. 2021 May;29(5):2699-2711.

doi: 10.1007/s00520-020-05775-5. Epub 2020 Sep 26.

Men's sexual help-seeking and care needs after radical prostatectomy or other non-hormonal, active prostate cancer treatments

Melissa K Hyde^{1

2}, Melissa Opozda^{3

4}, Kirstyn Laurie⁵, Andrew D Vincent^{3

4}, John L Oliffe^{6

7}, Christian J Nelson⁸, Jeff Dunn^{5

9

10

11

12}, Eric Chung^{13

14}, Michael Gillman¹⁵, Rustom P Manecksha^{16

17

18}, Gary Wittert^{3

4}, Suzanne K Chambers^{5

10

12

19}

Affiliations

¹ School of Psychology, The University of Queensland, Brisbane, Queensland, Australia. m.hyde@uq.edu.au.
² Menzies Health Institute Queensland, Griffith University, Southport, Queensland, Australia. m.hyde@uq.edu.au.
³ Freemasons Foundation Centre for Men's Health, Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia.
⁴ Centre for Nutrition and Gastrointestinal Research, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia.
⁵ Menzies Health Institute Queensland, Griffith University, Southport, Queensland, Australia.
⁶ School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada.
⁷ Department of Nursing, University of Melbourne, Melbourne, Victoria, Australia.
⁸ Department of Psychiatry and Behavioural Sciences, Memorial Sloane Kettering Cancer Centre, New York, NY, USA.
⁹ Cancer Research Centre, Cancer Council Queensland, Brisbane, Queensland, Australia.
¹⁰ Institute for Resilient Regions, University of Southern Queensland, Toowoomba, Queensland, Australia.
¹¹ Prostate Cancer Foundation of Australia, Sydney, New South Wales, Australia.
¹² University of Technology Sydney, Sydney, New South Wales, Australia.
¹³ Department of Urology, Princess Alexandra Hospital, University of Queensland, Brisbane, Queensland, Australia.
¹⁴ AndroUrology Centre, Brisbane, Queensland, Australia.
¹⁵ St Andrew's War Memorial Hospital, Brisbane, Queensland, Australia.
¹⁶ Department of Urology, St James's Hospital, Dublin, Ireland.
¹⁷ Department of Urology, Tallaght University Hospital, Dublin, Ireland.
¹⁸ Department of Surgery, Trinity College Dublin, Dublin, Ireland.
¹⁹ Exercise Medicine Research Institute, Edith Cowan University, Perth, Western Australia, Australia.

PMID: 32978635
DOI: 10.1007/s00520-020-05775-5

Men's sexual help-seeking and care needs after radical prostatectomy or other non-hormonal, active prostate cancer treatments

Melissa K Hyde et al. Support Care Cancer. 2021 May.

. 2021 May;29(5):2699-2711.

doi: 10.1007/s00520-020-05775-5. Epub 2020 Sep 26.

Authors

Affiliations

¹ School of Psychology, The University of Queensland, Brisbane, Queensland, Australia. m.hyde@uq.edu.au.
² Menzies Health Institute Queensland, Griffith University, Southport, Queensland, Australia. m.hyde@uq.edu.au.
³ Freemasons Foundation Centre for Men's Health, Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia.
⁴ Centre for Nutrition and Gastrointestinal Research, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia.
⁵ Menzies Health Institute Queensland, Griffith University, Southport, Queensland, Australia.
⁶ School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada.
⁷ Department of Nursing, University of Melbourne, Melbourne, Victoria, Australia.
⁸ Department of Psychiatry and Behavioural Sciences, Memorial Sloane Kettering Cancer Centre, New York, NY, USA.
⁹ Cancer Research Centre, Cancer Council Queensland, Brisbane, Queensland, Australia.
¹⁰ Institute for Resilient Regions, University of Southern Queensland, Toowoomba, Queensland, Australia.
¹¹ Prostate Cancer Foundation of Australia, Sydney, New South Wales, Australia.
¹² University of Technology Sydney, Sydney, New South Wales, Australia.
¹³ Department of Urology, Princess Alexandra Hospital, University of Queensland, Brisbane, Queensland, Australia.
¹⁴ AndroUrology Centre, Brisbane, Queensland, Australia.
¹⁵ St Andrew's War Memorial Hospital, Brisbane, Queensland, Australia.
¹⁶ Department of Urology, St James's Hospital, Dublin, Ireland.
¹⁷ Department of Urology, Tallaght University Hospital, Dublin, Ireland.
¹⁸ Department of Surgery, Trinity College Dublin, Dublin, Ireland.
¹⁹ Exercise Medicine Research Institute, Edith Cowan University, Perth, Western Australia, Australia.

PMID: 32978635
DOI: 10.1007/s00520-020-05775-5

Abstract

Objective: To examine prostate cancer (PCa) survivors' sexual help-seeking intentions, behaviours, and unmet needs.

Methods: In this prospective cohort study, men who underwent active, non-hormonal treatment completed baseline (N = 558) and 6-month follow-up (N = 387) questionnaires. Theory of planned behaviour (TPB) constructs (sexual help-seeking intention, perceived behavioural control (PBC), subjective norm, attitude), masculine values (e.g., sexual importance/priority, emotional self-reliance), sex life and functioning, sexual supportive care needs, distress (anxiety, depression), and sexual help-seeking behaviour were assessed.

Results: Most men (M age = 64.6 years; M years post-diagnosis = 4.0) received prostatectomy (93%), reported severe erectile dysfunction (52%), ≥ 1 unmet sexual care need (66%), and sought help from a doctor (baseline 52%, follow-up 42%). Sexual care needs were significantly associated with poorer erectile function, reduced satisfaction with sex-life, valuing sex as important/integral to identity (masculine values), and increased depression (p ≤ 0.001). Sexual help-seeking intentions were significantly associated with valuing sex as important/integral to identity, recent help-seeking, greater confidence/control, perceiving support from important others, and positive attitudes, for sexual help-seeking (p < 0.001). Significant predictors of sexual help-seeking (follow-up) were baseline intentions, recent help-seeking (p < 0.001), and increased anxiety (p < 0.05).

Conclusions: Men's unmet sexual care needs, sexual help-seeking intentions, and behaviour appear driven by the importance/value attributed to sex, distress, positive feelings, support from others, and confidence for help-seeking. Psychosocial providers are well-placed to address men's concerns, yet few sought their assistance. Interventions to improve men's access to effective sexual care are needed, particularly focused on reframing masculine values about the importance of sex and leveraging TPB-based predictors of help-seeking.

Keywords: Health service needs; Help-seeking behaviour; Longitudinal studies; Men; Prostate cancer; Sexuality.

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Men's sexual help-seeking and care needs after radical prostatectomy or other non-hormonal, active prostate cancer treatments

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Men's sexual help-seeking and care needs after radical prostatectomy or other non-hormonal, active prostate cancer treatments

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