IMPROVING THE SEX LIVES OF PROSTATE CANCER SURVIVORS
The goal of my Postdoc was to help prostate cancer survivors and their partners have better sex lives after prostate cancer treatments. I did this by creating a new treatment using mindfulness and sex therapy for couples.
As the old saying goes, it really does take a village… I was fortunate to work with some incredible people and organizations during my Postdoc. I was supervised by the prolific Dr. Lori Brotto, the UBC Sexual Health Lab, and the Prostate Cancer Supportive Care (PSCS) Program at Vancouver General Hospital.
I believe that it’s important to combine research and therapy in all the work that I do (read more about that in my About Page).
A WONDERFUL HONOUR
In April 2018, I presented my research at the Society for Sex Therapy and Research (SSTAR) conference. I am very pleased to announce that my research was awarded the very first Sexual Tipping Point Award via the MAP Education & Research Foundation!
The Sexual Tipping Point Award is presented at select professional society meetings: In recognition of an excellent abstract and presentation most consistent with the MAP Education & Research Foundation’s Biomedical-Psychosocial & Cultural Approach to the understanding, diagnoses and treatment of sexual disorders.
HELPING COUPLES HAVE GOOD SEX AFTER PROSTATE CANCER: MY RESEARCH
One in seven men in Canada will be diagnosed with prostate cancer in their lifetime.
Advances in prostate cancer detection and treatments mean that prostate cancer is now considered a chronic illness. It’s no longer the ‘death sentence’ that it once was.
This means that the number of prostate cancer survivors alive today is higher than ever.
BUT… even though we are very good at treating prostate cancer, these treatments come with many side effects. These side effects can be devastating to men and their partners, they’re usually life-long… and ALMOST NO ONE TALKS ABOUT THEM!
Up to 90% of prostate cancer survivors will have side-effects that impact their sexual lives.
PROSTATE CANCER AND SEXUAL HEALTH
Some of the most common side-effects of prostate cancer include:
- Erectile dysfunction (ED)
- “Anorgasmia”, or not being able to reach orgasm
- “Dry orgasms”, or no longer ejaculating
- Urinary incontinence (or the accidental loss of urine)
- “Climacturia” (or the accidental loss of urine with orgasm)
As you can imagine, these side-effects can have a terrible impact on people’s lives!
Indeed, when asked, most prostate cancer survivors report that they need help to fix these sexual problems.
Although some medical treatments for ED exist (for example, Viagra), these medications are not a “magic cure all” for most men. For example, even if treatments can bring an erection back, about half of all men will stop using these “erectile aids” after only 6 months.
What does this tell us??
…It tells us that medical treatments alone don’t magically fix all the sexual problems faced by prostate cancer survivors! We need to address the three pillars of sexual health: the body, the mind, and relationships.
You may have heard about mindfulness.
Mindfulness refers to non-judgmental, present-moment awareness.
Mindfulness is a new tool in sex therapy. It’s been shown to help treat sexual problems in women, including low desire, genital pain, and sexual problems following gynaecological cancers.
Mindfulness has also been shown to help men who have survived prostate cancer, both mentally and physically. For example, mindfulness helps men cope with a diagnosis of prostate cancer, it improves men’s quality of life, and it even boosts immune system functioning in these men!
As a postdoc, I was curious to see if we could take the same mindfulness-based sex therapy that we know helps women have better sex, and teach couples to have better sex after prostate cancer treatments.
WHAT WE DID
Couples with sexual problems after prostate cancer came to a group for 4 weeks. We met once a week for about 2 hours. During that time, we went over some sex ed (they stuff the don’t teach you in school!), information about how to have a great sex life, some tools for dismissing sexual myths, and – importantly – we practiced mindfulness skills.
Some of the mindfulness skills in the group could be done alone. For example, one exercise called “The Body Scan” is a pretty standard mindfulness exercise where you pay careful attention to one body art at a time. Eventually we scan the entire body. It takes somewhere between 20-40 minutes to complete.
Other exercises taught in the group could be done as a couple. One example of a couple exercise was called “Back to Back Sensing”. In this exercise, a couple sat – you guessed it – back to back. The couple just paid careful attention to the physical sensations of having their partner’s back resting against their own. If someone noticed mental sensations (mindfulness speak for “thoughts”), they were instructed to simply notice those thoughts with a sense of curiosity.
In between sessions, couples were asked to practice their mindfulness skills every single day (either alone or together).
In order to see if or how the group helped people, we asked everyone to complete questionnaires three times: (1) before they took part in the group, (2) as soon as the group was done, and (3) 6 months after the group ended.
We also invited everyone to take part in a follow-up interview to get a sense of their experience in the group.
WHAT DID WE FIND?
In short…. This two-year study suggests that it is possible to use mindfulness to help men and their partners deal with changes to their sexual lives after prostate cancer.
The “Quantitative Results” showed us that couples felt like their sexual intimacy got better. That was great news!
The “Qualitative Results” were a little more of a mixed bag. Basically, it looks like there are some people who felt they got a lot out of mindfulness. They learned a lot about themselves, their relationship, and mindfulness, and felt very hopeful for the future.
There seemed to be a second group, though, who felt they got less out of the group. After a closer look, it seems that mindfulness just isn’t for everyone! Or, that mindfulness isn’t right for everyone at any time. For example, if you are still grieving the loss of your erections after your cancer treatments, perhaps joining a mindfulness group that talks about how to enjoy your sex life without erections may not be the right thing at the right time.
Of course, this is just the very first study looking at mindfulness to help couples have better sex after prostate cancer. We have a long way to go before we have more solid answers about how to best help prostate cancer survivors live their best sex lives.
For us, we are very excited about the findings from this study. We’re so excited, in fact, that PART 2 of the study is underway!
With a generous award from the Movember Discovery Grant, the UBC Sexual Health Lab and PCSC Program are busy developing another study to understand how to better help prostate cancer survivors and their partners have great sex after cancer. Except this time, we’re doing it even bigger and better!
If you are in the Vancouver area and you or your partner have been diagnosed with prostate cancer, consider checking out the INTROSPPECT Study (Innovations in the Treatment of Sexual Health Post Prostate Cancer Treatment).
You can find more information about it here: http://brottolab.med.ubc.ca/studies/introsppect/