More than four in five men (81%) with prostate cancer struggle with poor sexual function following treatment for the disease, but over half (56%) fail to receive support, according to new research published today by the Lancet Oncology.

Researchers at Queen’s University Belfast, in collaboration with three UK universities, found that sexual problems were common in men diagnosed with prostate cancer regardless of the stage of their disease, their treatment, or their age. However, more than half of men over the age of 65 (61%) were not offered support for erection problems, compared to younger men under the age of 55 – only about a fifth of whom (22%) were not offered support.

Erectile dysfunction is a known side effect of prostate cancer treatment. But following these latest findings, leading men’s health charities, Prostate Cancer UK and the Movember Foundation have issued concerns that too many men are left with inadequate support to deal with the impact of treatments. The charities are calling on men to have the confidence to speak out about their side effects without embarrassment, and for healthcare professionals to proactively discuss sexual problems post treatment and signpost them to the appropriate support they need.

The study, entitled Life After Prostate Cancer Diagnosis, was funded by the Movember Foundation in partnership with Prostate Cancer UK and is the UK’s largest ever patient-reported outcomes study for the disease. It involved over 30,000 men across the UK and brought together researchers from Queen’s University Belfast, the University of Leeds, University of Southampton, Oxford Brookes University with Public Health England.

Men were asked about their quality of life and experiences of living with prostate cancer 18-42 months following their diagnosis, from the side effects of treatment to the psychological impact of living with the disease.  

Key findings from the report include:

• Poor sexual function was most commonly reported by men who underwent hormone therapy (94%) or surgery (84%), with 79% of men who had radiotherapy also reporting poor sexual function.
• Although 81% of men who had had surgery were offered support, this dropped to just over one third (35%) for men who received radiotherapy.
• Men diagnosed with cancer that has not spread beyond the prostate generally reported a good overall quality of life 18-42 months following a prostate cancer diagnosis. However, poor sexual function remained a significant issue for 75% of these men.

Dr Anna Gavin from Queen’s University Belfast and joint senior author of the report, said: “Prostate cancer is the second most common cancer in men in Northern Ireland after the easily treated non melanoma skin cancer. In Northern Ireland, there are an estimated 10,000 men living following a diagnosis of prostate cancer.

“This study showed that while many will enjoy a good-health related quality of life, this could be further improved if we can address issues related to sexual bother and dysfunction. We hope that this research will lead to clearer guidance, enabling health professionals treating men for prostate cancer to incorporate support for erection problems within post-treatment follow-up plans.”

Heather Blake, Director of Support and Influencing from Prostate Cancer UK said;

“For some men, it can be months before any erection problems are experienced following their treatment, especially if they’ve received radiotherapy. By this stage follow up appointments may have reduced, with far fewer opportunities to raise any late side effect issues.   

“As a result, too many men are being left without any support for sexual problems – with older men in particular missing out. This simply isn’t good enough. With long term implications including depression and relationship breakdowns, this is a side effect that must not be swept under the carpet, no matter how old the man is, or what treatment he has received.

In a bid to tackle the problem, the Movember Foundation is funding an online self-management programme for people living with prostate cancer, through the global TrueNTH initiative which will be available early this year. It will provide personalised self-management strategies to help improve sexual wellbeing after prostate cancer.

Owen Sharp, CEO of the Movember Foundation, said: “Providing better support for men after prostate cancer is a major priority for Movember. Programmes like ours give medical teams the tools they need to help men who are struggling with sexual dysfunction.”

Hugh Butcher, Chair of the project’s User Advisory Group said: “Far too many men like me who benefit from medical procedures and treatments for prostate cancer nevertheless suffer from significant ‘late effects’ from their experience over months and years. Erectile dysfunction is a serious issue for many of these men, which too often leads to distressing relationship difficulties, stress, or even depression.

“Despite this, more than half of these men fail to receive professional support for such late effects, and I know from speaking to them that this can have a huge impact on their quality of life.

“That’s why it’s so crucial that continuing advances in prostate cancer treatment are urgently matched by professionally led advances in post-treatment support services.”

Life After Prostate Cancer Diagnosis was funded by the Movember Foundation, in partnership with Prostate Cancer UK, as part of the Prostate Cancer Outcomes programme. It was delivered in partnership between Queen’s University Belfast, the University of Leeds, University of Southampton, Oxford Brookes University and Public Health England.

 

Dr Anna Gavin

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