(O-15) SEXUALITY IN PATIENTS WITH ADVANCED PROSTATE CANCER: A REVIEW

Abstract

Abstract Introduction Androgen deprivation therapy (ADT) remains the gold standard in treatment of advanced prostate cancer (APC). Disease remission means improved quality of life, mental health, social interactions, in addition to pain reduction. However, most experience a significant drop in sexual desire, reduction in rigidity and duration of erections, and a decrease in the frequency of sexual intercourse. Material and Methods A review of literature on sexuality in patients with APC was carried out. Results The prevalence of sexual dysfunction (SD) in patientes with APC is higher. However, its treatment remains in the background, considering the priority given to oncological treatment. Assessing baseline sexual function before starting ADT, as well as monitoring changes that occur during treatment are important aspects to mitigate negative effects. Individualization of the therapeutic plan allows satisfactory erectile response with oral medications in up to 33% of patients, reaching 80% with the use of combined therapies, such as injections and vacuum devices. Intermittent ADT appears as an interesting option for selected groups of patients with APC, with biochemical recurrence and low-volume metastatic disease, allowing a recovery of sexual function in the intervals without treatment, although recovery of sexual function becomes less pronounced and treatment-free intervals become shorter over time. Conclusions The significant drop observed in sexual health still remains a major challenge in the management of patients with APC. Although physical and psychosocial variables may be involved in the etiology of SD, erectile function remains the main determinant of sexual satisfaction in men undergoing any treatment for prostate cancer. Despite emerging themes have been observed in the literature, such as sexual psychotherapy and the role of physical exercises in mitigating the negative effects of ADT, specific studies in this population are still needed. Financing No conflict.