Sexual Function of Men Undergoing Active Prostate Cancer Treatment Versus Active Surveillance: Results of the Europa Uomo Patient Reported Outcome Study

Background: Europa Uomo initiated the Europa Uomo Patient Reported Outcome Study (EUPROMS) to inform future patients with prostate cancer about the impact of prostate cancer treatment on sexual function. Methods: A one-time online survey was conducted among patients with prostate cancer who underwent treatment for the disease. The survey included the Expanded Prostate Cancer Index Composite short form 26 (EPIC-26) and questions on the use of medications or devices to aid/improve erections in men. Descriptive statistics were used to analyse the EPIC-26 sexual domain and the use of medications or devices. Results: Men on active surveillance reported the highest median sexual function scores (57.0, interquartile range [IQR]: 26.3–83.3) compared with men who underwent radical prostatectomy (20.8, IQR: 8.3–44.5) or radiotherapy (17.3, IQR: 9.7–40.3). Of the men on active surveillance, 44.7% reported “very poor to none/poor ability” to have an erection compared with 71.7–88.2% of the men undergoing active treatment for prostate cancer. Of the men treated actively, 66.6–88.3% rated their ability to function sexually as “very poor/poor” compared with 43.1% for men on active surveillance; more than half of the men who underwent radical prostatectomy viewed their lack of sexual function as a moderate or big problem for which they had tried medications or devices. Conclusions: The EUPROMS study showed that the impact of prostate cancer treatment on sexual function can be significant and non-negligible. These data can be used in daily clinical practice to guide the preference-sensitive decisionmaking process faced by patients newly diagnosed with prostate cancer.