UBC study aims to improve prostate cancer survivors’ sexual satisfaction
RESEARCHERS HOPE FINDINGS WILL TRANSLATE INTO STRATEGIES ADDRESSING PSYCHOSOCIAL NEEDS AROUND INTIMACY, SEXUALITY AND QUALITY OF LIFE
With one in seven Canadian men being diagnosed with prostate cancer at some point in their lives, it’s the most common cancer in men. Remarkable advances have been made in detecting and treating the disease, but survivors often face lasting effects from treatment that they never imagined having to deal with: sexual difficulties.
In fact, problems with sex affect up to 90 per cent of men who’ve been treated for prostate cancer. Many men can no longer get an erection. However, the impact of sexual dysfunction goes far beyond the physical. The emotional and psychological side can greatly affect quality of life for survivors and their partners.
Contrary to popular thought, the answer isn’t as simple as taking Viagra. The blue pill may be the go-to for men who have trouble achieving or maintaining an erection, but for prostate-cancer survivors, it’s largely ineffective, as treatment can result in permanent nerve or vascular damage. What’s more, current treatments for sex-related problems don’t address the subject of intimacy or feelings of loss, shame and diminished selfconfidence.
And while curing prostate cancer is always the goal for physicians, follow-up care rarely prepares men for lasting sexual dysfunction.
“That all leaves men and their partners really, really dissatisfied,” says Dr. Lori Brotto, director of the UBC Sexual Health Laboratory. “Viagra has been so successful that it’s reinforced this idea that an erect penis is the sign of men’s masculinity and virility. The notion of accepting this loss and still retaining an identity as a sexual man is new, and for prostatecancer survivors, that concept can be difficult to grapple with.”
Brotto has done extensive research into the beneficial effects of mindfulness in women for improving sexual function and genital pain. Now, through a collaboration of the UBC Sexual Health Lab and the Vancouver Prostate Centre, she’s heading a study that’s examining how the evidence-based approach could help men.
The Innovations in the Treatment of Sexual Health Post Prostate Cancer Treatment (INTROSPPECT) study is a randomized clinical trial comparing mindfulness and cognitive behavioural therapy. Researchers hope that findings will translate into strategies addressing psychosocial needs around intimacy, sexuality and quality of life.
“These men need to adopt a different approach to how they engage with sexuality, and that approach should not or cannot depend on having an erect penis,” Brotto says. “It has to be an approach that teaches them broader and more diverse ways of being sexual. Mindfulness is perfect for that. There’s science behind how and why it works. It teaches them acceptance—this is a loss—but also compassion: how can I be kind enough to myself and my relationship to explore other ways of being sexual?
“A lot of survivors progressively become more distressed by sexual dysfunction as time goes on, and that affects mood, quality of life, relationship satisfaction, communication and body image,” she adds. “Mindfulness has been found in many other studies to target all those domains. Through those roots, it serves to improve sexual satisfaction.”
The team’s pilot project proved promising, with men and their partners participating together. With the current study, even men who were skeptical of mindfulness overcame doubts.
“The sitting, touching…the mindfulness…took away a lot of the garbage that had been [in] our heads and allowed [us], based on just what we learned in the group, to be together without a lot of other crap floating in our heads,” one of the participants remarked. “That’s unbelievable.”
For INTROSPPECT, which has received funding from the Movember Discovery Grant/Prostate Cancer Canada, couples will attend a twohour group session once a week for four weeks with four to six other pairs. There is homework, including exercises done individually or as a couple.
“We recognize that the partner plays a key role,” Brotto says. “We’ll be measuring sexual satisfaction and qualify of life. Those we expect to improve. Men can still be sexual without a firm erection. Men have hope.”
To participate in INTROSPPECT or find out more, please contact fmiller@ prostatecentre.com or visit www. brottolab.com/introsppect.