The Psychosocial Consequences of Prostate Cancer Treatments on Body Image, Sexuality, and Relationships.

Abstract

Body image can have an important impact on quality of life, particularly in the context of cancer. Body image is considered the “attitudes and perceptions about the body, particularly its appearance” (Tylka, 2018) including “thoughts, beliefs, feelings, and behaviors” pertaining to one's body (Cash, 2004). Body image is often impacted by cancer and its treatment. In the context of prostate cancer (PCa), how men view their body can change as a result of treatment side effects. The impact of PCa treatments on men vary with cancer stage and treatment. Localized PCa is regularly treated with radical prostatectomy (surgical removal of the prostate, seminal vesicles, and proximal lymph nodes) or radiation therapy. Such treatments are known to have side effects that significantly impact sexual function, urinary and even bowel control (Sun et al., 2014; Downing et al., 2019). In the case of cancer recurrence, patients with systemic or locally advanced PCa are regularly treated with androgen deprivation therapy (ADT). ADT is also used as neo-adjuvant therapy along with radiotherapy. ADT controls PCa growth by greatly suppressing testosterone in the body and therefore has profound physical, sexual, and psychological side effects (Smith, 2007; Downing et al., 2019; Wibowo et al., 2019). Considering the low mortality rate of PCa (Lu-Yao et al., 2008; Hamdy et al., 2016), many patients endure treatment side effects for years and sometimes decades. Some of these side effects, including physical and sexual effects, can directly affect body image and can have negative psychological and social implications.