Patient-Reported Sexual Aid Utilization and Efficacy After Radiation Therapy for Localized Prostate Cancer.

Abstract

PURPOSE:

To report sexual health-related quality of life outcomes and utilization and efficacy of sexual aids in a contemporary cohort of patients treated for localized prostate cancer.

PATIENTS AND METHODS:

Between 2008 and 2013, 471 consecutive men with localized prostate cancer were treated on 2 institutional protocols (NCT01766492, NCT01618851) or on a prospective institutional registry with patient-reported health-related quality of life. All patients were treated with ultra-hypofractionated radiation therapy. Erectile function (EF) was defined as "firm enough for intercourse" with or without aids per Expanded Prostate Cancer Index Composite-26 (n = 222 at baseline); results apply to this cohort unless specifically noted. Sexual aid utilization and efficacy were patient reported. Multivariable analysis of EF was performed.

RESULTS:

Median follow-up was 60 months, median age was 67 years, and 70% had intermediate- or high-risk disease per National Comprehensive Cancer Network guidelines. At 24 and 60 months, questionnaire response rates were 86% and 67%, and EF was retained in 53% and 41%, respectively. Baseline sexual aid utilization was 37% (n = 82) and was associated with lower 24-month EF preservation on multivariable analysis (adjusted odds ratio 0.49, 95% confidence interval 0.26-0.92). By 60 months, 70% of men had tried aids. Of those who found aids helpful at baseline, 84% to 89% reported continued benefit at 24 to 60 months. Among aid-naïve patients, efficacy was 80% with first-time use within 12 months and 70% more than 12 months after radiation therapy (P = .02). Among men who developed erectile dysfunction but found sexual aids helpful, 25% were not current users at 60 months.

CONCLUSIONS:

One-third of men used sexual aids at baseline, which doubled by 5 years after radiation therapy. Self-reported efficacy was high and sustained. Despite significant declines in EF, a number of men reported helpfulness of aids but were not active users. Future study is required to understand drivers of aid utilization to optimize posttreatment sexual function.

• Authors: Robert T Dess, Theresa P Devasia, Nima Aghdam, William C Jackson, Payal D Soni, Clayton P Smith, Amyre L Mitchell, Simeng Suy, Daniel A Hamstra, Shruti Jolly, Paul L Nguyen, Felix Y Feng, Matthew J Schipper, Ted A Skolarus, David C Miller, Daniela A Wittmann, Sean P Collins, Daniel E Spratt
• Journal: International journal of radiation oncology, biology, physics (Int J Radiat Oncol Biol Phys) Vol. 101 Issue 2 Pg. 376-386 (06 01 2018) ISSN: 1879-355X [Electronic] United States
• PMID: 29487023 (Publication Type: Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2018 Elsevier Inc. All rights reserved.

Topics

• Aged
• Humans
• Male
• Middle Aged
• Multivariate Analysis
• Penile Erection (physiology)
• Prospective Studies
• Prostatic Neoplasms (pathology, radiotherapy)
• Quality of Life
• Radiation Dose Hypofractionation
• Self-Help Devices (statistics & numerical data)