Friend support on sex-related symptoms in patients with prostate cancer after prostatectomy

Background and objective With the increase in the survival rate of patients undergoing prostate cancer surgery, management of the quality of life has become important. Particularly, since sex-related disabilities of patients immensely affect their quality of life, management of the same is of utmost necessity. This study aimed to investigate whether support from friends could play a mediating role in patients with prostate cancer, after radical prostatectomy, for the management of sex-related symptoms and improvement of the quality of life. Material and methods This descriptive survey was conducted on 212 patients, aged 20 years or older, diagnosed with prostate cancer, and subjected to radical prostatectomy, in two South Korean University Hospitals. Data were collected from June 20 to August 10, 2017, using self-report questionnaires. Data were analyzed using the t-test, Pearson’s correlation coefficient, and multiple regression analysis. A mediation analysis was performed according to Baron and Kenny, along with bootstrapping methods. Results Patients’ quality of life was significantly correlated with the experience of sex-related symptoms (r = –0.65, P< 0.001) and support from friends (r = 0.47, P< 0.001); the latter had a significant negative correlation with the experience of sex-related symptoms (r = –0.35, P < 0.001). Support from friends showed a partial mediating effect in the correlation between the experience of sex-related symptoms and quality of life (95% CI, –0.65 to –0.06). Friend support on sex-related symptoms in patients with prostate cancer after prostatectomy e129 J Mens Health Vol 16(3):e128–e137; 24 September 2020 This article is distributed under the terms of the Creative Commons Attribution-Non Commercial 4.0 International License. ©2020 Nam KH and Shim JL INTRODUCTION Prostate cancer is the second most prevalent cancer in men,1 and according to the Annual Report of Cancer Statistics in Korea, it is also the fourth most prevalent cancer in South Korea, following gastric, lung, and colorectal cancer.2 The 10-year survival rate, following the diagnosis of prostate cancer, has increased from 46.3% in 1993 to 91.7% in 2013, and is the highest survival rate among various cancers, owing to the constant development of medical technology.2 Accordingly, management of the quality of life (QoL) of patients is now of paramount importance. Physical side effects, such as erectile dysfunction, loss of libido, and urinary incontinence, have been reported as the most common complications after radical prostatectomy (which is one of the treatments of prostate cancer), with 60–70% manifestation; they are also the key factors that could sharply lower the QoL of patients with prostate cancer.3,4 In particular, patients with prostate cancer treated with radical prostatectomy reportedly have a lower QoL than those who receive radiation therapy or androgen deprivation therapy, due to post-surgery physical complications.5 Such patients experience serious crisis regarding their value of existence owing to their loss of masculinity and sexual dysfunction; they feel despair, sense a crisis in their marital relationship, experience dissatisfaction in life, and feel alienated.6,7 Patients with prostate cancer might experience a crisis, both at home and at work, due to the unexpected occurrences of post-surgery symptoms, such as urinary incontinence and erectile dysfunction, and might face negative psychosocial problems, such as anxiety and depression; hence, their QOL might be compromised, raising doubts about the need of surgery and treatment.8,9 Social support could play a vital role in improving the QOL of such patients, by helping them to solve the problems, reduce their seriousness, and enable effective management of the crisis through buffering action that would prevent emotional responses of the individuals under stressed situations.10 Most previous studies on patients with prostate cancer have emphasized the importance of support from a spouse or from a peer group that has experienced the same disease and treatment process.7,9,11,12 Specifically, patients with prostate cancer have been reported to resolve mental stress by consulting their friends or colleagues about physical and sexual problems, rather than consulting their spouses, despite the latter being considered the closest person to notice physical changes that might have occurred after surgery.13 The overall happiness of patients, who, in addition to their families, had consulted their friends about the treatment methods prior to the treatment, was found to be significantly improved compared to that of others that did not.14 Therefore, for patients with prostate cancer, support from friends to whom they could express their feelings seems to be important. Walsh and Hegarty,15 however, reported that patients with prostate cancer might as well withdraw from social interactions owing to the fear of false prejudice or spread of rumors regarding their physical side effects after prostate cancer treatment. This was observed in many patients who feared negative evaluation from others, and if the fear was strong enough, they tended to avoid situations that might provoke social comparisons, eventually causing Conclusions Our findings indicated the necessity of psychosocial nursing programs that could utilize the support from friends to improve the quality of life of patients with prostate cancer following radical prostatectomy.