Preoperative education should be coupled with postoperative support for prostate cancer survivors, researchers suggest
Nearly half of men undergoing surgery for prostate cancer expect better recovery from the side effects of the surgery than they actually attain one year after the operation, a University of Michigan Comprehensive Cancer Center study finds.
In addition, prior to surgery, a small proportion of men had expected to have better urinary continence and sexual functions a year after the surgery than they had before it – the exact opposite of what typically happens.
“This is a belief that does not reflect preoperative counseling which, on the contrary, alerts men to urinary and sexual problems after surgery,” says study author Daniela Wittmann, M.S.W, sexual health coordinator at the U-M prostate cancer survivorship program.
The study, published in the August issue of the Journal of Urology, surveyed 152 men undergoing radical prostatectomy, an operation to remove the prostate. All of the men filled out questionnaires before surgery, after receiving preoperative counseling. The questions asked the men about their expectations of urinary, bowel, hormonal and sexual function a year after the surgery.
The study showed that for the most part, men’s expectations of hormonal and bowel function matched what happened one year after surgery. But, when it came to urinary incontinence only 36 percent of the men’s expectations corresponded to what happened one year post-surgery.
In addition, only 40 percent of men found what they expected for sexual function to be true one year post-surgery.
Also, 46 percent of the men found worse than expected outcomes in urinary incontinence and 44 percent of men found worse than expected outcomes in sexual function one year after surgery.
"When we provide preoperative education, we can only inform men in terms of overall statistics. We can't predict for the individual,” explains Wittmann. “This may mean that, if in doubt, people tend toward being hopeful and optimistic, perhaps overly optimistic.”
The researchers suggest that it is important to provide men with tools for urinary and sexual recovery after surgery and with support that will lead to the best possible outcome.
Patients who undergo surgery for prostate cancer at U-M participate in the prostate cancer survivorship program. The program includes partners as well. It is designed to provide men with excellent surgical care along with tailored, couples-oriented support both before and after surgery to help ease recovery from the side-effects of surgery.
“Although preoperative education is very important and should be explicit about the general expectations regarding outcomes, we also need to help men and their partners with the recovery process after surgery in order to help them regain their intimate lives,” says Wittmann.
Additional authors: Chang He, M.S.; Michael Coelho, B.S.; Brent Hollenbeck, M.D., M.S.; James E. Montie, M.D.; and David P. Wood Jr., M.D., all from U-M
Reference: Journal of Urology, Vol. 186, No. 2, pp.494-499