Us -Too! Brampton General Meeting 
Feb 10th, 2009

"Sex, Intimacy and Prostate Cancer"

Dr. Andrew Matthew

Dr. Matthew gave a very personal presentation to the 50 or so members and their
parteners regarding the frequent difficulties couples must confront during Prostate
Cancer treatment. After the initial diagnosis of Prostate Cancer, patients and partners
are often focused on the primary treatment and recovery from Surgery or Radiation
Therapy but with time that focus shifts to the recovery of sexual function and the
resumption of normal sexual activity. Dr. Mathew's research and clinical practice
focuses on a Bio-Medical and Psycho-Social approach to the treatment of
Erectile Dysfunction post Prostate Cancer treatment.

The presentation covered topics like "Why is sex so important", "What problems do
patients and couples encounter", "How frequently do problems occur", "What treatments
and approaches can yield positive results", "What are normal expectations and timeframes".

Dr. Mathew introduced the Sternberg Triangle concept of a sound relationship.
The three foundations of this triangle are defined as Commitment, Intimacy and Passion.
After Prostate Cancer treatment, Passion which represents Sexual Activity is initially
lost and this can often result in a subsequent loss of Intimacy which can weaken the
patient/partner relationship resulting in a state defined by Sternberg as Empty Love.
For this reason it is important that couples try to reestablish regular sexual activity.

The presentation noted that 40-75% of men suffer from sexual dysfunction 2-5 years
after treatment and that in about 60% of those cases patients and partners experience
moderate to severe distress as a result. This occurs in spite of a number of pro-erectile
agents including oral medications, injections, vacuum devices and implants that are available.

Dr. Mathew initiated a Research Study into this subject and interviewed both patients
and partners to help determine typical problems and possible solutions to ongoing
sexual dysfunction. The study uncovered a number of common themes related to the
disorder. Men generally have difficulty dealing with the condition and tend to retreat
inwardly. This lack of communication with their partner often results in a sense of isolation.
This removes the typical social support that one might rely on in other situations. For many
couples erectile dysfunction treatment options seem to remove the spontaneity of their
sexual relationship. In many cases expectations may be too high leading to performance
anxiety when function is slow to return. The study also found a degree of confusion with
respect to treatment regimens and potential recovery times leading some couples to give
up out of a sense of frustration.

After the study it was decided that a different approach to the problem was required.
A clinic was setup at Princess Margaret to provide an educated and thoughtful approach
to restoring Sexual Intimacy in couples undergoing Prostate Cancer Therapy. This starts
with a pre-operative session with a trained Urologist and Sexual Health Counselor. This
begins the process by providing more realistic expectations and a better sense of the
potential problems that the couple may experience. Then at regular intervals post surgery,
different erectile dysfunction therapies are initiated and evaluated with the patient and
partner to determine their effectiveness. This forms the basis of strategies to aid with
patient adaptation and the acceptance of change leading to the hopeful resumption of
normal sexual activity.

We are pleased to offer the complete AUDIO recordings and SLIDES downloads
of Dr. Matthew's excellent session. Please visit the links below.

ABOUT Dr. Andrew Matthew
Dr. Matthew is a clinical psychologist at the Prostate Center, Princess Margaret Hospital,
University Health Network, a clinician investigator in the Departments of Surgery,
and Psychosocial Oncology and Palliative Care, and Assistant Professor in the
Department of Surgery at the University of Toronto.

AUDIO & SLIDES DOWNLOADS

Track 01: Sex, Intimacy and Prostate Cancer - Talk
[http://www.ustoo-brampton.com/Matthew09/sexintimacytalk.ram]
[11.8 Mbytes, Talk time: 00:50:06]

Track 02: Sex, Intimacy and Prostate Cancer - Q&A Session
[http://www.ustoo-brampton.com/Matthew09/sexintimacyqa.ram]
[4.9 Mbytes, Talk time: 00:20:48]

SLIDES:
"Sex, Intimacy and Prostate Cancer " - Presentation Slides
[http://www.ustoo-brampton.com/Matthew09/Sexintimacy.pdf]
[0.5 Mbytes, 68 Sildes]