Prostate Cancer & Sexuality
•
1 like•56,394 views
This presentation provides real, in-depth information from a doctor as well as prostate cancer survivors and their partners. Treatments for prostate cancer carry significant side effects that change many issues. We recognize that prostate cancer becomes a problem for the survivor and partner. Traditional concepts of masculinity and femininity often complicate the problem.
More Related Content
Similar to Prostate Cancer & Sexuality
Similar to Prostate Cancer & Sexuality (20)
Recently uploaded
Recently uploaded (20)
Prostate Cancer & Sexuality
- 2. Prostate Cancer & Sexuality Dr. Jo-an Baldwin Peters BSc MSc PhD
- 3. Dr. Jo-an Baldwin Peters BSc MSc PhD • Feels the fact that treatments for prostate cancer carry significant side effects that change many issues. • Recognizes that prostate cancer becomes a problem for the survivor and partner. • Understands that traditional concepts of masculinity and femininity often complicate the problem and the problem is ignored and not solved. • Her PhD was completed at the age 69. • As the wife of a prostate cancer survivor and an Epidemiologist Jo-an felt that partners, especially women were left out of the picture. • Jo-an is staying involved, hopeful that other women will join her.
- 4. dr.jo.an.p @ gmail.com
- 5. Prostate Cancer Sexuality Online Survey Results First Response 19 Oct 2009 Last Response 29 Oct 2010 Survivor Partner # Questions 65 45 Responses 448 203 Total Responses 651
- 6. Venezuela Australia -1% 2% Spain -1% Greece Canada -1% 19% USA Holland 77% -1% Hungary -1% Mongolia -1% Japan -1% South Africa -1% Israel UK 1% Switzerland 1% -1% France 1%
- 7. Prostate Cancer Sexuality Survey 448 Survivor Respondent Ages 30 28 Nu m b er o f r esp o n d en t s 25 23 20 15 13 10 5 2 2 0 42 46 48 50 52 54 56 58 60 62 64 66 68 70 72 74 76 78 80 82 84 Age a t r esp o n se t im e
- 8. Prostate Cancer Sexuality Survey Respondent Reported Treatments Brachy Hormone HIFU 7% Chemo 16% -1% 2% Radiation 21% Robotic 14% Cryo 2% Active Surveillance 2% Radical 36%
- 9. S25. How would you rate your ability to have a spontaneous erection after treatment for prostate cancer? Treatments/Time/Age Respondents answered “Sometimes” or “Always” Months 3 6 12 18 24 +24 Resps. Radical prostatectomy 14% 22% 26% 27% 28% 29% 144 Radical retropupic prostatectomy 13% 20% 13% 13% 20% 20% 15 Radical nerve sparing prostatectomy 25% 33% 40% 46% 42% 38% 48 Robotic prostatectomy 16% 19% 22% 22% 27% 21% 73 Radicals All 16% 23% 27% 28% 30% 28% 280 Brachytherapy/seed implants 66% 68% 73% 66% 56% 56% 41 Cryosurgery/Crotherapy 44% 44% 33% 33% 33% 44% 9 External beam radiation 50% 60% 50% 40% 50% 30% 10 Proton beam radiation 100% 60% 60% 60% 60% 60% 5 Radiation Totals 67% 60% 53% 47% 53% 40% 15 Age 50 and less 31% 13% 19% 13% 19% 13% 16 Age 50-60 23% 30% 33% 31% 31% 30% 122 Age 60-70 43% 49% 54% 55% 56% 54% 144 Age 70+ 21% 21% 24% 24% 21% 22% 102
- 10. S25 P11 How would you rate your partner's ability to have a spontaneous erection after treatment for prostate cancer? 80% 70% 60% 50% 40% 30% 20% 10% 0% Never So m et i m es Al w a ys SURVIVOR PARTNER Each category read columns left to right Within 3, 6, 12, 18, 24 and “more than 24” months
- 11. S42 S44 P28 P30 Overall how big a problem do you consider your sexual dysfunction (all respondents) 40% 35% 30% 25% 20% 15% 10% 5% 0% Su r vivo r P a r tn er P a r tn er Su r vivo r Gu es s F o r Gu es s fo r Su r vivo r P a r tn er No p r o b lem Ver y s m a ll p r o b lem Sm a ll p r o b lem M o d er a te p r o b lem B ig p r o b lem
