ABSTRACT
OBJECTIVE: Side effects of cancer treatment have been found to have a significant impact on patients' psychological well-being. Each of the primary treatment options for prostate cancer is associated with significant side effects that can have a dramatic impact on quality of life. Hot flashes are a notable side effect of androgen deprivation therapy (ADT) and a potential source of distress due to their episodic nature and low frequency in a normal aging male population. The current study sought to examine the relationship between hot flashes and cancer-related distress during the first three months of ADT. METHODS: Participants were 68 men with various stages of prostate cancer scheduled to begin ADT for the first time. Study measures were completed at the beginning of treatment and 3 months later. RESULTS: Repeated measures ANOVA indicated that men who did not experience hot flashes had a significant decrease in total cancer-related distress and avoidance over the 3-month period, while men with hot flashes exhibited no change in distress. Among men with hot flashes, results of hierarchical regression analyses indicated that a worse experience with hot flashes was a significant predictor of greater increases in intrusion and total cancer-related distress over the 3-month period. CONCLUSIONS: These results suggest that hot flashes serve to maintain levels of distress during the treatment period. Further research should extend these findings by lengthening the follow-up period and using ecological momentary assessment to refine measurement of these constructs and provide evidence for the direction of causality between hot flashes and distress.
Subject(s)
Adaptation, Psychological , Antineoplastic Agents, Hormonal/adverse effects , Gonadotropin-Releasing Hormone/agonists , Goserelin/adverse effects , Hot Flashes/chemically induced , Hot Flashes/psychology , Leuprolide/adverse effects , Prostatic Neoplasms/drug therapy , Prostatic Neoplasms/psychology , Sick Role , Aged , Aged, 80 and over , Antineoplastic Agents, Hormonal/therapeutic use , Chemotherapy, Adjuvant , Combined Modality Therapy , Delayed-Action Preparations , Goserelin/therapeutic use , Humans , Injections, Intramuscular , Leuprolide/therapeutic use , Male , Middle Aged , Neoplasm Recurrence, Local/drug therapy , Neoplasm Recurrence, Local/psychology , Prostate-Specific Antigen/blood , Prostatic Neoplasms/blood , Quality of Life/psychology , Surveys and QuestionnairesABSTRACT
Penile prosthesis surgery is a recommended treatment option for a subset of patients who present with erectile dysfunction (ED). Although treatment outcome research indicates that patients are generally satisfied with this intervention, it remains an invasive procedure with risk for complications. A review of the literature reveals general agreement for the importance of a thorough preoperative evaluation to determine appropriateness for a penile implant; however, there are no known descriptions of such an evaluation in the literature. This article provides an introduction to the domains that are most relevant to assess in a patient who is considering penile implant surgery: sexual history (including organic and psychogenic causes of ED), success and utilization of other treatment interventions, relationship functioning, and patient expectations for and knowledge of the procedure. The advantages to this approach are presented, particularly in enhancing patient satisfaction with treatment outcomes.
