To investigate physical and psychological sexual dysfunction (SD) in prostate cancer (PCa) patients, according to disease stage and treatment modality.
Participants diagnosed with PCa completed an online survey reporting sexual side effects across 13 domains, the importance of sexual function, and their support needs. Disease stage and treatment data were collected to identify variations in experience. Results were analysed descriptively and with chi-squared significance testing.
Six hundred fifty-four participants diagnosed with localised (66.1%), locally advanced (25.1%), and advanced (8.9%) PCa responded to the survey. Their disease management included radical prostatectomy (RP; 49.7%), radiotherapy (RT; 45.9%), and androgen deprivation therapy (ADT; 43.6%). More than 98% reported new-onset post-treatment sexual problems. The most common physical dysfunctions were erectile dysfunction (ED; 91.0%), ejaculatory disturbance (82.9%), and anatomical penile change (70.0%). The most common psychosexual dysfunctions were loss of sexual confidence (76.2%), loss of sex drive (67.1%), and loss of self-esteem (57.1%). Participants diagnosed with advanced disease were significantly more likely to report SD than participants with localised or locally advanced disease in 5 of 13 domains (p < .05). Participants whose treatment included a combination of RP, RT, and ADT were most likely to report SD in 7 of 13 domains. Overall, 78.3% of participants said sexual activity was important to them, with 61.8% placing sexual problems in their top three current concerns. Furthermore, 78.3% wanted to discuss sexual problems with a healthcare professional, with most wishing to focus on ED, loss of sexual confidence, and low libido.
SD is a common, wide-ranging, and distressing side effect of treatment, and PCa survivors place a high level of importance on sexual recovery. Those with advanced disease are among the worst affected and report high levels of psychosexual problems. Holistic rehabilitation strategies addressing a broad range of side effects would benefit all, but particularly those treated with permanent ADT.
Clinical oncology (Royal College of Radiologists (Great Britain)). 2025 Mar 08 [Epub ahead of print]
W Kinnaird, P Schartau, M Kirby, V Jenkins, S Allen, H Payne
University College London, Gower Street, WC1E 6BT, London, UK; University College London Hospitals NHS Foundation Trust, 235 Euston Road, London NW1 2BU, UK. Electronic address: ., University College London, Gower Street, WC1E 6BT, London, UK., Trends in Urology and Men's Health, Editor, UK., Sussex Health Outcomes Research & Education in Cancer, Brighton and Sussex Medical School, University of Sussex, Science Park Road, Falmer, Brighton, BN1 9RX, UK., Tackle Prostate, 124 City Road, London, EC1V 2NX, UK., University College London, Gower Street, WC1E 6BT, London, UK; University College London Hospitals NHS Foundation Trust, 235 Euston Road, London NW1 2BU, UK.