Matthew A, Lutzky-Cohen N, Jamnicky L, Currie K, Gentile A, Mina D Santa, Fleshner N, Finelli A, Hamilton R, Kulkarni G, Jewett M, Zlotta A, Trachtenberg J, Yang Z, Elterman D
Department of Surgical Oncology, University Health Network, Toronto, ON.
Curr Oncol. 2018 Dec;25(6):393-402. doi: 10.3747/co.25.4111. Epub 2018 Dec 1.
The most prevalent intervention for localized prostate cancer (pca) is radical prostatectomy (rp), which has a 10-year relative survival rate of more than 90%. The improved survival rate has led to a focus on reducing the burden of treatment-related morbidity and improving the patient and partner survivorship experience. Post-rp sexual dysfunction (sdf) has received significant attention, given its substantial effect on patient and partner health-related quality of life. Accordingly, there is a need for sdf treatment to be a fundamental component of pca survivorship programming.
Most research about the treatment of post-rp sdf involves biomedical interventions for erectile dysfunction (ed). Although findings support the effectiveness of pro-erectile agents and devices, most patients discontinue use of such aids within 1 year after their rp. Because side effects of pro-erectile treatment have proved to be inadequate in explaining the gap between efficacy and ongoing use, current research focuses on a biopsychosocial perspective of ed. Unfortunately, there is a dearth of literature describing the components of a biopsychosocial program designed for the post-rp population and their partners.
In this paper, we detail the development of the Prostate Cancer Rehabilitation Clinic (pcrc), which emphasizes multidisciplinary intervention teams, active participation by the partner, and a broad-spectrum medical, psychological, and interpersonal approach.
The goal of the pcrc is to help patients and their partners achieve optimal sexual health and couple intimacy after rp, and to help design cost-effective and beneficial rehabilitation programs.
局限性前列腺癌(pca)最常见的干预措施是根治性前列腺切除术(rp),其10年相对生存率超过90%。生存率的提高使得人们将重点放在减轻治疗相关的发病负担以及改善患者及其伴侣的生存体验上。rp后性功能障碍(sdf)因其对患者及其伴侣与健康相关的生活质量有重大影响而受到了广泛关注。因此,sdf治疗有必要成为pca生存规划的一个基本组成部分。
大多数关于rp后sdf治疗的研究都涉及针对勃起功能障碍(ed)的生物医学干预措施。尽管研究结果支持促勃起药物和器械的有效性,但大多数患者在rp后1年内就停止使用这些辅助工具。由于促勃起治疗的副作用不足以解释疗效与持续使用之间的差距,目前的研究聚焦于从生物心理社会角度看待ed。不幸的是,缺乏描述为rp后人群及其伴侣设计的生物心理社会项目组成部分的文献。
在本文中,我们详细介绍了前列腺癌康复诊所(pcrc)的发展情况,该诊所强调多学科干预团队、伴侣的积极参与以及广泛的医学、心理和人际方法。
pcrc的目标是帮助患者及其伴侣在rp后实现最佳的性健康和夫妻亲密关系,并帮助设计具有成本效益且有益的康复项目。