Men would benefit from better education on prostate cancer

By Glenna Picton

Improved education about prostate cancer treatment and the side effects of treatment would help men who are concerned about how their sexual health and relationships will be affected, said a Baylor College of Medicine researcher in a report in The Cancer Journal.

"A lot of men feel blindsided with the prostate cancer diagnosis. They do not understand possible treatment-related side effects," said David Latini, Ph.D., assistant professor in the Scott Department of Urology at BCM. "Outcomes are specific to each individual patient, and unfortunately there are not a lot of education programs out there to help them understand how their decisions may affect their sexual health and their relationships."

Most men have difficulty dealing with post-treatment symptoms, including erectile dysfunction, low sexual urge, incontinence, fatigue, memory changes and hormonal changes, Latini said.

Poor information

The information that is out there is not very well-written, is misleading pharmaceutical advertising or is written for such a sophisticated audience that it is not very useful for the typical prostate cancer patient, he said.

"Some men misunderstand. They think they will take a magic pill and everything will be wonderful. In reality, that's not the way it works," said Latini, also an assistant professor in the National Cancer Institute-designated Dan L. Duncan Cancer Center at BCM and a member of the Health Services Research and Development Center of Excellence at the Michael E. DeBakey Veterans Affairs Medical Center in Houston. "If we give them the appropriate information, we can work with them to correct this unrealistic mindset."

Partner's needs

Prostate cancer surgery can affect a man's sexual performance, said Latini. "This is extremely distressing for some and throws off goals of physical and emotional intimacy," he said.

It is also important to consider the sexual partner in the relationship and how the problems will affect sexual intimacy in the future, he said.

"Many men who have prostate cancer tend to be older and in relationships where their partners have also had health issues," said Latini. "Before making the treatment decision, physicians must think about the couple, relationship, partner needs and how to introduce the treatment. Some couples have their own agendas. Their levels of desire may vary or they may be in a situation where sex is not their highest priority."

Symptom management

With funding from the American Cancer Society and National Cancer Institute, Latini and his colleagues are developing an educational program on managing symptoms.

"We want to figure out where patients are struggling, give them the information they need to understand their problem and help them practice new skills like exercises to help reduce incontinence or talk with their partner," he said.

Latini said the programs will focus on men who have little knowledge of medicine or health and help them understand how to live with the side-effects of treatment in a way that works for them, their partner and family.

Others who took part in this research include Dr. Sara J. Knight from the San Francisco VA Medical Center and The University of California at San Francisco.

Funding for this work came from The American Cancer Society.

A link to the abstract is available.