A $1.6 million grant from the Movember Foundation, an Australian nonprofit organization, will fund the development of a web-based intervention to provide support and guidance for sexual rehabilitation for men undergoing prostate cancer diagnosis and treatment, as well as their partners.
Whether patients undergo surgery, hormonal therapy, or radiation therapy for active treatment of prostate cancer, all treatments can have sexual side effects. As many as 20-80% of men can expect to experience some disruptions to their usual sexual experience, which can include changes in sex drive, erections, or orgasms.
A multidisciplinary, multisite team led by Daniela Wittmann, Ph.D., M.S.W., clinical assistant professor of urology, is spearheading the project. Wittmann considers helping men achieve satisfaction with their sex lives after prostate cancer treatment to be a critical piece of their overall sense of well-being and recovery, as well as maintaining a supportive relationship with their partners through the cancer journey.
Men often have overly optimistic expectations about their recovery from the sexual side effects of prostate cancer treatment, research by Wittmann has shown, which can be significant and long-lasting.
With appropriate education and guidance, however, men and their partners can both recover sexual function and maintain intimacy in their relationships, even if this means adjusting to a “new normal” in their sex lives post-treatment. The new intervention will aim to help men regain and maintain satisfaction with their sex lives with their partners, an important factor in restoring overall quality of life during and after prostate cancer.
“While couples may have to make accommodations in their sexual relationships, they can arrive at a point where they feel really satisfied with their sex lives, and that is an outcome that patients and their partners, rather than providers or researchers, can help define,” Wittmann says. “Our team thinks this is a good primary outcome to try to be successful with.”
Prostate cancer is a highly prevalent disease that also has a high survival rate. Improved detection methods for prostate cancer mean that greater numbers of men, and more at a younger age, are now receiving treatment, and thus are subject to a myriad of sexual side effects. Wittmann notes that healthy sexuality and sexual lives are an important quality of life issue for men of all ages, no matter what difficulties they may experience post-treatment.
Co-investigators Craig Pollack, M.D., M.P.H., associate professor of primary care at Johns Hopkins University, and Akanksha Mehta, M.D., assistant professor of urology at Emory University, are collaborating on the design of the intervention. Co-Investigator Larry An, M.D., associate professor of internal medicine and director of the U-M Center for Health Communications Research (CHCR), will direct the technical and creative team to make the intervention available in a web-based format.
U-M is the coordinating institution for the development of the sexual recovery intervention and for the randomized controlled trial that will evaluate it, with the goal of making the intervention publicly available by 2019. Other institutions participating in the RCT are UCLA and Memorial Sloan Kettering Cancer Center.
Both Wittmann and An are members of U-M's Institute for Healthcare Policy & Innovation.
The sexual recovery intervention's 12 modules will be integrated into a holistic program with five other interventions, developed by Movember's TrueNTH - USA collaborative network of 15 academic institutions across the U.S. The goal of all of these interventions is to improve the quality of life for men living with and beyond prostate cancer by offering a free, effective web-based intervention offering information to individuals, their partners, and their providers anywhere.
In addition to the sexual recovery intervention, the other components of the larger program that are also currently in development at other sites across the U.S. They will cover symptom management, decision support, social support networks, exercise and diet, and care plan and navigation.
Each year during the month of “Movember,” the Movember Foundation challenges men to grow moustaches to raise awareness for men’s health issues, and funding for its programs – participants ask friends and family for donations to support their efforts. According to the foundation, “4 million moustaches have been grown worldwide” in support of its causes, raising $559 million to fund more than 800 programs in 21 countries.
Wittmann, who is one of the leading members in the Prostate Cancer Survivorship Program at the University of Michigan Comprehensive Cancer Center as well as a member of the Dow Division for Urologic Health Services Research, has more than 30 years of experience in individual, couple, and family psychotherapy with patients with chronic illnesses, including cancer and severe mental illness. She has been a certified sex therapist since 2008.