TY - JOUR
T1 - Changes in Sexual Roles and Quality of Life for Gay Men after Prostate Cancer
T2 - Challenges for Sexual Health Providers
AU - Hart, Tae L.
AU - Coon, David
AU - Kowalkowski, Marc A.
AU - Zhang, Karen
AU - Hersom, Justin I.
AU - Goltz, Heather H.
AU - Wittmann, Daniela A.
AU - Latini, David M.
N1 - Funding Information: Additional support was provided by Baylor College of Medicine Dan L Duncan Cancer Center and the Canadian Institute of Health Research. DML also received support from Mentored Research Scholar Grant 06‐083‐01‐CPPB from the American Cancer Society. TLH received support from a New Investigator Award in Gender and Health from the Canadian Institute of Health Research. Funding Information: This work was partly supported by the Houston VA HSR&D Center of Excellence (HFP90‐020). The views expressed reflect those of the authors and not necessarily the views of the Department of Veterans Affairs/Baylor College of Medicine.
PY - 2014/9
Y1 - 2014/9
N2 - Introduction: Gay men with prostate cancer (GMPCa) may have differential health-related quality of life (HRQOL) and sexual health outcomes than heterosexual men with prostate cancer (PCa), but existing information is based on clinical experience and small studies. Aims: Our goals were to: (i) describe HRQOL and examine changes in sexual functioning and bother; (ii) explore the psychosocial aspects of sexual health after PCa; and (iii) examine whether there were significant differences on HRQOL and sexual behavior between GMPCa and published norms. Methods: A convenience sample of GMPCa completed validated disease-specific and general measures of HRQOL, ejaculatory function and bother, fear of cancer recurrence, and satisfaction with prostate cancer care. Measures of self-efficacy for PCa management, illness intrusiveness, and disclosure of sexual orientation were also completed. Where possible, scores were compared against published norms. Main Outcome Measures: Main outcome measures were self-reported sexual functioning and bother on the Expanded Prostate Cancer Index. Results: Compared with norms, GMPCa reported significantly worse functioning and more severe bother scores on urinary, bowel, hormonal symptom scales (Ps<0.015-0.0001), worse mental health functioning (P<0.0001), greater fear of cancer recurrence (P<0.0001), and were more dissatisfied with their PCa medical care. However, GMPCa reported better sexual functioning scores (P<0.002) compared with norms. Many of the observed differences met criteria for clinical significance. Physical functioning HRQOL and sexual bother scores were similar to that of published samples. GMPCa tended to be more "out" about their sexual orientation than other samples of gay men. Conclusions: GMPCa reported substantial changes in sexual functioning after PCa treatment. They also reported significantly worse disease-specific and general HRQOL, fear of recurrence, and were less satisfied with their medical care than other published PCa samples. Sexual health providers must have an awareness of the unique functional and HRQOL differences between gay and heterosexual men with PCa.
AB - Introduction: Gay men with prostate cancer (GMPCa) may have differential health-related quality of life (HRQOL) and sexual health outcomes than heterosexual men with prostate cancer (PCa), but existing information is based on clinical experience and small studies. Aims: Our goals were to: (i) describe HRQOL and examine changes in sexual functioning and bother; (ii) explore the psychosocial aspects of sexual health after PCa; and (iii) examine whether there were significant differences on HRQOL and sexual behavior between GMPCa and published norms. Methods: A convenience sample of GMPCa completed validated disease-specific and general measures of HRQOL, ejaculatory function and bother, fear of cancer recurrence, and satisfaction with prostate cancer care. Measures of self-efficacy for PCa management, illness intrusiveness, and disclosure of sexual orientation were also completed. Where possible, scores were compared against published norms. Main Outcome Measures: Main outcome measures were self-reported sexual functioning and bother on the Expanded Prostate Cancer Index. Results: Compared with norms, GMPCa reported significantly worse functioning and more severe bother scores on urinary, bowel, hormonal symptom scales (Ps<0.015-0.0001), worse mental health functioning (P<0.0001), greater fear of cancer recurrence (P<0.0001), and were more dissatisfied with their PCa medical care. However, GMPCa reported better sexual functioning scores (P<0.002) compared with norms. Many of the observed differences met criteria for clinical significance. Physical functioning HRQOL and sexual bother scores were similar to that of published samples. GMPCa tended to be more "out" about their sexual orientation than other samples of gay men. Conclusions: GMPCa reported substantial changes in sexual functioning after PCa treatment. They also reported significantly worse disease-specific and general HRQOL, fear of recurrence, and were less satisfied with their medical care than other published PCa samples. Sexual health providers must have an awareness of the unique functional and HRQOL differences between gay and heterosexual men with PCa.
KW - Functioning
KW - Gay Men
KW - Prostate Cancer
KW - Quality of Life
KW - Symptom
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U2 - 10.1111/jsm.12598
DO - 10.1111/jsm.12598
M3 - Article
C2 - 24888965
SN - 1743-6095
VL - 11
SP - 2308
EP - 2317
JO - Journal of Sexual Medicine
JF - Journal of Sexual Medicine
IS - 9
ER -