At the second day of the 25th SMSNA Annual Fall Scientific Meeting, Dr. Petar Bajic and Dr. Daniela Wittmann shared crucial insights on the often underappreciated impact of androgen deprivation therapy (ADT) on sexual wellbeing and overall quality of life for prostate cancer patients.
Dr. Bajic explained that ADT, while effective in shrinking and controlling cancer by "starving" cancer cells of testosterone, does not kill them. He emphasized that patients undergoing ADT often suffer from side effects such as hot flashes, erectile dysfunction, and fatigue due to low testosterone levels. In his practice, he takes a symptom-directed approach, offering treatments like PDE5 inhibitors, testosterone replacement therapy (TRT), and inflatable penile prostheses in some cases to help manage these issues. However, TRT is not without risks, and some patients may face worsened cancer progression but choose it to improve their quality of life.
Dr. Wittmann shed light on the emotional and psychological toll of ADT, noting the high rates of depression and even suicidality among patients, particularly with newer antiandrogen treatments. She discussed how men experience grief over the loss of sexual function, body changes, and diminished intimacy with their partners. Contrary to popular belief, many men continue to value their sexuality despite lowered libidos due to treatments. Dr. Wittmann stressed the importance of providing referrals for counseling and offering erectile aids to support patients and couples in navigating these challenges.
Their session highlighted the need for more comprehensive care for this population of patients, ensuring that the sexual wellbeing of prostate cancer patients undergoing ADT is not overlooked.
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