Skip to main content

Advertisement

SpringerLink
Log in

Men’s Experience with Sexual Dysfunction Post-rectal Cancer Treatment: A Qualitative Study

  • Published:
Journal of Cancer Education Aims and scope Submit manuscript

Abstract

In an effort to address reports from men that their sex life is worse after treatment for rectal cancer, this qualitative study was designed to better understand their experience with sexual dysfunction following rectal cancer treatment, thus providing information on the adaptation of a psycho-educational sexual health intervention for male rectal cancer survivors and simultaneously investigating barriers and promoters that would influence their participation in a psycho-educational sexual health intervention. Thirteen male rectal cancer survivors who were treated at Memorial Sloan-Kettering Cancer Center (MSKCC) for rectal cancer participated (median time post-treatment was 6.4 years). Six survivors participated in individual semi-structured phone interviews, and seven others took part in focus groups. We performed standard procedures of qualitative thematic text analysis, which involved independent review of interview and focus group transcripts by several analysts followed by consensus meetings to identify key themes. Participants reported bowel dysfunction (N = 13, or 100 %) and erectile dysfunction (N = 12, or 92 %) as chief complaints. The participants thought a psychoeducational sexual health intervention post-surgery would be helpful because it would provide educational information regarding the etiology of their problems and treatments to improve their sexual health (N = 8, or 62 %). Most participants' primary concern immediately after treatment was surviving their disease; improving sexual functioning seemed to become more important over time. Barriers to potentially participating in a psycho-educational sexual health intervention included geographical distance from MSKCC (N = 3, or 3/13) and the risk of embarrassment when discussing sexual issues (N = 5, or 5/13). Men reported that a psycho-educational sexual health intervention would be helpful to improve their sexual functioning post-treatment. Discussion of bowel issues and logistical concerns gave information on the psycho-educational sexual health intervention.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. American Cancer Society Facts and Figures (2013) Cancers of the colon and rectum key statistics. Atlanta, GA, American Cancer Society

  2. Ho VP, Lee Y, Stein SL, Temple LK (2011) Sexual function after treatment for rectal cancer: a review. Dis Colon Rectum 54:113–125

    Article  PubMed  Google Scholar 

  3. Potosky AL, Davis WW, Hoffman RM et al (2004) Five-year outcomes after prostatectomy or radiotherapy for prostate cancer: the prostate cancer outcomes study. J Natl Cancer Inst 96:1358–1367

    Article  PubMed  Google Scholar 

  4. Hendren SK, O'Connor BI, Liu M et al (2005) Prevalence of male and female sexual dysfunction is high following surgery for rectal cancer. Ann Surg 242:212–223

    Article  PubMed  Google Scholar 

  5. Mannaerts G, Schijven MP, Hendrikx A, Martijn H, Rutten HJ, Wiggers T (2001) Urologic and sexual morbidity following multimodality treatment for locally advanced primary and locally recurrent rectal cancer. Eur J Surg Oncol 27:265–272

    Article  PubMed  CAS  Google Scholar 

  6. Moriya Y (2006) Function preservation in rectal cancer surgery. Int J Clin Oncol 11:339–343

    Article  PubMed  Google Scholar 

  7. Heriot AG, Tekkis PP, Fazio VW, Neary P, Lavery IC (2005) Adjuvant radiotherapy is associated with increased sexual dysfunction in male patients undergoing resection for rectal cancer: a predictive model. Ann Surg 242:502–510, discussion 10–1

    PubMed  Google Scholar 

  8. Marijnen CA, van de Velde CJ, Putter H, van den Brink M, Maas CP, Martijn H, Rutten HJ, Wiggers T, Kranenbarg EK, Leer JW, Stiggelbout AM (2005) Impact of short-term preoperative radiotherapy on health-related quality of life and sexual functioning in primary rectal cancer: report of a multicenter randomized trial. J Clin Oncol 23:1847–1858

    Article  PubMed  Google Scholar 

  9. Andersen BL, Cyranowski JM, Espindle D (1999) Men's sexual self-schema. J Pers Soc Psychol 76:645–661

    Article  PubMed  CAS  Google Scholar 

  10. Nelson CJ, Deveci S, Stasi J, Scardino PT, Mulhall JP (2010) Sexual bother following radical prostatectomy. J Sex Med 7:129–135

