CUA 2018: An Educational Intervention for Androgen Deprivation Therapy Patients: Dyadic Adjustment and Intimacy Outcomes

Halifax, Nova Scotia ( Richard Wassersug, MD, presented their study assessing the impact of an educational intervention for patients treated with androgen deprivation therapy (ADT). It is known that adjustment to ADT can have a negative impact on patient’s quality of life and on couples’ relationships. A pilot of a couples-based intervention for patients on ADT demonstrated improved dyadic adjustment and relational intimacy for patients in the treatment group and declines for patients in the control group.  Despite the intervention, partners experiences attenuated declines in dyadic adjustment and declines in relational intimacy.

In the ADT educational program presented in this study, couples attended a 90-minute educational class and read the ADT book (Figure 1). This program teaches them the essentials of ADT, and how to manage physical, psychological, and relational side effects of ADT. The program goal is to help patients cope well with treatment side effects, maintain good quality of life, and maintain good intimate relationships while on ADT. This study aims to assess the dyadic adjustment and emotional and sexual intimacy of couples following participation in the ADT education program.

Figure 1 – The androgen deprivation book:

From 2014 to 2017, 482 prostate cancer (PC) patients and 294 partners attended the ADT educational program in 5 sites across Canada. All participants completed several specific questionnaires assessing intimacy in relationships. These were completed before the ADT class and 2-3 months later.

Dr. Wassersug presented data on 48 couples who joined the program. 85% of the patients had started ADT before attending the ADT class. 19 couples were classified as low sexual intimacy and 29 as high sexual intimacy at baseline.  A 3-way interaction between pre-post comparison, level of intimacy, and member of the couple was found. For partners, sexual intimacy did not change from baseline to follow-up for the low intimacy group, whereas it decreased for the high intimacy group. This interaction was not significant for patients.

28 couples were classified as low intimacy and 20 couples as high intimacy at baseline. Patients reported greater emotional intimacy than partners. Emotional intimacy did not change from baseline to follow-up for the low intimacy group, it did decrease for the high intimacy groups.

16 couples were classified as low adjustment and 32 as high at baseline. Patients reported better dyadic adjustment than partners. Dyadic adjustment of couples in the high adjustment group did not change from baseline to follow-up. However, dyadic adjustment of couples in the low adjustment group increased from baseline to follow-up.

In conclusion, patients’ sexual intimacy remains consistent over time for all patients, while partners’ sexual intimacy remains consistent for those reporting low sexual intimacy, but declines for those reporting high sexual intimacy. 

Presented by: Richard Wassersug, PhD, University of British Columbia, Vancouver, BC, Canada

Written By: Hanan Goldberg, MD, Urologic Oncology Fellow (SUO), University of Toronto, Princess Margaret Cancer Centre, Twitter: @GoldbergHanan at the 73rd Canadian Urological Association Annual Meeting - June 23 - 26, 2018 - Halifax, Nova Scotia