New tool reveals impact of prostate cancer on sexual health of female partners

A team of investigators has developed a new instrument that can be used to assess sexual health among female partners of patients with prostate cancer.^1,2

The investigators next plan to explore the effects of prostate cancer on the sex lives of male and nonbinary partners of patients with the disease.

The questionnaire, called Sexual Concerns In Partners of Patients with Prostate cancer (SCIPPP-F), was validated among a diverse sample of 200 female partners across the United States, showing that treatment for prostate cancer has a significant impact on the sexual health and quality of life of female partners.

"Our findings highlight the substantial impact of prostate cancer on female partners of patients. Couples may benefit from referral to a sexual medicine specialist, sex therapy, support groups, or mental health services that focus on loss and grief and sexual rehabilitation," said lead author Stacy Loeb, MD, in a news release on the findings.² Loeb is a professor in the departments of urology and population health at NYU Grossman School of Medicine and Perlmutter Cancer Center in New York, New York.

For the study, the investigators developed a 32-item questionnaire through a literature review, 2 previous studies, and a consensus panel with 11 experts. The team then conducted 90-minute interviews with 12 partners of patients with prostate cancer for further refinement of the survey. The resulting 27-item questionnaire was then validated among 200 female partners across the United States.

The exploratory factor analysis included 19 items on the questionnaire, revealing 7 key themes: “(1) distress/satisfaction, (2) loss of connection as a couple, (3) active communication, (4) discomfort with communication, (5) frustration with sexual counseling, (6) expansion of sexual repertoire, and (7) nonpenetrative sexual activity.”¹

The communalities for these items ranged from 0.61 to 0.83, and the inter-item correlations ranged from 0.05 to 0.80. Further, the scale demonstrated strong internal consistency, with an ordinal alpha value of 0.94, as well as test-retest reliability, with a score of 0.89.

Participants in the study scored an average of 8.1 (out of 9) on the Knowledge of Hereditary Prostate Cancer Scale. The authors also noted that across participants in the validation study, the average score on the PHQ-9 depression questionnaire was 4.4, which is higher than what is seen in other population-based samples.

They wrote, “In our survey, loss of connection as a couple was the domain most closely correlated with depression, suggesting that this is a key determinant of mental health. Therefore, female partners of patients with [prostate cancer] may benefit from additional support and mental health services focusing on loss and grief.”

Overall, the mean age of participants in the validation study was 61.7 years. Among all participants, 83% were White and 16.5% were Black and/or Latinx. The average time in the relationship was 25 years, and the average time since their partner’s diagnosis was 5 years.

Moving forward, the team hopes that the tool may be used in research and clinical practice to better address the sexual quality of life of female partners.

"Our hope is that clinicians will use our survey to help patients and their partners identify issues in their sex lives that are impacted by this common cancer and to help determine what support services could be useful," added Loeb in the news release.² "When thinking about living with prostate cancer, this is really a couples' disease, and partners' unmet needs should be part of the conversation."

The team of investigators next plans to explore the effects of prostate cancer on the sex lives of male and nonbinary partners of patients with the disease.

References

1. Loeb S, Gupta N, Wittmann D, et al. Development and validation of a survey to assess sexual health in female partners of patients with prostate cancer. Eur Urol Oncol. 2024:S2588-9311(24)00113-5. doi:10.1016/j.euo.2024.04.022

2. New tool flags hidden sexual struggles in female partners of patients with prostate cancer. News release. NYU Grossman School of Medicine and NYU Langone Health. May 20, 2024. Accessed May 22, 2024. https://www.prnewswire.com/news-releases/new-tool-flags-hidden-sexual-struggles-in-female-partners-of-patients-with-prostate-cancer-302150402.html