Prostate cancer is the second most common cancer in gay, bisexual, and other men who have sex with men (GBM). Few studies have assessed the effects of treatment on GBM's sexual behavior. For an online survey, 193 gay and bisexual men with prostate cancer were recruited from the North American's largest online cancer support group. Sexual functioning was measured using the Expanded Prostate Cancer Index Composite (EPIC) and a tailored Gay Sexual Functioning Inventory (GSFI). GBM have worse EPIC urinary and hormonal function and worse hormonal bother, but better sexual function and bother scores than published norms. In the GSFI, two-thirds of participants described their sexual functioning, post-treatment, as fair to poor. Only 22% reported erections sufficient for insertive anal sex. For receptive anal sex, one-third met criteria for anodyspareunia. Over half reported urination problems during sex or at orgasm. Erectile difficulties were common, severe, and a reason cited for not using condoms. Three men HIV seroconverted post-prostate cancer treatment. Differences in function and bother scores were observed by type of treatment, age, race/ethnicity, sexual orientation, but not relationship status. Sexual functioning significantly predicted long-term mental and physical health. GBM scored significantly worse on mental health and better on physical health than published norms. Sexual recovery after prostate cancer treatment is problematic for most GBM. Research to develop more effective sexual recovery, tailored to the needs of GBM treated for prostate cancer, is needed. Six implications for clinicians treating GBM with prostate cancer are identified.
Archives of sexual behavior. 2019 Apr 23 [Epub ahead of print]
B R Simon Rosser, Nidhi Kohli, Elizabeth J Polter, Lindsey Lesher, Benjamin D Capistrant, Badrinath R Konety, Darryl Mitteldorf, William West, James Dewitt, Gunna Kilian
Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 S. 2nd St., #300, Minneapolis, MN, 55454, USA. ., Department of Educational Psychology, University of Minnesota, Minneapolis, MN, USA., Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 S. 2nd St., #300, Minneapolis, MN, 55454, USA., School of Social Work, Smith College, Northampton, MA, USA., Department of Urology, University of Minnesota, Minneapolis, MN, USA., Malecare Cancer Support, New York, NY, USA., Department of Writing Studies, University of Minnesota, Minneapolis, MN, USA.