Learning to live with the “new normal” … or avoid it if you can

Very, very, very slowly it appears that we are starting to see some serious interest in research into the psychosocial impact of prostate cancer and its treatment on men and their close family members and/or intimate partners.

A recent paper by Hanly et al., originally published in BMC Urology and recently reprinted in full on the Medscape web site, offers an example of the early stages of this type of research.

The study tell us little that is really new (if one has any reasonable amount of experience as a prostate cancer advocate), but it does start to lay out a landscape addressing the areas of potential research that can be done, and the need for well-coordinated care processes designed to address the many pre-treatment and post-treatment needs of men who require invasive treatment for localized prostate cancer. It also may be helpful in presenting men with information about why active surveillance (as opposed to aggressive interventional therapy) may be a wise strategy for carefully selected patients with low-risk disease.

The study is small, involving intense interviews with just 21 Australian patients, but it presents a very clear outline of the varied ways in which treatment for prostate cancer can affect the patients and his relationships with others under three major headings:

  • The psychosexual impact of treatment
  • The issues related to communication and support
  • Integration of the impacts of treatment into a “new normal” for the patient and his wife/partner

While other researchers have documented the existence of these issues  in similar, small studies over the years, Hanly and her colleagues appear (at least to this commentator) to have truly listened to and “heard” what they were being told by the patients. Their article feeds this information back in a way that “feels different” to the information offered by other researchers, which all too often has appeared to lack an essential empathy for the ways in which patients’ lives have been changed.

The increasing recognition by many clinicians that, in the attempt to “cure” prostate cancers that may or may not really have required aggressive forms of treatment, we have been having truly severe, long-term, psychosocial and psychosexual effects on many men and their families is at the heart of this paper by Hanly and her colleagues — and they give full acknowledgement to this fact in the very first line of the abstract of their paper.

Perhaps this paper really does represent a “new beginning” in the attempt to make sure that men will always understand, as they explore the implications of treatment for localized prostate cancer, that the risks associated with such treatment are by no means small.

One Response

  1. I had already forwarded this to all online support lists to which I subscribe as well to all prostate cancer patients and physicians in the Wichita, Kansas, metro area for whom I have e-mail addresses, making note that physicians need to do more and may need to designate a nurse/staff member to study this issue more and be prepared to address this issue with patients and their spouses/partners pre-treatment for prostate cancer. I also have provided it as a subject on my website “Observations” webpage.

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