TrueNTH Sexual Recovery Intervention for couples coping with prostate cancer: Randomized controlled trial results.
couples
prostate cancer
rehabilitation
sexual dysfunction
telemedicine
Journal
Cancer
ISSN: 1097-0142
Titre abrégé: Cancer
Pays: United States
ID NLM: 0374236
Informations de publication
Date de publication:
01 Apr 2022
01 Apr 2022
Historique:
revised:
22
11
2021
received:
24
09
2021
accepted:
30
11
2021
pubmed:
6
1
2022
medline:
7
4
2022
entrez:
5
1
2022
Statut:
ppublish
Résumé
Despite significant sexual dysfunction and distress after localized prostate cancer treatment, patients typically receive only physiologic erectile dysfunction management. The authors performed a randomized controlled trial of an online intervention supporting couples' posttreatment recovery of sexual intimacy. Patients treated with surgery, radiation, or combined radiation and androgen deprivation therapy who had partners were recruited and randomized to an online intervention or a control group. The intervention, tailored to treatment type and sexual orientation, comprised 6 modules addressing expectations for sexual and emotional sequelae of treatment, rehabilitation, and guidance toward sexual intimacy recovery. Couples, recruited from 6 sites nationally, completed validated measures at the baseline and 3 and 6 months after treatment. Primary outcome group differences were assessed with t tests for individual outcomes. Among 142 randomized couples, 105 patients (mostly surgery) and 87 partners completed the 6-month survey; this reflected challenges with recruitment and attrition. There were no differences between the intervention and control arms in Patient-Reported Outcomes Measurement Information System Global Satisfaction With Sex Life scores 6 months after treatment (the primary outcome). Three months after treatment, intervention patients and partners reported more engagement in penetrative and nonpenetrative sexual activities than controls. More than 73% of the intervention participants reported high or moderate satisfaction with module content; more than 85% would recommend the intervention to other couples. Online psychosexual support for couples can help couples to connect and experience sexual pleasure early after treatment despite patients' sexual dysfunction. Participants' high endorsement of the intervention reflects the importance of sexual health support to couples after prostate cancer treatment. This study tested a web-based program supporting couples' sexual recovery of sexual intimacy after prostate cancer treatment. One hundred forty-two couples were recruited and randomly assigned to the program (n = 60) or to a control group (n = 82). The program did not result in improvements in participants' satisfaction with their sex life 6 months after treatment, but couples in the intervention group engaged in sexual activity sooner after treatment than couples in the control group. Couples evaluated the program positively and would recommend it to others facing prostate cancer treatment.
Sections du résumé
BACKGROUND
BACKGROUND
Despite significant sexual dysfunction and distress after localized prostate cancer treatment, patients typically receive only physiologic erectile dysfunction management. The authors performed a randomized controlled trial of an online intervention supporting couples' posttreatment recovery of sexual intimacy.
METHODS
METHODS
Patients treated with surgery, radiation, or combined radiation and androgen deprivation therapy who had partners were recruited and randomized to an online intervention or a control group. The intervention, tailored to treatment type and sexual orientation, comprised 6 modules addressing expectations for sexual and emotional sequelae of treatment, rehabilitation, and guidance toward sexual intimacy recovery. Couples, recruited from 6 sites nationally, completed validated measures at the baseline and 3 and 6 months after treatment. Primary outcome group differences were assessed with t tests for individual outcomes.
RESULTS
RESULTS
Among 142 randomized couples, 105 patients (mostly surgery) and 87 partners completed the 6-month survey; this reflected challenges with recruitment and attrition. There were no differences between the intervention and control arms in Patient-Reported Outcomes Measurement Information System Global Satisfaction With Sex Life scores 6 months after treatment (the primary outcome). Three months after treatment, intervention patients and partners reported more engagement in penetrative and nonpenetrative sexual activities than controls. More than 73% of the intervention participants reported high or moderate satisfaction with module content; more than 85% would recommend the intervention to other couples.
CONCLUSIONS
CONCLUSIONS
Online psychosexual support for couples can help couples to connect and experience sexual pleasure early after treatment despite patients' sexual dysfunction. Participants' high endorsement of the intervention reflects the importance of sexual health support to couples after prostate cancer treatment.
LAY SUMMARY
BACKGROUND
This study tested a web-based program supporting couples' sexual recovery of sexual intimacy after prostate cancer treatment. One hundred forty-two couples were recruited and randomly assigned to the program (n = 60) or to a control group (n = 82). The program did not result in improvements in participants' satisfaction with their sex life 6 months after treatment, but couples in the intervention group engaged in sexual activity sooner after treatment than couples in the control group. Couples evaluated the program positively and would recommend it to others facing prostate cancer treatment.