    Article  PubMed  Google Scholar 

  11. Nelson CJ, Mulhall JP, Roth AJ (2010) The association between erectile dysfunction and depressive symptoms in men treated for prostate cancer. J Sex Med 8:560-566

    Google Scholar 

  12. Canada AL, Neese LE, Sui D, Schover LR (2006) Pilot intervention to enhance sexual rehabilitation for couples after treatment for localized prostate carcinoma. Cancer 104:2689-2700

    Google Scholar 

  13. Schover LR, Fouladi RT, Warneke CL et al (2002) The use of treatments for erectile dysfunction among survivors of prostate carcinoma. Cancer 95:2397–2407

    Article  PubMed  Google Scholar 

  14. Sundaram CP, Thomas W, Pryor LE, Sidi AA, Billups K, Pryor JL (1997) Long-term follow-up of patients receiving injection therapy for erectile dysfunction. Urology 49:932–935

    Article  PubMed  CAS  Google Scholar 

  15. Guest G, Bunce A, Johnson L (2006) How many interviews are enough?: an experiment with data saturation and variability. Field Methods 18:59–82

    Article  Google Scholar 

  16. Bernard HR (ed) (1994) Research methods in anthropology: qualitative and quantitative approaches. Sage Publications, Thousand Oaks

    Google Scholar 

  17. Creswell JW (ed) (1998) Qualitative inquiry and research design: choosing among five traditions. Sage Publications, Thousand Oaks

    Google Scholar 

  18. Green J, Thorogood N (eds) (2004) Qualitative methods for health research. Sage Publications, London

    Google Scholar 

  19. Patton MQ (ed) (2002) Qualitative evaluation and research methods. Sage Publications, Thousand Oaks

    Google Scholar 

  20. Miles MB, Huberman AM (eds) (1994) Qualitative data analysis, 2nd edn. Sage, Thousand Oaks

    Google Scholar 

  21. Patton MQ (1999) Enhancing the quality and credibility of qualitative analysis. Health Serv Res 34:1189–1208

    PubMed  CAS  Google Scholar 

  22. Warren CAB, Karner TX (2005) Discovering qualitative methods: field research, interviews, and analysis. Roxbury Publishing Company, Los Angeles

    Google Scholar 

  23. Guba EG (1978) Toward a methodology of naturalistic inquiry in educational evaluation. Los Angeles: University of California, Graduate School of Education, Center for the Study of Evaluation

  24. Hubbard G, Kidd L, Kearney N (2010) Disrupted lives and threats to identity: the experiences of people with colorectal cancer within the first year following diagnosis. Health (London) 14:131–146

    Article  Google Scholar 

  25. List MA, Stracks J, Colangelo L et al (2000) How do head and neck cancer patients prioritize treatment outcomes before initiating treatment? J Clin Oncol 18:877–884

    PubMed  CAS  Google Scholar 

  26. Arndt V, Merx H, Stegmaier C, Ziegler H, Brenner H (2004) Quality of life in patients with colorectal cancer 1 year after diagnosis compared with the general population: a population-based study. J Clin Oncol 22:4829–4836

    Article  PubMed  Google Scholar 

  27. Temple LK, Bacik J, Savatta SG et al (2005) The development of a validated instrument to evaluate bowel function after sphincter-preserving surgery for rectal cancer. Dis Colon Rectum 48:1353–1365

    Article  PubMed  Google Scholar 

  28. Araujo AB, Durante R, Feldman HA, Goldstein I, McKinlay JB (1998) The relationship between depressive symptoms and male erectile dysfunction: cross-sectional results from the Massachusetts Male Aging Study. Psychosom Med 60:458–465

    PubMed  CAS  Google Scholar 

  29. Shabsigh R, Klein LT, Seidman S, Kaplan SA, Lehrhoff BJ, Ritter JS (1998) Increased incidence of depressive symptoms in men with erectile dysfunction. Urology 52:848–852

    Article  PubMed  CAS  Google Scholar 

  30. Shiri R, Koskimaki J, Tammela TL, Hakkinen J, Auvinen A, Hakama M (2007) Bidirectional relationship between depression and erectile dysfunction. J Urol 177:669–673

