Faculty of Medicine, McGill University, Montreal, QC, Canada.
Department of Radiation Oncology, Princess Margaret Cancer Centre, University Health Network (UHN), University of Toronto, Toronto, ON, Canada.
Int J Impot Res. 2021 May;33(4):410-417. doi: 10.1038/s41443-020-00389-1. Epub 2021 Jan 6.
The treatment of prostate cancer is partly guided by patient preferences. Radical prostatectomy and radiation therapy are the standard radical therapies for localized disease and render comparable oncologic outcomes. Considering that survival is high regardless of the chosen treatment, factors such as treatment-related toxicities affecting the patients' quality of life play an important role in their decision. Notably, post-treatment sexual dysfunction, which includes decreased libido, erectile dysfunction, and ejaculatory dysfunction has been shown to be an important and prevalent concern of prostate cancer survivors. In this literature review, we sought to characterize the sexual complications associated with radiation therapy and map the available sexual rehabilitation options for prostate cancer survivors experiencing sexual dysfunction as a result of radiation therapy. We identified medical, non-biomedical, counseling, and lifestyle modification options for prostate cancer survivors seeking sexual rehabilitation. Future research in this area should address the standardization of sexual side-effect reporting and investigate sexual outcomes and rehabilitation in more diverse groups and of transgender and nonheterosexual prostate cancer survivors.
前列腺癌的治疗部分取决于患者的偏好。根治性前列腺切除术和放射治疗是局部疾病的标准根治性治疗方法，可产生相当的肿瘤学结果。考虑到无论选择哪种治疗方法，生存率都很高，因此在决策中，治疗相关的毒性等影响患者生活质量的因素起着重要作用。值得注意的是，治疗后性功能障碍，包括性欲下降、勃起功能障碍和射精功能障碍，已被证明是前列腺癌幸存者的一个重要且普遍存在的关注点。在这篇文献综述中，我们试图描述与放射治疗相关的性并发症，并为因放射治疗而出现性功能障碍的前列腺癌幸存者描绘可用的性康复选择。我们为寻求性康复的前列腺癌幸存者确定了医学、非生物医学、咨询和生活方式改变的选择。该领域的未来研究应解决性副作用报告的标准化问题，并在更多不同群体和跨性别及非异性恋前列腺癌幸存者中调查性结果和康复问题。