Substances chimiques
Androgen Antagonists
0
Types de publication
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1513-1522Subventions
Organisme : Movember Foundation
ID : 15-PAF05268
Commentaires et corrections
Type : CommentIn
Informations de copyright
© 2021 American Cancer Society.
Références
Miller KD, Nogueira L, Mariotto AB, et al. Cancer treatment and survivorship statistics, 2019. CA Cancer J Clin. 2019;69:363-385. doi:10.3322/caac.21565
Sanders S, Pedro LW, Bantum EO, Galbraith ME. Couples surviving prostate cancer: long-term intimacy needs and concerns following treatment. Clin J Oncol Nurs. 2006;10:503-508.
Walker LM, Wassersug RJ, Robinson JW. Psychosocial perspectives on sexual recovery after prostate cancer treatment. Nat Rev Urol. 2015;12:167-176. doi:10.1038/nrurol.2015.29
Gomella LG. Contemporary use of hormonal therapy in prostate cancer: managing complications and addressing quality-of-life issues. BJU Int. 2007;99(suppl 1):25-29; discussion 30.
Resnick MJ, Koyama T, Fan KH, et al. Long-term functional outcomes after treatment for localized prostate cancer. N Engl J Med. 2013;368:436-445. doi:10.1056/nejmoa1209978
Avulova S, Zhao Z, Lee D, et al. The effect of nerve sparing status on sexual and urinary function: 3-year results from the CEASAR study. J Urol. 2018;199:1202-1209. doi:10.1016/j.juro.2017.12.037
Maliski SL, Connor S, Fink A, Litwin MS. Information desired and acquired by men with prostate cancer: data from ethnic focus groups. Health Educ Behav. 2006;33:393-409.
Schover LR, Fouladi RT, Warneke CL, et al. Seeking help for erectile dysfunction after treatment for prostate cancer. Arch Sex Behav. 2004;33:443-454.
Bernat JK, Skolarus TA, Hawley ST, Haggstrom DA, Darwish-Yassine M, Wittmann DA. Negative information-seeking experiences of long-term prostate cancer survivors. J Cancer Surviv. 2016;10:1089-1095. doi:10.1007/s11764-016-0552-5
Walker LM. Psychosocial contributors to patients' and partners' postprostate cancer sexual recovery: 10 evidence-based and practical considerations. Int J Impot Res. 2021;33:464-472.
Nguyen DD, Berlin A, Matthew AG, Perlis N, Elterman DS. Sexual function and rehabilitation after radiation therapy for prostate cancer: a review. Int J Impot Res. 2021;33:410-417. doi:10.1038/s41443-020-00389-1
Rosser BR, Capistrant B, Torres B, et al. The effects of radical prostatectomy on gay and bisexual men's mental health, sexual identity and relationships: qualitative results from the Restore study. Sex Relat Ther. 2016;31:446-461. doi:10.1080/14681994.2016.1228871
Ussher JM, Perz J, Rose D, Dowsett G, Latini D. Threat to gay identity and sexual relationships: the consequences of prostate cancer treatment for gay and bisexual men. In: Ussher JM, Rosser BR, eds. Gay and Bisexual Men Living With Prostate Cancer From Diagnosis to Recovery. Harrington Press; 2019:38-53.
Canada AL, Neese LE, Sui D, Schover LR. Pilot intervention to enhance sexual rehabilitation for couples after treatment for localized prostate carcinoma. Cancer. 2005;104:2689-2700.
