Clinic Utilization and Characteristics of Patients Accessing a Prostate Cancer Supportive Care Program's Sexual Rehabilitation Clinic.

Julie Wong,Monita Sundar,Ryan Flannigan,Wen Liao,Eugenia Wu,Celestia S Higano,Christine Zarowski,Stacy Elliott,Luke Witherspoon,Sara Sheikholeslami,Jenna Bentley,Wallace Yuen

doi:10.3390/jcm9103363

Abstract

Prostate cancer (PC) treatment leads to impairment of sexual function. The Prostate Cancer Supportive Care (PCSC) Program’s Sexual Rehabilitation clinic (SRC) assists patients and their partners with sexual recovery using a biopsychosocial approach to rehabilitation. This study characterizes patients seen in the SRC between July 2013–1 July 2019. Data was retrospectively abstracted from clinic records. In total, 965 patients were seen over 3391 appointments during the study period. Median age (standard deviation (SD)) was 66 years (SD = 7.1), 82.0% were partnered, yet 81.7% attended appointments alone. 88.0% were treated with surgery, 5.1% with brachytherapy, 3.7% with external beam radiation (EBRT), 1.8% with combined brachytherapy and EBRT, and 1.4% with androgen deprivation therapy. In total, 708 patients (73.4%) attended ≥1 follow-up appointment. Median time (SD) between end of prostate cancer treatment to first SRC appointment was 270 days (range 0–7766). The mean (SD) self-reported overall sexual satisfaction (extracted from International Index of Erectile Function-5 (IIEF-5)) significantly increased both with erectile aids (1.69 (SD = 1.52) to 2.26 (SD = 1.66), p < 0.001, n = 148) and without erectile aids (1.71 (SD = 1.44) to 2.35 (SD = 1.57), p < 0.001, n = 235). This study provides guidance for further investigation to refine treatment, wait-times, support, and/or resource offerings in this type of program.

Highlights

Prostate cancer (PC) is the most common malignancy affecting Canadian men, with an estimated incidence of 23,300 men in 2020 [1]
We performed a retrospective analysis of the prospectively maintained Prostate Cancer Supportive Care (PCSC) database evaluating records from patients enrolled in the sexual rehabilitation clinic (SRC) from 17 July 2013 to 1 July 2019
With regard to baseline sexual function before therapy, the majority (74.8%) reported being sexually active with 29.6% taking phosphodiesterase type 5 inhibitors (PDE5 inhibitors) as needed and 3.1% regularly using some sort of sexual aid (PDE5 inhibitors, vacuum erectile device (VED), or intracavernosal injection (ICI)) (Table 1)

Summary

Introduction

Prostate cancer (PC) is the most common malignancy affecting Canadian men, with an estimated incidence of 23,300 men in 2020 [1]. The side effects of the various treatment for prostate cancer are well documented and include impaired sexual function and sexuality, the most cited being long-lasting and distressing symptoms to patients and their partners [2,3,4,5]. In order to address this outcome, treating sexual health issues with a biopsychosocial approach—where medical, psychological, and interpersonal factors are all addressed—is logical [9,10,11]. This model of survivorship care allows cancer survivors and their partners to enter a multidisciplinary program that provides disease and patient-specific care plans. Despite increased interest in this treatment model, there is scant literature surrounding these programs with regard to efficacy [12]

Methods

Results

Discussion

Conclusion