Thanks to early detection and aggressive treatment for prostate cancer, 97 percent of all men diagnosed with the disease will survive at least 5 years and nearly 80 percent will survive at least a decade.
Yet as many prostate-cancer survivors come to discover, the lifesaving benefits of surgery, radiation and hormone therapy can come with a cost. All three treatments may bring on sexual dysfunction and urinary incontinence. In addition, by depriving the body of testosterone, long-term hormone therapy can blunt a man's sex drive, sap his energy and trigger mood swings. These and other quality-of-life adjustments affect patients as well as their partners and aren't easily resolved in the doctor's office, said Dr. Tia Higano, a prostate-cancer specialist at the Seattle Cancer Care Alliance.
"We know that families have many needs that we as physicians cannot always adequately meet," said Higano, an associate professor of medicine at the University of Washington. "These include assistance to cope with the side effects of treatments for prostate cancer, which can have major impacts on a couple's day to day life. We'd like to do something more to help patients/families deal with these changes."
'Toolbox of strategies'
Higano found her answer in Dr. Sylvie Aubin, a psychologist who completed postdoctoral studies last year at the University of Washington. Aubin sits in on Higano's patient consults, and offers prostate-cancer patients and their partners a "toolbox" of strategies to cope with challenges that are often hard to talk about. She began her collaboration with Higano in March.
"Men can live a long time after treatment for prostate cancer, and they deserve to have a good quality of life," said Aubin, an acting instructor in the Department of Psychiatry and Behavioral Sciences at UW. "But it's often very hard to get men to open up about these problems, which is the first step. Once I open the door for them to do that, my role is to be a 'tool person' — to provide patients and partners with a collection of strategies to help them deal with these challenges."
Patients or couples may elect to schedule follow-up sessions with Aubin, in which they receive individualized counseling. Aubin estimates that currently, about 30 percent of couples have pursued additional counseling, a number that is steadily rising.
Aubin teaches patients and couples a variety of coping strategies. For example, if a couple is having intimacy problems, she first works with them to redefine intimacy and then provides various exercises for them to try.
"If a man is having mood swings, I first work on increasing his awareness of how he reacts across situations with an emphasis on the relationship between physical, emotional and cognitive states," she said. "I then provide communication and/or assertiveness skills such as active listening and expressing one's thoughts and feelings."
The changes men experience can touch many aspects of their day-to-day life, particularly if they undergo hormone therapy. The treatment, which is common among men whose cancer recurs, produces an array of side effects collectively known as "male menopause." In addition to changes in sexual functioning, men on hormone therapy may notice changes in appetite, weight gain and a drop in their usual energy levels.
In addition to providing assistance to patients, one of Aubin's primary goals is to offer resources for spouses and partners, who often feel unprepared to deal with the effects of treatment on their loved ones. At a local prostate-cancer conference last year, Aubin co-hosted a session for patient spouses and significant others to discuss their concerns and provide them with information and resources to ease their adjustment. Based on the event's success, Aubin and colleagues will offer the session again at this year's meeting on June 25. She also developed a monthly support group for spouses and significant others at the Alliance that will begin July 14.
Although her work is primarily clinical now, Aubin is developing new intervention strategies to combat the effects of prostate-cancer therapies. She and Higano plan to measure the benefits of those interventions in the coming months in a research study.
Prostate-cancer conference will address quality of life June 24-25
The University of Washington, Oregon Health and Sciences University, and the American Cancer Society will host the Pacific Northwest Prostate Cancer Conference on June 24-25. The conference is open to cancer patients, their families and members of the public and will feature talks from experts on prostate-cancer treatment and quality of life issues. An evening session from 6 to 8 p.m. on June 24 in Kane Hall at the University of Washington will focus on sex and intimacy issues after treatment. The second day of the conference will take place from 8 a.m. to 4:30 p.m. at Nile Golf and Country Club in Mountlake Terrace and will offer sessions on diagnosis, treatment and spouse or caregiver concerns.
The cost for the June 24 evening session is $7.50 per person or $10 per couple. The cost for the June 25 session is $35 per person. To register, or for more information, visit the conference Web site: http://depts.washington.edu/guoncres/News.html or call 206-288-6269.
