title: Co-constructing sexual recovery after prostate cancer: a qualitative study with couples.
abstract: BACKGROUND
  Men are likely to experience deterioration in sexual functioning as a consequence of treatment for prostate cancer. Indeed, sexual difficulties are common across all treatment modalities.
  
  
  OBJECTIVE
  To determine the impact of treatment for prostate cancer on intimacy and sexual expression/relationships from the perspective of couples.
  
  
  METHODS
  An observational study was conducted including in-depth interviews with 18 people affected by prostate cancer; comprising eight couples and two individual men.
  
  
  RESULTS
  Four categories were identified that illustrated the impact of prostate cancer on intimacy and sexual recovery. These related to social influences and language used to describe the loss or recovery of sexual activities; difficulties in discussing sexual activity with clinicians; the clash of individual impact of prostate cancer recovery versus the impact on the couple, and the re-integration of sexual activities into the relationship.
  
  
  CONCLUSIONS
  Though only one person in a partnership experiences cancer, these data indicated the extent to which prostate cancer treatment also impacts on partners. The study indicates that adjustment to erectile dysfunction (ED) takes time, but is a highly significant event in couples' lives and its importance should not be under-estimated. Consequently, we suggest that relational models of care should be considered, whereby side-effects are recognised as impacting on both members of the partnership (for example ED, or lack or ejaculate). Supportive care in this context, therefore, may best be based on a relational approach using language and interventions that are appropriate to the patient and their situation.
authors.affiliation: 1 School of Healthcare Sciences, Cardiff University, Wales, UK ; 2 Australian Catholic University, Canberra, Australia ; 3 Kingston University & St George's University of London, London, UK ; 4 The Royal Marsden Hospital NHS Foundation Trust, London, UK.
authors.forename: Daniel
authors.initials: D
authors.lastname: Kelly
authors.affiliation: 1 School of Healthcare Sciences, Cardiff University, Wales, UK ; 2 Australian Catholic University, Canberra, Australia ; 3 Kingston University & St George's University of London, London, UK ; 4 The Royal Marsden Hospital NHS Foundation Trust, London, UK.
authors.forename: Liz
authors.initials: L
authors.lastname: Forbat
authors.affiliation: 1 School of Healthcare Sciences, Cardiff University, Wales, UK ; 2 Australian Catholic University, Canberra, Australia ; 3 Kingston University & St George's University of London, London, UK ; 4 The Royal Marsden Hospital NHS Foundation Trust, London, UK.
authors.forename: Sylvie
authors.initials: S
authors.lastname: Marshall-Lucette
authors.affiliation: 1 School of Healthcare Sciences, Cardiff University, Wales, UK ; 2 Australian Catholic University, Canberra, Australia ; 3 Kingston University & St George's University of London, London, UK ; 4 The Royal Marsden Hospital NHS Foundation Trust, London, UK.
authors.forename: Isabel
authors.initials: I
authors.lastname: White
keywords: Prostate cancer; couples; sexuality; survivorship
references.citation: J Natl Cancer Inst. 2000 Oct 4;92(19):1582-92
references.pmid: 11018094
references.citation: J Urol. 2005 May;173(5):1701-5
references.pmid: 15821561
references.citation: J Urol. 2005 Jul;174(1):258-62; discussion 262
references.pmid: 15947650
references.citation: BJU Int. 2006 Apr;97 Suppl 2:29-33; discussion 44-5
references.pmid: 16507051
references.citation: Soc Sci Med. 2006 Aug;63(4):911-9
references.pmid: 16798130
references.citation: Soc Sci Med. 2006 Dec;63(12):3162-73
references.pmid: 16989928
references.citation: J Sex Med. 2007 Sep;4(5):1394-403
references.pmid: 17634055
references.citation: J Sex Med. 2008 Mar;5(3):693-704
references.pmid: 18194174
references.citation: J Sex Med. 2009 Nov;6(11):3111-24
references.pmid: 19674250
references.citation: Eur J Cancer Care (Engl). 2010 Mar;19(2):234-42
references.pmid: 19686355
references.citation: J Sex Med. 2010 Jan;7(1 Pt 1):129-35
references.pmid: 20104671
references.citation: BJU Int. 2010 Dec;106(11):1719-22
references.pmid: 20394611
references.citation: Patient Educ Couns. 2011 Aug;84(2):200-7
references.pmid: 20702055
references.citation: Urol Oncol. 2010 Sep-Oct;28(5):550-6
references.pmid: 20816615
references.citation: Eur J Cancer Care (Engl). 2011 Mar;20(2):237-47
references.pmid: 20825459
references.citation: J Sex Med. 2011 Apr;8(4):1197-209
references.pmid: 21210958
references.citation: BJU Int. 2012 Jan;109(1):98-103
references.pmid: 21631697
references.citation: Semin Oncol Nurs. 2011 Nov;27(4):300-8
references.pmid: 22018409
references.citation: Contemp Clin Trials. 2013 Mar;34(2):227-31
references.pmid: 23220254
references.citation: Trials. 2014 May 24;15:183
references.pmid: 24886676
references.citation: Transl Androl Urol. 2013 Mar;2(1):74-81
references.pmid: 26816727