Counseling helps sex life after prostate cancer

NEW YORK (Reuters Health) – Even a few counseling sessions
on sex after prostate cancer can help improve a couple’s sex
life, at least in the short term, research hints.

Researchers found that among 84 prostate cancer survivors,
those who completed four therapy sessions — whether they
attended alone or with their partners — reported better sexual
functioning 3 months later. Similarly, their wives and partners
said their sex lives were more satisfying.

These improvements, however, began to wane 6 months after
therapy.

The bottom line, according to the study authors, is that
while counseling can help couples rekindle their sexual
relationship after prostate cancer, a lingering question is how
to make the benefits last.

Dr. Andrea L. Canada and her colleagues at the University
of Texas M.D. Anderson Cancer Center in Houston report the
findings in the journal Cancer.

Sexual dysfunction is a common side effect of surgery and
radiation treatment for prostate cancer. Studies have
consistently found that the large majority of men have erectile
dysfunction (ED) after treatment, while many may also have a
low libido and trouble reaching orgasm.

Medications, like Viagra, can help some patients, but ED
caused by prostate cancer treatment does not respond as well to
drugs as other forms of ED do, Canada and her colleagues note.

To see whether counseling sessions could help couples
improve their sex life, the researchers randomly assigned 84
men and their partners to one of two groups. In one group, men
attended counseling alone, while couples in the second group
went to sessions together.

Counseling focused on open communication between partners,
treatment options for ED and how to enjoy sex despite ED. Both
groups received four sessions plus “homework” assignments.

Immediately following treatment and 3 months later, both
men and their partners reported improvements in their sex life,
regardless of which group they were in. In addition, more men
began using ED treatments – more than 50 percent after
counseling, versus 31 percent before.

However, the improvements both partners reported in their
sex life had begun to wane by the 6-month mark, the study
found. Women, in particular, seemed happiest immediately after
the counseling sessions ended.

It’s possible, the researchers speculate, that over time,
couples went back to their “perfunctory” sexual routine,
especially as more men received treatment for their erectile
problems.

But the success of counseling, according to Canada and her
colleagues, depends on men being able to shed their beliefs
about the all-importance of the erection and the ability of a
“magic pill” to restore their sex life.

“It is not surprising that men and women prefer the magic
pill,” the researchers write, “but if we can create more
realistic expectations, perhaps they will be willing to try
interventions that focus less on penile rigidity and more on
relationship flexibility.”

SOURCE: Cancer, December 15, 2005.