Unlike many other physiological side effects of cancer treatment, sexual problems do not tend to resolve within the first year or 2 of disease-free survival; rather, they may remain constant and fairly severe. Although it is unclear how much sexual problems influence a survivor’s rating of overall health-related quality of life, these problems are clearly bothersome to many patients and interfere with a return to normal posttreatment life. In a qualitative study of 48 men (130 approached) with erectile dysfunction after treatment for prostate cancer, quality of life was significantly affected, including areas such as the quality of sexual intimacy, everyday interactions with women, sexual fantasy life, and perceptions of their masculinity. Patients who participated in a randomized trial that compared radical prostatectomy with watchful waiting were asked to complete a questionnaire regarding symptoms, psychological functioning, and quality of life. Although the frequency of sexual thoughts was similar in both groups, the prevalence of erectile dysfunction (changes in voluntary erection in sexual situations, erection on awakening, and spontaneous erections) was higher in the radical prostatectomy group (80%) than in the watchful-waiting group (45%). Among men who underwent radical prostatectomy, 56% were moderately or greatly distressed by the decline in sexual function, as compared with 40% of men in the watchful-waiting group. Assessment, referral, intervention, and follow-up are important for maximizing quality of life and survival.
This publication was written by the National Cancer Institute, a component of the National Institutes of Health (NIH) that conducts and supports research, training, health information dissemination, and other programs with respect to the cause, diagnosis, prevention, and treatment of cancer, rehabilitation from cancer, and the continuing care of cancer patients and the families of cancer patients.
