified nonheterosexual men (n = 96) completed an online survey. The men in the 2 groups were then compared using logistic regressions that controlled for differences among countries

Non-heterosexual men received a diagnosis of PCa at an earlier cancer stage than heterosexual men, due to knowing the importance of getting tested. There was no difference in PC treatments or side effects of urinary incontinence or erectile dysfunction for non-heterosexual and heterosexual men. The only area where both populations diverged was in the loss of ejaculation, with non-heterosexual men finding this more distressing

West et al. (2021) (USA)

To investigate the experience of communicating sexual orientation by GBM and MSM to physicians involved in their prostate cancer care

A qualitative analysis conducted on GBM (n = 30) with in-depth interviews

Participants expressed difficulty in disclosing being GBM with their doctors as. GBM with PCa feel that their relationship with their specialist(s) is extremely important and need to be able to trust their physicians

Wheldon et al. (2022) (USA)

To explore the impact of prostate cancer and its treatments on RAI among GBM

A quantitative cross-sectional online survey of GBM prostate cancer survivors (n = 100) who reported pleasurable RAI prior to treatment

23% of the men who had attempted recent RAI reported having Anodyspareunia which was negatively associated with mental health, performing oral sex on a partner, and bowel function. The overwhelming majority received no information from their healthcare providers about loss of RAI function prior to prostate cancer treatment. Culturally responsive cancer survivorship care may need to address the loss of RAI function for GBM PCa survivors