- 12. S42 S44 P28 P30 Overall how big a problem do you consider your sexual dysfunction (all respondents) 45% 40% 35% 30% 25% 20% 15% 10% 5% 0% N o p r o b lem Ver y sm a ll Sm a ll M o d er a t e B ig p r o b lem p r o b lem p r o b lem p r o b lem Su r vivo r P a r tn er Gu es s F o r Su r vivo r P a r tn er Su r vivo r Gu es s fo r P a r tn er
- 13. S25. How would you rate your ability to have a spontaneous erection after treatment for prostate cancer? Age/Time Respondents answered “Sometimes” or “Always” 60% 50% 40% 30% 20% 10% 0% Months 3 6 12 18 24 24+ Age 5 0 a n d les s Age 5 0 -6 0 Age 6 0 -7 0 Age 7 0 +
- 14. S30 & P16 How important is it to experience an orgasm on a regular basis even if it does not result from penetrative sex? Completed the questions: 94 % Survivors, 86% Partners 70% 60% 60% 50% 42% 40% 30% 20% 8% 8% 10% 0% No t I m p o r ta n t I m p o r ta n t o r ver y im p o r ta n t Su r vivo r P a r tn er
- 15. S33 P19 Which of these forms of assistance resulted in an orgasm with or without penetration? (94% PCa Survivors & 86% of Partners answered this Question) Achieved Achieved orgasm most orgasm Response Achieved Method of the time always Count Success Rate Achieved Achieved Response Percentage Self masturbation 140 108 326 76% 29 39 93 73% Penile shots 83 49 189 71% 11 8 44 43% Mutual masturbation 31 29 84 70% 42 37 115 69% Penile implant 8 6 21 1 3 6 67% 67% 56 43 161 34 32 100 Oral sex 61% 66% Toys,vibrators,movies 16 9 42 15 15 47 56% 64% Oral medication 51 41 178 52% 24 14 76 50% Pump 11 6 40 43% 11 6 40 43% 2 0 6 33% 0 0 2 Other 0% 4 2 18 1 1 8 Urethral Supositories 33% 25% Nothing 13 12 60 42% 10 3 46 28%
- 16. Respondent Comment Sample Prostate Cancer Sexuality Online Survey
- 17. • I passed out when I self-injected. Then we went to Cialis with no positive result. Now back to injections, with my wife doing it. We have not had frequent sex beause it upsets her to do the injections and ruins the mood. Will keep trying
- 18. • We tend to keep too busy and have not been concentrating on sex lately. Levitra almost works.
- 19. • The range of time mattered a lot. It's been over two years. The first six months there was almost nothing; now after two years we can often have enjoyable sex without Viagra, although we usually do it with Viagra to be sure we have the fun we want.
- 20. • Hard to answer since most of the 12 years were satisfactory and only recently started hormone therapy which changed everything. Other issue is that I am 12 years older so always wonder what would be the natural course of my potency if I was not treated or had Prostate Cancer. Once it metastasizes and survival becomes an issue one's oersoective on the importance of sex changes. I wish there were more resources available now to both my wife and i about achieving intimacy without intercourse. She does not like to use the internet for a source.
- 21. • Some of the implications of these questions appear to center on whether of not we can have successful intercourse or not. Many men I believe must reach a point where they come to peace with the situation. Is sex more important than life. We also must learn that our partner, especially nearing age 60 is more interested in feeling loved, than having rousing sexual encounters. The intimacy that results when the man concentrates on the female's needs, and bringing her to an aroused state and orgasm is a satisfying sexual encounter for both.
- 22. • Thanks for being willing to research this area. For individuals like me, it's important to see that there are others out there that have similar issues.
- 23. • Again, I think it is important that the doctor visit with both husband and wife. I think my wife may have been more interested if she realized that my sexual desires were normal for a man of my age (65 ) at the time of surgery.
