Discrepancy between Expectations and Experiences after Prostate Cancer Treatment: A Dutch Multicenter Study

Published:September 05, 2019DOI:



      To evaluate possible discrepancies between patients’ expectations concerning sexual side effects related to prostate cancer treatment, based on the obtained information prior to treatment. Moreover, to determine if demographic or clinical factors may have an effect on the accuracy of patients’ expectations concerning sexual side effects after treatment.


      A multicenter, cross-sectional survey was performed among men treated with prostatectomy, brachytherapy, external-beam radiotherapy and/or hormonal therapy.


      In total, 412 questionnaires were analyzed. Of men with sexual side effects after treatment, 1 in 3 (32.5%, n = 109) reported their complaints as worse than expected; significantly more often reported by men treated surgically (P = .001), men with a local stage tumor (P = .005) and by men with a lower prostate-specific antigen level at diagnosis (P = .046). It was significantly less often reported by men treated with radiotherapy combined with hormonal therapy (P = .031). Men who used brochures as an information source reported their sexual side effects significantly less often as worse than expected (P < .001).


      One in three men with sexual side effects after prostate cancer treatment, experienced their complaints as worse than expected based on the obtained information prior to treatment. Men treated with radiotherapy combined with hormonal therapy indicated less discrepancy between expectations and developed sexual side effects, whereas prostatectomy, low stage tumor and low prostate-specific antigen level were associated with more discrepancy. Brochures should be administered additionally to verbal information to improve patients’ understanding of possible sexual side effects and to enhance the accuracy of patients’ expectations.
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        • Deveci S
        • Gotto GT
        • Alex B
        • O'Brien K
        • Mulhall JP
        A survey of patient expectations regarding sexual function following radical prostatectomy.
        BJU Int. 2016; 118: 641-645
        • Haglind E
        • Carlsson S
        • Stranne J
        • Wallerstedt A
        • Wilderang U
        • Thorsteinsdottir T
        • et al.
        Urinary incontinence and erectile dysfunction after robotic versus open radical prostatectomy: a prospective, controlled, nonrandomised trial.
        Eur Urol. 2015; 68: 216-225
        • Calman KC
        Quality of life in cancer patients–an hypothesis.
        J Med Ethics. 1984; 10: 124-127
        • Symon Z
        • Daignault S
        • Symon R
        • Dunn RL
        • Sanda MG
        • Sandler HM
        Measuring patients’ expectations regarding health-related quality-of-life outcomes associated with prostate cancer surgery or radiotherapy.
        Urology. 2006; 68: 1224-1229
        • van Stam M-A
        • van der Poel HG
        • van der Voort van Zyp JRN
        • Tillier CN
        • Horenblas S
        • Aaronson NK
        • et al.
        The accuracy of patients’ perceptions of the risks associated with localised prostate cancer treatments.
        BJU Int. 2018; 121: 405-414
        • Kessels RPC
        Patients' memory for medical information.
        J R Soc Med. 2003; 96: 219-222
        • Mottet N
        • Bellmunt J
        • Bolla M
        • Briers E
        • Cumberbatch MG
        • De Santis M
        • et al.
        EAU-ESTRO-SIOG guidelines on prostate cancer. Part 1: screening, diagnosis, and local treatment with curative intent.
        Eur Urol. 2017; 71: 618-629
        • Gay HA
        • Sanda MG
        • Liu J
        • Wu N
        • Hamstra DA
        • Wei JT
        • et al.
        External beam radiation therapy or brachytherapy with or without short-course neoadjuvant androgen deprivation therapy: results of a multicenter, prospective study of quality of life.
        Int J Radiat Oncol*Biol*Phys. 2017; 98: 304-317
        • Walker LM
        • Hampton AJ
        • Wassersug RJ
        • Thomas BC
        • Robinson JW
        Androgen deprivation therapy and maintenance of intimacy: a randomized controlled pilot study of an educational intervention for patients and their partners.
        Contemp Clin Trials. 2013; 34: 227-231
        • Stensvold A
        • Dahl AA
        • Brennhovd B
        • Cvancarova M
        • Fossa SD
        • Lilleby W
        • et al.
        Methods for prospective studies of adverse effects as applied to prostate cancer patients treated with surgery or radiotherapy without hormones.
        Prostate. 2012; 72: 668-676
        • Lardas M
        • Liew M
        • van den Bergh RC
        • De Santis M
        • Bellmunt J
        • Van den Broeck T
        • et al.
        Quality of life outcomes after primary treatment for clinically localised prostate cancer: a systematic review.
        Eur Urol. 2017; 72: 869-885
        • Paich K
        • Dunn R
        • Skolarus T
        • Montie J
        • Hollenbeck B
        • Palapattu G
        • et al.
        Preparing patients and partners for recovery from the side effects of prostate cancer surgery: a group approach.
        Urology. 2016; 88: 36-42
        • Grondhuis Palacios LA
        • Krouwel EM
        • Duijn M
        • den Oudsten BL
        • den Ouden MEM
        • Putter H
        • et al.
        Written information material and availability of sexual health care for men experiencing sexual dysfunction after prostate cancer treatment: an evaluation of Dutch urology and radiotherapy departments.
        Eur J Cancer Care. 2017; 26 (e12629-n/a)