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J Sex Med. 2016 Mar;13(3):425-34. doi: 10.1016/j.jsxm.2015.12.026. Epub 2016 Feb 4.

Health-Related Quality of Life, Psychological Distress, and Sexual Changes Following Prostate Cancer: A Comparison of Gay and Bisexual Men with Heterosexual Men.

Author information

1
Centre for Health Research, School of Medicine, Western Sydney University, Sydney, New South Wales, Australia. Electronic address: j.ussher@uws.edu.au.
2
Centre for Health Research, School of Medicine, Western Sydney University, Sydney, New South Wales, Australia.
3
Menzies Health Institute, Griffith University, Queensland, Australia; Australian and New Zealand Urogenital and Prostate Cancer Trials Group (ANZUP).
4
Baylor College of Medicine, Houston, Texas, United States.
5
Monash University, Melbourne, Victoria, Australia; Australian and New Zealand Urogenital and Prostate Cancer Trials Group (ANZUP); Eastern Health, Melbourne, Victoria, Australia.
6
Australian Research Centre in Sex, Health and Society, La Trobe University, Melbourne, Victoria, Australia.
7
Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia; Australian and New Zealand Urogenital and Prostate Cancer Trials Group (ANZUP).

Abstract

INTRODUCTION:

Decrements in health-related quality of life (HRQOL) and sexual difficulties are a recognized consequence of prostate cancer (PCa) treatment. However little is known about the experience of gay and bisexual (GB) men.

AIM:

HRQOL and psychosexual predictors of HRQOL were examined in GB and heterosexual men with PCa to inform targeted health information and support.

METHOD:

One hundred twenty-four GB and 225 heterosexual men with PCa completed a range of validated psychosexual instruments.

MAIN OUTCOME MEASURE:

Functional Assessment of Cancer Therapy-Prostate (FACT-P) was used to measure HRQOL, with validated psychosexual measures, and demographic and treatment variables used as predictors.

RESULTS:

GB men were significantly younger (64.25 years) than heterosexual men (71.54 years), less likely to be in an ongoing relationship, and more likely to have casual sexual partners. Compared with age-matched population norms, participants in both groups reported significantly lower sexual functioning and HRQOL, increased psychological distress, disruptions to dyadic sexual communication, and lower masculine self-esteem, sexual confidence, and sexual intimacy. In comparison with heterosexual men, GB men reported significantly lower HRQOL (P = .046), masculine self-esteem (P < .001), and satisfaction with treatment (P = .013); higher psychological distress (P = .005), cancer related distress (P < .001) and ejaculatory concern (P < .001); and higher sexual functioning (P < .001) and sexual confidence (P = .001). In regression analysis, psychological distress, cancer-related distress, masculine self-esteem, and satisfaction with treatment were predictors of HRQOL for GB men (R2Adj = .804); psychological distress and sexual confidence were predictors for heterosexual men (R2Adj = .690).

CONCLUSION:

These findings confirm differences between GB and heterosexual men in the impact of PCa on HRQOL across a range of domains, suggesting there is a need for GB targeted PCa information and support, to address the concerns of this "hidden population" in PCa care.

KEYWORDS:

Erectile Dysfunction; Gay and Bisexual Men; Health-Related Quality of Life; Prostate Cancer; Psychosexual Predictors

PMID:
26853048
DOI:
10.1016/j.jsxm.2015.12.026
[Indexed for MEDLINE]
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