The Effects of Radiation Therapy for Prostate Cancer on Gay and Bisexual Men’s Experiences of Mental Health, Sexual Functioning and Behavior, Sexual Identity, and Relationships

Abstract

C H A P T E R S U M M A R Y As part of a larger study of prostate cancer in gay, bisexual and other men who have sex with men (GBM) in North America, we conducted individual semistructured telephone interviews with 6 GBM who received radiation treatment and 19 who underwent radical prostatectomy. GBM who underwent radiation treatment reported multiple sexual challenges similar to those published for men who underwent radical prostatectomy. Two key differences were identified. GBM who received radiation reported additional bowel and urinary urgency challenges that were not reported by GBM who had radical prostatectomies, which had implications for receptive anal sex. Conversely, GBM who received radiation were less likely to report severe erectile dysfunction, anatomical changes, and total ejaculate loss than GBM with radical prostatectomies. Clinical implications include the importance of addressing these differences in sexual outcomes when discussing treatment options with GBM, possibly as part of a broader discussion of role-in-sex and how to minimize the negative effects of treatment.