Presentation Authors: Channa Amarasekera*, Vincent Wong, Kathryn Jackson, Christopher Morrison, Oliver Ko, David Victorson, Shilajit Kundu, Chicago, IL
Introduction: Deciding on which treatment to pursue for prostate cancer (PCa) is a complex process. There is some evidence that men who have sex with men (MSM) and heterosexual men (HSM) have differing approaches to choosing treatment for prostate cancer and weigh the side effects associated with treatment differently. Our objective was to identify what was important to sexually active men in each group when choosing treatment for prostate cancer and assess for differences in how side effects are perceived before and after treatment.
Methods: We queried a database containing self-reported survey responses from 706 men between 50-89 years old from across the US regarding their views on PCa treatment. 308 MSM were sexually active in the preceding 12 months (47 had PCa), 306 HSM were sexually active in the preceding 12 months (42 had PCa). Continuous variables were analyzed with a t-test, and a chi-square test was used for categorical variables.
Results: Treatment effectiveness to eradicate cancer was most important when choosing treatment in both groups (69.1% MSM vs. 70.4% HSM, p=.54). In sexually active men, preservation of ejaculatory function (53.7% vs. 26.4%, p < .0001) was significantly more important to MSM. There were no differences in importance placed on preservation of penile length, bother with erectile function, or perception of diminished masculinity with impaired erectile function between the groups. Interestingly, when analyzing the sub-groups of MSM and HSM with PCa, treatment effectiveness continued to be the most important factor influencing choice of treatment, but the percentage of MSM who found ejaculatory function to be important dropped to levels similar to HSM, with no differences between the groups (33.3% vs. 26.3%, p=0.66)
Conclusions: In comparing how several sexual factors are viewed, our study shows that MSM and HSM without a PCa diagnosis only differed in how they viewed ejaculatory function, with MSM finding this to be more important. Interestingly, when examining men treated for PCa, lesser importance is placed on ejaculatory function by MSM possibly suggesting the use of successful adapting or coping mechanisms.