- 24. Broaden discussion/presentation topics beyond just PC treatment and fundamental incontinence and ED treatments. Emphasize that an active life, including sex, is quite achievable despite damaged plumbing. Emphasize that early PC detection is very important--every male should know this! My greatest hope is that more doctors will be told that they must address the subject of sex. If they aren't comfortable doing this, or don't have the time to do it properly, they should direct the patient & his partner to a good source of information. It's sad when the problems are not understood until they've become established, and the patient doesn't even know he could have done things to help with his rehabilitation. Lack of success achieving penetrative sex has left us with a failing desire for sex at all. We agreed prior to his operation 8 years ago that life was more important... it seems it was so easy to believe that then. We failed to appreciate how devastating it would be to a relationship. It's like losing a loved-one; the memory is dear but the loss tangible.
- 26. Thank you!
Editor's Notes
- Change the date and this could be the heading if we leave out the words “comments”
- Need to develop a heading for Our presentation,
- Need to get your name and email address up as well
- Disappointing number of Partners participating in the survey 31%. The partners have had such a “small” voice and it is sad that they missed making a larger impact on this survey.
- When broken down per Capita Canada actually had more people who did the survey.
- Fewer countries included as compared to the main survey sample of 651 respondents.
- A broad spectrum of ages ranging from 42 to 84 with the bulk in the middle age 62. A perfect bell curve.
- Some extremes and not as even a bell curve as for all 651respondents but the number are significantly smaller, 24% of the total
- The majority , 50%. of the men had some form of surgery
- After treatment penetrative sex certainly took a “nose dive” compared to pre-treatment estimates. Survivors and Partners concurred in their reports of frequency with the exception where the Partners reported more sexual activity 3 or more times per week. These were not matched partners, however.
- Examining the results of the various forms of prostatectomies the initial results were lower when compared to the other forms of treatment. The improvement over 24 months was significant with the radical nerve sparing heading the group.The radiation group on the other hand showed a significant decrease in erectile function over a 24 month period. The number of men receiving radiation was a much smaller group and these findings need to be followed up with a larger group. It must be emphasized that no matter what the treatment is there is significant erectile dysfunction.In light of the fact that there is recovery over time it is extremely important to exercise the penile tissue; oral medication started early even if it doesn’t result in an erection followed up with penile shots at 3 weeks after treatment. Some surgeons advocate a pumpIt is of interest to note that the group that had the better recovery of erectile function were in the age group 60 to 70. Why?
- The “Never” category gets less over time and the “Always” category improves over time. Partners and survivors are close to agreement except in the “Always” category when the survivors are? Truth full or optomistic?
- Partner guess for Survivor felt that he had a bigger problem than he said he had. The Partner felt the Survivor had a smaller problem than he stated.The Survivor felt the Partner had less of a “Big” and “Moderate” problem than they stated . Lisa Slide #14 or #15 ?
- In the first 3 categories the Survivor over estimated the problem his Partner had with his ED. The Survivor underestimates the “ Big Problem “ his Partner has with his ED and the Partner overestimates the “Big Problem” category that their Survivor has.
- There was contamination of the “date” data which only allowed us to capture 79 matched couples.As in the small survey sample I did for my dissertation we found that the Partner felt that their Survivor partner felt penetrative sex was less “Important” than he found it. Again the Survivor guessed that his Partner felt penetrative sex was more “Important” than they were. In the “Somewhat Important” category the Partner felt penetrative sex was more disruptive than their Survivor guessed.Although ED problems and Penetrative Sex are not identical questions the inability of Survivors and Partners to accurately guess what each other feels identifies a lot of questions needing resolution. Open, honest communication is essential if sexuality issues are to be solved.
- It appears that having an orgasm is extremely important for both parties. Achieving an orgasm without penetration or ejaculation is possible. This could be a vital factor in compensating for and removing the stress from, the loss of penetrative sex .
- There are many methods of achieving an orgasm with or without penetrative sex. It is up to each individual person or couple to select methods they are comfortable with. Again honest open discussion is essential.STILL WORKING ON THIS TO TIDY IT UP
- Change the date and this could be the heading if we leave out the words “comments”