(122) Disability and Men’s Experience of Sexual Dysfunction Associated with Prostate Cancer
Authors: Kinnaird W , Kirby M , Schartau P , Jenkins V , Allen S , Payne H 
Published: March 2024

Abstract

Introduction
The physical and psychological health benefits of sexual activity are well documented. However, sexual needs in people with disabilities are often unrecognised and they are less likely to access professional support when problems arise. Almost all prostate cancer (PCa) treatments are associated with sexual side effects that can have negative effects on sexual well-being.

Objective
To explore the impact disability has on PCa patients' experiences of sexual dysfunction and accessing support.

Methods
An anonymous online survey was distributed to men with PCa in collaboration with the charity Prostate Cancer UK. Questions focused on participants’ experience of sexual dysfunction and the level of support they received. The focus of the current sub-analysis was on participants who self-reported any kind of disability. Chi-square testing was used for categorical variable analysis.

Results
654 out of 893 adult participants (73.2%) reported having a diagnosis of prostate cancer. Of those 95 (14.5%) self-reported having a disability, 553 (84.6%) reported not having a disability, and 6 (0.9%) said they would ‘prefer not to say’. Physical and psychological sexual problems were common among men with self-reported disabilities, with more than 50% reporting sexual dysfunction in 9 out of 13 domains. They were more likely to report sexual dysfunction than men with no disability in 11 out of those 13 domains, reaching the level of significance in five of those (p&lt;.05). [Fig 1] Sexual activity was rated as ‘fairly/very important’ by 77.9% (n=74) of men with a disability. Further, 60.0% (n=57) reported ‘sexual problems’ to be in their top three current concerns, the highest ranked concern from a list of 15 categories. There was no significant difference in these two results when compared with those for men who did not self-report a disability (p=.90 & p=.68). Despite this, men with a disability were significantly less likely to have discussed the sexual side effects of PCa treatment with a healthcare professional (HCP) (44.2% vs 65.3%, p&lt;.05). Of the men who did discuss sexual side effects, only a minority in both groups were offered a referral on to a specialist clinic, with no significant difference between the groups (27.6% vs 29.9%, p=.71). Men with a disability reported lower levels of satisfaction in each of five statements assessing satisfaction with support for sexual side effects, reaching the level of significance in four (p&lt;0.05) [Fig 2].

Conclusions
This study is the first to report on disability and men’s experience of sexual dysfunction associated with PCa. Our findings suggest wide-ranging physical and psychological sexual side effects are common and distressing among men with disabilities. Sexual activity is equally as important to men with disabilities but they are less likely to access support through HCPs. This results in high levels of dissatisfaction with care. The results suggest men with disabilities face additional barriers to accessing sexual support and highlight the importance of giving all men equitable access to supportive care.

Disclosure
Yes, this is sponsored by industry/sponsor: Astellas Pharma
Clarification: Industry funding only - investigator initiated and executed study.