Prostate cancer counseling should include partners

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Including wives and partners in the care of men with Prostate cancer could help couples fare better in the long run, according to researchers.

Their study of 103 couples in which the man was newly diagnosed with Prostate cancer found that patients’ partners generally had more symptoms of depression, anxiety and other negative emotions than the men themselves did.

In addition, when asked about sexual function, women tended to say that their partners had more problems than the men acknowledged.

Emotional distress over a prostate cancer diagnosis and any resulting sexual dysfunction can affect how a man manages his disease—whether that distress is his or his partner’s—according to the study authors, led by Dr. Cynthia T. Soloway of the University of Miami School of Medicine.

The new findings, they say, suggest that wives and other partners should be included in prostate cancer treatment decisions, and in counseling throughout patients’ care.

“The results...underscore how important it is to hear the voice of the couple,” Soloway and her colleagues report in the British Journal of Urology International.

Their study included 103 men between the ages of 43 and 80, along with their female partners, mostly wives. Many studies, according to Soloway’s team, have looked at quality of life after a Prostate cancer diagnosis, but comparatively little is known about how the disease affects the relationship between men and their partners.

In the study, couples often reported having a generally strong bond, but there were clear differences in men’s and women’s emotional states and views on their sexual relationships.

On standard questionnaires, women generally reported more symptoms of depression, anxiety, anger and confusion than men did. They also rated their partners’ sexual performance and ability to maintain erections as poorer than the men did themselves.

Erectile dysfunction is a common side effect of prostate cancer treatment, and one of the implications of the current findings, according to Soloway’s team, is that women should be included in discussions about treatment and its possible side effects.

In addition, they say, the high rate of emotional distress among partners points to a need for counseling. At diagnosis, the researchers note, nearly a third of the couples in the study could have been referred for psychological care.

But, they add, whether patients and partners are in fact routinely evaluated for depression and referred for treatment is unclear.

“The present study,” Soloway and her colleagues conclude, “provides evidence that the prostate cancer ‘couple’ at diagnosis has complex and disparate needs, and shows a need for psychosexual interventions that augment current treatments for sexual and psychological problems arising from a prostate cancer diagnosis.”

SOURCE: British Journal of Urology International, April 2005.

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