The female partners of patients with prostate cancer may experience quality-of-life issues that impact their sexual well-being, according to a recent study published by Loeb et al in European Urology Oncology.
Background
Prostate cancer—one of the most common cancer types in U.S. men—and its treatments are known to cause side effects such as erectile dysfunction and decreased libido. Although these side effects may impact patients’ partners, the details of their struggles have remained poorly understood and assessed. As a result, female partners often do not receive appropriate support from health-care providers.
In a previous study conducted in 2022, the investigators analyzed online posts written by female partners of prostate cancer survivors, expressing concerns about their sex lives and relationships. A large proportion noted they felt “invisible” to the health-care system.
Study Methods and Results
With a lack of resources available to measure the extent of these issues and track them over time, the investigators designed a formal questionnaire to evaluate the sexual health of 200 female partners of patients with prostate cancer recruited from clinical sites, online health communities, and prostate cancer organizations across the United States—with the goal of identifying the challenges faced by these partners.
To develop the questionnaire, the investigators drafted an initial assessment using data from the 2022 analysis and hosted meetings with experts to refine the questions. The questions addressed communication, distress, feelings about loss of intimacy and connection, satisfaction with nonpenetrative sexual activity, and willingness to expand the variety of their sexual activity. The investigators then held 90-minute interviews with 12 female partners to further ascertain common experiences, determine how effectively the questions captured their sexual health concerns, and refine the questionnaire. Using a statistical analysis, they arrived at 19 questions that optimally captured and represented partners’ concerns.
The investigators found that the partners experienced difficulties communicating about their sexual needs, inadequate sexual health counseling by physicians, and feelings of isolation and loss of intimacy. The responders consistently cited loss of connection as a couple, high levels of distress, and poor communication with their spouses and health-care providers regarding the impact of sexual dysfunction from prostate cancer treatment. Additionally, they showed higher levels of depression than U.S. women in the same age groups evaluated in past studies.
Conclusions
The investigators hope the questionnaire can help physicians gauge partners’ sexual health and refer them for support. The average scores for each question could serve as a baseline of comparison for other individuals when thinking about their sexual health.
“Our findings highlight the substantial impact of prostate cancer on female partners of patients. Couples may benefit from referral to a sexual medicine specialist, sex therapy, support groups, or mental health services that focus on loss and grief and sexual rehabilitation,” emphasized lead study author Stacy Loeb, MD, Professor in the Department of Urology and Population Health and a urologist at the New York University (NYU) Grossman School of Medicine and Perlmutter Cancer Center. “Our hope is that clinicians will use our survey to help patients and their partners identify issues in their sex lives that are impacted by this common cancer and to help determine what support services could be useful. When thinking about living with prostate cancer, this is really a couples’ disease, and partners’ unmet needs should be part of the conversation,” she suggested.
The investigators have developed a website in collaboration with the Prostate Cancer Foundation to provide the new questionnaire as a free resource in addition to sexual health resources addressing key issues related to recovering sexual intimacy following prostate cancer treatment. In future studies, the investigations plan to explore the impact of prostate cancer on the sex lives of male and nonbinary partners.
Disclosure: The research in this study was supported by grants from the U.S. Department of Defense and National Institutes of Health. For full disclosures of the study authors, visit euoncology.europeanurology.com.
