Online Sexual Health Support Program for Couples May Aid in Sexual Recovery After Prostate Cancer Treatment

An online program for sexual recovery after prostate cancer treatment may help men and their partners improve their sexual health despite dysfunction, according to a recent study.

Findings from this study, which were published in Cancer, highlight the importance of focusing on sexual health as a part of their quality of life after undergoing prostate cancer treatment.

“Sexual health is part of overall health, and people often feel uncertain about whether it's OK to ask for help with sexual problems after cancer treatment,” said Daniela Wittman, a clinical associate professor of urology and clinical associate adjunct professor of social work at University of Michigan in Ann Arbor, in an interview with CURE®. “Oftentimes, people will say, ‘(My cancer team) already tried to help and saved my life, so this is extra and I don't have a right to ask about it.’ Everybody has a right to have a sex life if they want to have it.”

Wittmann added that it was important for this study to be conducted based on findings from past research.

“Over the past 20 years, we’ve done research to try to understand the experience of prostate cancer survivors vis-a-vie their treatment and its impact on quality of life,” she said. “What we have learned is that for many patients, especially if they have localized prostate cancer, but even those with advanced prostate cancer, they get treated, they often can get rid of the cancer and survive for a long time. But the treatment itself has a pretty significant impact on their quality of life in the long term, and the most long-term side effect is sexual dysfunction.”

To assess the potential effectiveness of an online program for posttreatment recovery of sexual intimacy, Wittmann and her team assigned 142 couples to either the online program (60 couples) or a control group (82 couples). Of note, patients were treated with radiation, surgery or combined radiation and androgen deprivation therapy.

Couples assigned the online program participated in a six-module program that integrated videos, educational content and suggested activities. Those assigned to the control group were directed to a page on the American Cancer Society’s website on sexuality after cancer. Couples from both groups completed questionnaires at the start of the study, at three months and at six months after treatment focused on their progress throughout their assigned program.

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At six months, 105 patients and 87 partners completed the survey. Responses demonstrated that there were no differences between groups assigned the intervention or the control group regarding sex life satisfaction six months after treatment. In contrast, at three months, patients and their partners assigned to the online program reported that they were more engaged in sexual activities than those assigned content from the American Cancer Society website.

“We already know that when partners are involved, men are more likely to use sexual aids,” Wittmann explained. “That's one of the things that research has shown us. We also know that paying attention to the partners is important. And what our research adds is that if you support men and their partners, if you educate them before treatment and support them after treatment, they return to sexual activity faster. They don't lose that connection for a long time because the longer you go without it, the harder it is to come back to it and, potentially, the more barriers you have to overcome to do that.”

For couples who participated in the online program, more than 73% of participants reported moderate or high satisfaction with the content contained in the module, and more than 85% would recommend the program to other couples.

Although findings from this study highlight how an online program can aid in sexual recovery after prostate cancer treatment, more research is needed in this area.

“We need to understand even better how to provide support in a timely manner,” Wittmann said. “What we found in our study is that it's possible that patients and partners have somewhat different motivations in the process of the recovery that we should be looking at that ongoingly. And instead of just offering one intervention, we should have maybe subsets of things that we can offer based on how we ongoingly assess what they (are) interested in, what they can tolerate and what is most motivating for them to participate in.”

In the meantime, Wittmann advised men to feel comfortable with talking about their sexual health especially after treatment.

“What I would say to men is, you may think that it's an uncomfortable situation, but if you're talking to a professional who's going to make you feel comfortable, even if you talk to other men actually and open up about it, you'll find that it gets easier the more you discuss it and you'll find help and support for the problems that you're facing.”

Wittmann added that there are several ways that men can be helped in this area, especially if sexual function has been compromised by treatment.

“There are professionals who can help them, and they should feel free to ask their oncologist about this,” she said. “If the oncologist can't help them — it's not their expertise and we shouldn't expect oncologists to be sex therapists — they should be able to point them to resources and to people who can actually help them.”

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