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Cited by 305Sexual function and dysfunction studiesProstate Cancer Diagnosis and TreatmentCancer survivorship and care

Defining sexual outcomes after treatment for localized prostate carcinoma

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Schover, Leslie R., Fouladi, Rachel T., Warneke, Carla L., Neese, Leah, Klein, Eric A., Zippe, Craig, Kupelian, Patrick A.·2002·Cancer
DOI 10.1002/cncr.10848
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Abstract

BACKGROUND: The objective of this survey was to identify factors associated with good sexual outcomes in a large group of survivors of localized prostate carcinoma. METHODS: A postal survey was sent to 2636 men in the Cleveland Clinic Foundation's Prostate Cancer Registry who either were treated with definitive radiotherapy or underwent prostatectomy for localized prostate carcinoma. The survey asked about demographic items, past and current sexual functioning, partner's sexual function and health, and a number of factors hypothesized to affect sexual satisfaction. Standardized questionnaires included the Sexual Self‐Schema Scale‐Male Version, the International Index of Erectile Function (IIEF), urinary and bowel symptom scales from the Los Angeles Prostate Cancer Index, and the Short Form Health Survey (SF‐36). RESULTS: The return rate was 49%, yielding a sample of 1236 men at an average of 4.3 years post‐treatment. Comparing responders with nonresponders suggested that the sample may have been somewhat biased toward men who were more interested in maintaining sexual function. At the time they were diagnosed with prostate carcinoma, 36% of men had erectile dysfunction (ED). Within the past 6 months, however, 85% of men reported having ED. Only 13% of men were having reliable, firm erections spontaneously, and another 8% of men were having erections with the aid of a medical treatment. Men were as distressed about loss of desire and trouble having satisfying orgasms as they were about ED. Of the 84% of men who reported having a current sexual partner, 66% indicated that she had a sexual problem. Younger age was associated strongly with better sexual outcome (global IIEF score). With demographic factors taken into account, better sexual outcome was related significantly to medical factors, including not having neoadjuvant or current antiandrogen therapy, undergoing bilateral nerve‐sparing prostatectomy or brachytherapy, and having better mental and physical health composite scores on the SF‐36. Sexual factors that were associated with a better outcome included having normal erections before treatment for prostate carcinoma, choosing a treatment based on the hope that it would preserve sexual function, having more sexual partners in the past year, and having a sexually functional partner. CONCLUSIONS: The great majority of men who survive prostate carcinoma do not achieve a return to functional sexual activity in the years after treatment. The priorities a man places on sexuality and on having a sexually functional partner are important factors in sexual satisfaction at follow‐up, over and above the influence of age and medical factors. Cancer 2002;95:1773–85. © 2002 American Cancer Society. DOI 10.1002/cncr.10848

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  • Reported rates of erectile dysfunction after prostatectomy vary widely, from 29% to 85%.

    “Unfortunately, a wide variation in rates of erectile dysfunction following prostatectomy have been reported in the literature and range from 29 to 85% [23].”

    From Prostate cancer: Psychosocial implications and management (2008) · cites this paper as [23]

    The paper discusses widely differing estimates of erectile function after prostatectomy and reports that 85% of its respondents had an erectile-dysfunction problem, but that sample included men treated with surgery or radiation. Its discussion of published post-treatment rates gives a 50–80% range for surgery or radiation together, not a 29–85% range specifically after prostatectomy. The cited copy therefore supports the general point about variation, but not the stated endpoints and population. (LLM, conf=0.84)

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  • Between 50% and 80% of men with prostate cancer stop using medical treatments for ED within a year.

    “The majority of men with prostate cancer (50-80%) discontinue the use of medical interventions for ED (i.e., pills, penile injections, vacuum devices) within one year (21, 22).”

    From Men's experience with penile rehabilitation following radical prostatectomy: a qualitative study with the goal of informing a therapeutic intervention. (2015) · cites this paper as [21]

    The Measures section says men were asked whether they still used ED treatments, but the passages found do not report a discontinuation rate or when treatment was stopped. The Discussion reports sexual function more than four years after prostate-cancer treatment, not whether 50–80% stopped ED interventions within one year. Searches for discontinuation, continued use, and specific ED treatments did not establish the claim. (LLM, conf=0.73)

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Cites

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Research works printed but not linked: 6

  1. [1]1. Robinson JW, Dufour Ms, Fung TS. Erectile functioning of men treated for prostate carcinoma. Cancer. 1997;79:538 - 544.
  2. [7]7. Schrader-Bogen CL, Kjellberg JL, McPherson CP, Murray CL. Quality of life and treatment outcomes: prostate carcinoma patients' perspectives after prostatectomy or radiation ther- apy. Cancer. 1997;79:1977-1986.
  3. [8]8. Smith DS, Carvalhal GF, Schneider K, Drygiel J, Yan Y, Cata- lona WJ. Quality-of-life outcomes for men with prostate carcinoma detected by screening. Cancer. 2000;88:1454 - 1463.
  4. [26]26. Andersen BL. Surviving cancer: the importance of sexual self-concept. Med Pediatr Oncol. 1999;33:15-23.
  5. [39]39. Zelefsky MJ, Cowen D, Fuks Z, et al. Long-term tolerance of high dose three-dimensional conformal radiotherapy in pa- tients with localized prostate carcinoma. Cancer. 1999;85: 2460 -2468.
  6. [43]43. Schover LR, Yetman RJ, Tuason LJ, et al. Partial mastectomy and breast reconstruction: a comparison of their effects on psychosocial adjustment, body image, and sexuality. Can- cer. 1995;75:54 -64.

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Authors
Schover, L. R., Fouladi, R. T., Warneke, C. L., Neese, L., Klein, E. A., Zippe, C., & Kupelian, P. A.
Affiliations
  • The University of Texas MD Anderson Cancer Center (US)
  • Cleveland Clinic (US)
Corresponding author
Schover, Leslie R.
ORCID
Venue
Cancer
Publisher
Wiley
Published
2002-10-03
Volume
95
Issue
8
Pages
1773-1785
ISSN
  • 0008-543X (ISSN-L)
  • 1097-0142
DOI
10.1002/cncr.10848
OpenAlex
W1966608234
Cited by
305
References
53
Citations by year
2025: 3 · 2024: 3 · 2023: 6 · 2022: 3 · 2021: 6 · 2020: 11 · 2019: 10 · 2018: 6 · 2017: 18 · 2016: 13 · 2015: 18 · 2014: 18 · 2013: 18 · 2012: 21
FWCI
8.14
Type
journal article
Language
en
Open access
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • Cancer (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Sexual function and dysfunction studies
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Prostate Cancer Diagnosis and Treatment
  • Health Sciences › Medicine › Oncology › Cancer survivorship and care
Keywords
prostate cancer, sexual function, erectile dysfunction, sexual satisfaction, prostate cancer survivors, nerve-sparing radical prostatectomy, brachytherapy, antiandrogen therapy, neoadjuvant therapy, sexual desire, quality of life
MeSH terms
Adult, Age Factors, Aged, Aged, 80 and over, Androgen Antagonists, Brachytherapy, Carcinoma, Health Surveys, Humans, Erectile Dysfunction, Male, Mental Health, Middle Aged, Postoperative Complications, Prostatectomy, Prostatic Neoplasms, Stress, Psychological, Bias, Incidence

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