The management of sexual dysfunction resulting from radiotherapy and androgen deprivation therapy to treat prostate cancer: A comparison of uro-oncology practice according to disease stage.

OBJECTIVES: To establish current uro-oncology practice in the management of sexual dysfunction (SD) following radiotherapy (RT) and/or androgen deprivation therapy (ADT) to treat prostate cancer. To identify differences in approach to the management of SD according to disease stage. SUBJECTS AND METHODS: A 14-question mixed methods survey was designed to assess the current UK practice. Closed- and open-ended questions were used to quantify results while allowing participants to expand on answers. The survey was distributed to members of the British Uro-Oncology Group at the 2019 annual meeting. RESULTS: Surveys were completed by 63 uro-oncologists attending the annual meeting of the British Uro-Oncology Group (response rate 66%). The major issue highlighted was a difference in approach to managing SD according to disease stage. More than half of the participants (56%) said 'advanced stage of disease' was a barrier to discussing SD. Clinicians were less likely to discuss SD, take baseline assessments, refer to a specialist clinic or offer rehabilitation when dealing with patients with advanced disease. Only a minority said that the management of SD was primarily their responsibility (11%). Nearly all clinicians (92%) had access to SD clinics; however, the majority of clinicians did not routinely refer patients. CONCLUSIONS: This study shows that men with advanced prostate cancer need better support in managing SD. Patients receiving long-term ADT are less likely to be offered any kind of help or intervention. Specific guidance on managing SD in this cohort may result in improvements in sexual function, emotional well-being, quality of life, mental health and confidence.

A systematic approach for providing concrete services and discharge planning based on using information handouts.

While information handouts are commonly used in healthcare education, this paper is about social workers systematically developing and using them to provide timely, efficient, and ultimately better patient care for concrete services and discharge planning. How to identify topics and suggestions for composing user-friendly handouts are discussed. Many clinical uses for handouts are considered including: engaging, assessing, and empowering patients, groups, and families. Related uses are considered such as educating the treatment team and students. How handouts can be a crucial bridge to developing a comprehensive, focused social resource database is considered. Follow-up survey results with an inner city VA social work staff (N= 41) confirm that social work discharge planners and non-discharge planners find systematically developed handouts valuable for providing efficient, better patient care.