Schover LR, Canada AL, Yuan Y, et al. A randomized trial of internet-based versus traditional sexual counseling for couples after localized prostate cancer treatment. Cancer. 2012;118:500-509. doi:10.1002/cncr.26308
Chambers SK, Occhipinti S, Schover L, et al. A randomised controlled trial of a couples-based sexuality intervention for men with localised prostate cancer and their female partners. Psychooncology. 2015;24:748-756. doi:10.1002/pon.3726
Chambers SK, Occhipinti S, Stiller A, et al. Five-year outcomes from a randomised controlled trial of a couples-based intervention for men with localised prostate cancer. Psychooncology. 2019;28:775-783. doi:10.1002/pon.5019
Wittmann D, Koontz BF. Evidence supporting couple-based interventions for the recovery of sexual intimacy after prostate cancer treatment. Curr Sex Health Rep. 2017;9:32-41. doi:10.1007/s11930-017-0095-4
Berry DL, Halpenny B, Wolpin S, et al. Development and evaluation of the Personal Patient Profile-Prostate (P3P), a Web-based decision support system for men newly diagnosed with localized prostate cancer. J Med Internet Res. 2010;12:e67. doi:10.2196/jmir.1576
Northouse L, Schafenacker A, Barr KL, et al. A tailored web-based psychoeducational intervention for cancer patients and their family caregivers. Cancer Nurs. 2014;37:321-330. doi:10.1097/ncc.0000000000000159
Skolarus TA, Metreger T, Wittmann D, et al. Self-management in long-term prostate cancer survivors: a randomized, controlled trial. J Clin Oncol. 2019;37:1326-1335. doi:10.1200/jco.18.01770
Matthew AG, Trachtenberg LJ, Yang ZG, et al. An online sexual health and rehabilitation eclinic (TrueNTH SHAReClinic) for prostate cancer patients: a feasibility study. Support Care Cancer. Published online August 31, 2021. doi:10.1007/s00520-021-06510-4
Wittmann D, Mehta A, Northouse L, et al. TrueNTH sexual recovery study protocol: a multi-institutional collaborative approach to developing and testing a web-based intervention for couples coping with the side-effects of prostate cancer treatment in a randomized controlled trial. BMC Cancer. 2017;17:664. doi:10.1186/s12885-017-3652-3
Sex and the adult male with cancer. American Cancer Society. Accessed March 1, 2014. https://www.cancer.org/treatment/treatments-and-side-effects/physical-side-effects/fertility-and-sexual-side-effects/sexuality-for-men-with-cancer.html
Mehta A, Pollack CE, Gillespie T, et al. What patients and partners want in interventions that support sexual recovery after prostate cancer treatment: an exploratory convergent mixed methods study. Sex Med. 2019;7:184-191.
Wittmann D, Carolan M, Given B, et al. What couples say about their recovery of sexual intimacy after prostatectomy: toward the development of a conceptual model of couples' sexual recovery after surgery for prostate cancer. J Sex Med. 2015;12:494-504. doi:10.1111/jsm.12732
Center for Health Communications Research. Accessed August 10, 2021. https://chcr.umich.edu/
Carle AC, Riley W, Hays RD, Cella D. Confirmatory factor analysis of the Patient Reported Outcomes Measurement Information System (PROMIS) adult domain framework using item response theory scores. Med Care. 2015;53:894-900. doi:10.1097/mlr.0000000000000413
Wei JT, Dunn RL, Litwin MS, Sandler HM, Sanda MG. Development and validation of the Expanded Prostate Cancer Index Composite (EPIC) for comprehensive assessment of health-related quality of life in men with prostate cancer. Urology. 2000;56:899-905.
Rosen R, Brown C, Heiman J, et al. The Female Sexual Function Index (FSFI): a multidimensional self-report instrument for the assessment of female sexual function. J Sex Marital Ther. 2000;26:191-208.
Rosen RC, Riley A, Wagner G, Osterloh IH, Kirkpatrick J, Mishra A. The international index of erectile function (IIEF): a multidimensional scale for assessment of erectile dysfunction. Urology. 1997;49(6):822-830.
Flynn KE, Lin L, Cyranowski JM, et al. Development of the NIH PROMIS ® sexual function and satisfaction measures in patients with cancer. J Sex Med. 2013;10(suppl 1):43-52.
Leiber L, Plumb MM, Gerstenzang ML, Holland J. The communication of affection between cancer patients and their spouses. Psychosom Med. 1976;38:379-389. doi:10.1097/00006842-197611000-00003
Nelson CJ, Saracino RM, Napolitano S, Pessin H, Narus JB, Mulhall JP. Acceptance and commitment therapy to increase adherence to penile injection therapy-based rehabilitation after radical prostatectomy: pilot randomized controlled trial. J Sex Med. 2019;16:1398-1408. doi:10.1016/j.jsxm.2019.05.013
Shindel A, Quayle S, Yan Y, Husain A, Naughton C. Sexual dysfunction in female partners of men who have undergone radical prostatectomy correlates with sexual dysfunction of the male partner. J Sex Med. 2005;2:833-841; discussion 841.
Northouse LL, Mood DW, Schafenacker A, et al. Randomized clinical trial of a family intervention for prostate cancer patients and their spouses. Cancer. 2007;110:2809-2818. doi:10.1002/cncr.23114
Wittmann D, Carolan M, Given B, et al. Exploring the role of the partner in couples' sexual recovery after surgery for prostate cancer. Support Care Cancer. 2014;22:2509-2515. doi:10.1007/s00520-014-2244-x
Kang HS, Kim HK, Park SM, Kim JH. Online-based interventions for sexual health among individuals with cancer: a systematic review. BMC Health Serv Res. 2018;18(1):167.
Wittmann D, Skolarus TA, Montie JE. Are we targeting the right outcome for sexual health after prostate cancer treatment? Eur Urol. 2015;68:550-551. doi:10.1016/j.eururo.2015.05.044