Access to and experiences of medication, devices, and support for sexual dysfunction in men with prostate cancer: finding from a UK-wide study


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Eila Watson1,Sarah Wilding2,Lauren Matheson1,Eilis McCaughan3,Jo Brett1,Amy Downing2,Penny Wright2,Adam Glaser2,Anna Gavin4,Richard Wagland5
1Oxford Brookes University,2University of Leeds,3Ulster University,4Queens University Belfast,5University of Southampton

Abstract

Background

Sexual dysfunction is common following diagnosis and treatment of prostate cancer, and can have a significant impact on psychological morbidity and quality of life for men and their intimate partners. We explored men’s access to and experiences of medications, devices and services to help with sexual functioning.

Method

As part of a UK-wide  survey of men 18-42 months post-prostate cancer diagnosis (Life After Prostate Cancer Diagnosis study), we explored access to and experience of medications, devices, and specialist services in respondents who reported poor sexual function which they considered a moderate/big problem (Expanded Prostate cancer Index Composite short form (EPIC-26)).  Free-text responses to open survey questions were analysed using thematic analysis to enrich understanding of men’s experiences. 

Results

13,974 men (41.3% of overall sample) reported poor sexual function which was a moderate/big problem. 51% (7,027) were not offered any intervention to aid sexual functioning.  Men were most commonly offered medications (n=6,374; 46.2%), with smaller proportions offered devices (n=3,714; 26.9%) and specialist services (n=2,106; 15.3%).Of men who were offered and had tried intervention, 49% (2,367) found it helpful.  Free-text responses revealed a) health care service and personal barriers to accessing support, such as embarrassment, negative beliefs, side-effects, poor timing of support/information  and a disconnect between secondary and primary care services; b) barriers to continuing use of sexual aids, such as medication ineffectiveness and inadequate ongoing support/medication supply; and c) drivers of recovery of sexual functioning, such as the man’s proactivity, motivation and persistence at trying different sexual aids/devices, and ongoing support from health professionals with different options.

 

Conclusion

Findings highlight significant shortcomings in the help available to men with sexual dysfunction following prostate cancer, and a pressing need to improve services for the growing number of prostate cancer survivors. 

The study was funded by the Movember Foundation, in partnership with Prostate Cancer UK.