Advances in the treatment of sexual dysfunction in men: Applications for mindfulness-based cognitive therapy

One in eight men will be diagnosed with prostate cancer in their lifetime. Advances in prostate cancer treatments mean that the number of prostate cancer survivors is higher than ever; however, prostate cancer treatments come with side effects, many of which are life-long. Up to 90 percent of prostate cancer survivors will go on to experience erectile dysfunction (ED) — difficulties obtaining/maintaining an erection sufficient for sexual activity that can be highly distressing for both men and their partners. Although some medical treatments for ED exist (e.g. Viagra), these medications tend not to be very effective for these men.

Mindfulness (non-judgmental present-moment awareness) is a new tool in sex therapy that has been shown to be effective in treating women with sexual dysfunction. Mindfulness has also been shown to have psychological and physiological benefits for men who have survived prostate cancer (for example, it improves quality of life as well as immune system functioning in these men). The current research study aims to take the same mindfulness-based sex therapy that is effective for women, and adapt it for men with ED following prostate cancer treatments and their partners.

Men experiencing ED following prostate cancer treatment will be recruited from the Vancouver Prostate Centre to take part in a mindfulness-based group therapy. Men will be randomized to either an immediate or a delayed treatment group. The group will consist of six to eight other men and their partners, and involves two-hour sessions for four consecutive weeks, with home practice activities in between sessions. Content of the sessions will include education, elements of sex therapy, and mindfulness training. We predict that mindfulness therapy represents a new and important treatment that will ultimately help improve quality of life in the growing number of men who experience ED following prostate cancer treatments.

This project will examine optimal combinations of psychological and medical care for men with ED following treatment for prostate cancer and their partners, with the ultimate goal of improving conceptualization and treatment. In order to increase men’s access to sexual health care, knowledge translation is pivotal. I will collaborate with Dr. Lori Brotto and Dr. Tia Higano to share the findings with academics (e.g. conferences, publications) and stakeholders (e.g. media), and train clinicians to deliver MBCT for men (e.g. clinical psychology students at UBC, paraprofessionals in sexual health clinics across UBC and Vancouver hospitals).