Life After Prostate Cancer: An Investigation of Patients' Health-Related Quality of Life, Sexual Outcomes, Mental Health, Social Support, and Healthcare Experiences
Prostate cancer is the most commonly diagnosed cancer in Canadian males. Survivorship rates, particularly for early-stage diagnoses, are high, meaning that the majority of diagnosed individuals must live with the consequences of the disease and its treatments. The purpose of this study was to investigate the experiences of individuals diagnosed with prostate cancer, specifically their health-related quality of life, sexual outcomes, mental health, social support, and experiences with the healthcare system. As well, this study sought to compare the experiences of heterosexual/cisgender and GLBTQ+ (e.g., gay, lesbian, bisexual, transgender, queer) prostate cancer patients. One-hundred and four participants who had been diagnosed with non-metastatic prostate cancer with no other cancer diagnosis completed an online survey which included a demographics questionnaire, questions about cancer diagnosis and treatment history, and measures of health-related quality of life, changes to sexual roles and activities, sexual satisfaction, sexual script flexibility, symptoms of depression and anxiety, social support, and satisfaction with care. In terms of overall health-related quality of life, there was no significant difference between individuals who had or had not undergone surgical treatment; however, surgical patients reported significantly worse urinary incontinence. For individuals with low to moderate sexual functioning, better sexual script flexibility was predictive of greater sexual satisfaction. Compared to their retrospective reports of pre-treatment sexual activity, after treatment, participants engaged in less frequent sexual activity, fewer identified as being in the insertive intercourse role, and many were no longer sexually active. Greater emotional support was predictive of fewer symptoms of depression, which in turn predicted better overall health-related quality of life. With regards to their healthcare experiences, participants most frequently reported wanting information on erectile functioning from their healthcare providers; for all topics of information, there were participants who wanted information from a healthcare provider but did not receive it. Finally, there were no significant differences between heterosexual/cisgender and GLBTQ+ participants on satisfaction with care, mental health, or health-related quality of life. Implications for prostate cancer patient care and directions for future research are discussed.
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