Clinicians need to provide more support to men with erectile dysfunction (ED) after prostate cancer (PCa) treatment, a new study suggests.
The UK-wide cross-sectional survey study, published in BMJ Open, aimed to explore how ED in patients with PCa is managed in real-life clinical practice from the perspective of patients and healthcare professionals (HCPs).
Responses were received from 546 men with ED after PCa treatment, along with 167 primary and 94 secondary care HCPs.
The responses revealed poor communication between HCPs and men, including failure to initiate discussions about ED and/or involve partners. Twelve per cent of men were not told that ED was a risk factor of PCa treatment.
Only 26 per cent of GPs said they ‘usually’/‘always’ initiated a discussion about ED with men after PCa treatment. This varied by gender, with 20 per cent of male GPs saying they ‘never’/‘rarely’ initiated a discussion, compared with 44 per cent of female GPs.
The majority of urologists (80%) said they ‘usually’/‘always’ performed a verbal baseline assessment of erectile function before treatment, with only 8 per cent saying they ‘never’/‘rarely’ did this.
When secondary care HCPs were asked who was the most likely to initiate a discussion about ED, the majority of urologists (61%) identified themselves. A fifth of urologists said that the duration of androgen deprivation therapy (ADT) would affect their decision whether to discuss ED with the patient, with the conversation more likely to take place for men on long-term ADT.
The study authors say a clearly defined pathway is required for the discussion and management of ED, starting from the planning stage of PCa treatment.