Sexual Intimacy After Prostate Treatment Improves Through Couples Counseling
M.D. Anderson CAREss study finds internet-based sexual counseling as effective as traditional therapy; watch videos
VIDEO: Hope for Restored Sexual Function for Prostate Cancer Patients
and their Partners VIDEO: Sexual Counseling for Couples after Prostate Cancer Treatment
PODCAST: Listen to expert Leslie Schover discuss results of face-to-face
and internet-based counseling.
Sept. 26, 2011 - Prostate cancer survivors and their partners experience improved sexual satisfaction and function after
couples counseling, according to research at The University of Texas MD Anderson Cancer Center. The article, published in the September issue
of Cancer, a journal of the American Cancer Society, revealed both Internet-based sexual counseling and traditional sex therapy are equally
effective in improving sexual outcomes.
Couples on a waiting list for counseling did not improve.
Men experienced a marked improvement in their sexual function for up to one year, and women who started out with a sexual
problem improved significantly with counseling.
"We know that one of the crucial factors in a man's having a good sexual outcome after treatment is a partner who also
wants their sex life to get better," said Leslie Schover, Ph.D, a professor in MD Anderson's Department of Behavioral Science, lead
investigator on the study and author of the paper, A Randomized Trial of Internet-Based Versus Traditional Sexual Counseling for Couples
After Localized Prostate Cancer Treatment.
"Women's issues such as ill health, post-menopausal vaginal dryness and lack of desire for sex can be a major barrier in
achieving satisfactory sexual outcomes."
CAREss (Counseling About Regaining Erections and Sexual Satisfaction) randomized 115 heterosexual prostate cancer
survivors who were experiencing erectile dysfunction and their partners into three groups: a wait list group that received delayed counseling,
a face-to-face counseling group, and a group that received an Internet-based sexual counseling program.
After three months, the wait-list couples were randomized into either the face-to face or the Internet-based counseling
group. A second Internet-based group of 71 couples was added to boost the numbers and allow researchers to analyze the relationship between
extent of website use and outcomes.
Couples were assessed before and after the three-month wait-list period, again after counseling, and also at six and
12-month follow-ups. In addition to web-based education and exercises, participants in the Internet-based group received feedback from their
counselor through email.
Treating the Body and the Mind
Many prostate cancer survivors are as concerned about loss of desire and lack of satisfying orgasms as they are about
erectile dysfunction. Men in this study improved on most dimensions of sexual function. From baseline to one year, men improved significantly
in erectile function, but also in orgasmic function, intercourse satisfaction and overall sexual satisfaction. Sexual desire remained stable.
Online Helps, Too
Some patients and/or partners are too anxious about sexual issues to seek help from a therapist face-to-face. An
internet-based program that offers online tools and surveys, as well as interaction with the therapist by email, gives them a less threatening
"Not only do men often use the internet to search for information on sex, but prostate cancer patients consider the web a
valuable resource for information on the impact of treatment on sex," said Schover.
Another advantage of web-based counseling for couples is the potentially lower cost. While many insurance companies cover
medical treatment of erection problems after prostate cancer, the cost of sex therapy is often not reimbursed. Already burdened with
co-payments for their cancer treatment, many couples cannot afford additional costs associated with mental health care.
"Very few insurance policies sufficiently cover sexual counseling in particular, and mental health counseling in
general," said Schover.
"Another barrier is that there are few mental health care professionals trained to deal with both cancer coping and
The results from the CAREss study have already contributed to Schover's current research. She is developing a more
general multimedia interactive counseling program to help men with any type of cancer and their partners improve their sex lives. She hopes
this program will help men and couples with limited insurance or lack of access to a big city or cancer center.
The CAREss trial, and surveys leading to its development, were funded by grants from the American Cancer Society.
Co-authors with Schover are Andrea L. Canada, Ph.D, Rush University Medical Center, Chicago; Ying Yuan, Ph.D and Dawen
Sui, MD Anderson Department of Biostatistics; Leah Neese, private practice, Mont Belvieu, Texas; Rosell Jenkins, Ph.D, private practice,
Houston; and Michelle M. Rhodes, Ph.D, Prairie View A&M University, Prairie View, Texas.
The University of Texas MD Anderson Cancer Center in Houston reports it ranks as one of the world's most respected
centers focused on cancer patient care, research, education and prevention. MD Anderson is one of only 40 comprehensive cancer centers
designated by the National Cancer Institute. For seven of the past nine years, including 2010, MD Anderson has ranked No. 1 in cancer care in
"America's Best Hospitals," a survey published annually in U.S. News & World Report.
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