Abstract
PurposeWe investigated the experiences of Japanese men with sexual dysfunction associated with various prostate cancer treatments.MethodsWe included 38 Japanese men who underwent the following initial treatments for prostate cancer: radical prostatectomy (n = 10), external beam radiotherapy (n = 12), brachytherapy (n = 5), and androgen deprivation therapy (n = 11). Semi-structured interviews were conducted regarding sexual dysfunction associated with prostate cancer treatment. Data were analyzed using a content analysis method. To obtain a unique experience for each treatment, we confirmed and organized the treatment method from which the code that constituted each category was derived. The category reliability was calculated based on Scott’s formula for the matching rate of the classification by three qualitative researchers. The criterion for good reliability was set at 70%.ResultsJapanese men with sexual dysfunction associated with prostate cancer treatments experienced the following: a desire to maintain sexual function and conflict in decision-making concerning the initial treatment for prostate cancer; a loss of values related to sexual dysfunction; an uncertainty regarding the consequences of sexual dysfunction; a sense of calm with fewer adverse effects of sexual dysfunction at the early treatment stage; an effort to accept sexual dysfunction; and management of their changed body at the later treatment stages. The concordance rates for the categories were 70% and 78%. Additionally, there were glimpses of experiences common to all treatments and trends in treatment-specific experiences.ConclusionIt is necessary to provide care based on the experience of Japanese men with sexual dysfunction after prostate cancer treatment.
Highlights
Prostate cancer is the most common type of cancer among men in Japan and worldwide [1, 2]
The men were insistent about maintaining their sexual function, searching for ways to preserve sexual function
Japanese men generally hesitate to reveal their sexual problems to their physicians [18, 19]
Summary
Prostate cancer is the most common type of cancer among men in Japan and worldwide [1, 2]. The main treatment options for prostate cancer are radical prostatectomy (prostatectomy), external beam radiotherapy (EBRT), and brachytherapy (LDR). Japan’s Prostate Cancer Practice Guidelines [3] state that androgen deprivation therapy (ADT) has a promising therapeutic effect; after careful discussions with physicians, many patients choose to undergo ADT monotherapy, considering the clinical stage and risk classification of the tumor, their age, health, and possible complications. Prostate cancer treatment generally causes deteriorated sexual function in men [4,5,6]. Treatment-related sexual dysfunction affects men’s quality of life and is associated with mental distress, depression, and changes in lifestyle and relationships [7,8,9,10].
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