    Article  PubMed  Google Scholar 

  31. Smith DP, Supramaniam R, King MT, Ward J, Berry M, Armstrong BK (2007) Age, health, and education determine supportive care needs of men younger than 70 years with prostate cancer. J Clin Oncol 25:2560–2566

    Article  PubMed  Google Scholar 

  32. Steginga SK, Occhipinti S, Dunn J, Gardiner RA, Heathcote P, Yaxley J (2001) The supportive care needs of men with prostate cancer (2000). Psychooncology 10:66–75

    Article  PubMed  CAS  Google Scholar 

  33. O'Brien R, Rose P, Campbell C, et al (2010) "I wish I'd told them": a qualitative study examining the unmet psychosexual needs of prostate cancer patients during follow-up after treatment. Patient Educ Couns 84:200-207

    Google Scholar 

  34. Giesler RB, Given B, Given CW et al (2005) Improving the quality of life of patients with prostate carcinoma: a randomized trial testing the efficacy of a nurse-driven intervention. Cancer 104:752–762

    Article  PubMed  Google Scholar 

  35. Lepore SJ, Helgeson VS, Eton DT, Schulz R (2003) Improving quality of life in men with prostate cancer: a randomized controlled trial of group education interventions. Health Psychol 22:443–452

    Article  PubMed  Google Scholar 

  36. Penson DF, Latini DM, Lubeck DP, Wallace K, Henning JM, Lue T (2003) Is quality of life different for men with erectile dysfunction and prostate cancer compared to men with erectile dysfunction due to other causes? Results from the ExCEED data base. J Urol 169:1458–1461

    Article  PubMed  Google Scholar 

  37. Kerr J, Engel J, Schlesinger-Raab A, Sauer H, Holzel D (2003) Doctor-patient communication: results of a four-year prospective study in rectal cancer patients. Dis Colon Rectum 46:1038–1046

    Article  PubMed  Google Scholar 

  38. Razavi D, Delvaux N, Hopwood P (1997) Improving communication with cancer patients. A challenge for physicians. Ann N Y Acad Sci 809:350–360

    Article  PubMed  CAS  Google Scholar 

  39. Montorsi F, Guazzoni G, Strambi LF et al (1997) Recovery of spontaneous erectile function after nerve-sparing radical retropubic prostatectomy with and without early intracavernous injections of alprostadil: results of a prospective, randomized trial. J Urol 158:1408–1410

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgment

NIH (site grant number 1 R21 CA137434-01A1).

Conflict of interest

The authors have no conflicts to report.

Author information

Authors and Affiliations

  1. Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, 641 Lexington Ave., 7th Floor, New York, NY, 10022, USA

    Melinda Ball, Christian J. Nelson, Elyse Shuk, Tatiana D. Starr, Heidi Woo, Sabrina Jennings & Katherine DuHamel

  2. Memorial Sloan-Kettering Cancer Center, 641 Lexington Ave., 7th Floor, New York, NY, 10022, USA

    Larissa Temple

  3. Department of Oncological Sciences, Mount Sinai School of Medicine, Icahn Medical Institute Floor 2nd Fl Room 2-70, 1425 Madison Avenue, New York, NY, 10029, USA

    Lina Jandorf

  4. Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX, 77030, USA

    Leslie Schover

  5. Department of Surgery, Memorial Sloan-Kettering Cancer Center, 353 E68th Street, New York, NY, 10065, USA

    John P. Mulhall

Authors
  1. Melinda Ball
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Christian J. Nelson
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Elyse Shuk
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Tatiana D. Starr
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Larissa Temple
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Lina Jandorf
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Leslie Schover
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. John P. Mulhall
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Heidi Woo
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Sabrina Jennings
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Katherine DuHamel
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Katherine DuHamel.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Ball, M., Nelson, C.J., Shuk, E. et al. Men’s Experience with Sexual Dysfunction Post-rectal Cancer Treatment: A Qualitative Study. J Canc Educ 28, 494–502 (2013). https://doi.org/10.1007/s13187-013-0492-y

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13187-013-0492-y

Keywords

Search

Navigation