Adamakis I, Vasileiou I, Constantinides CA. The treatment of iatrogenic male incontinence: latest results and future perspectives. Rev Recent Clin Trials.. 2013; 8:(1)36-41

Anandadas CN, Clarke NW, Davidson SE Early prostate cancer—which treatment do men prefer and why?. BJU Int.. 2011; 107:(11)1762-1768

Benson JS, Abern MR, Levine LA. Penile shortening after radical prostatectomy and Peyronie's surgery. Curr Urol Rep.. 2009; 10:(6)468-474

Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol.. 2006; 3:(2)77-101

Carlsson S, Nilsson AE, Johansson E, Nyberg T, Akre O, Steineck G. Self-perceived penile shortening after radical prostatectomy. Int J Impot Res.. 2012; 24:(5)179-184

Carmack Taylor CL, Kulik J, Badr H A social comparison theory analysis of group composition and efficacy of cancer support group programs. Soc Sci Med.. 2007; 65:(2)262-273

Cash TF. Body image: past, present, and future. Body Image.. 2004; 1:(1)1-5

Christie DRH, Sharpley CF, Bitsika V. Why do patients regret their prostate cancer treatment? A systematic review of regret after treatment for localized prostate cancer. Psychooncology.. 2015; 24:(9)1002-1011

Fobair P, Stewart SL, Chang S, D'Onofrio C, Banks PJ, Bloom JR. Body image and sexual problems in young women with breast cancer. Psychooncology.. 2006; 15:(7)579-594

Frey A, Sonksen J, Jakobsen H, Fode M. Prevalence and predicting factors for commonly neglected sexual side effects to radical prostatectomies: results from a cross-sectional questionnaire-based study. J Sex Med.. 2014; 11:(9)2318-26

Gwede CK, Pow-Sang J, Seigne J Treatment decision-making strategies and influences in patients with localized prostate carcinoma. Cancer.. 2005; 104:(7)1381-1390

Haliloglu A, Baltaci S, Yaman O. Penile length changes in men treated with androgen suppression plus radiation therapy for local or locally advanced prostate cancer. J Urol.. 2007; 177:(1)128-130

Harrington JM, Jones EG, Badger T. Body image perceptions in men with prostate cancer. Oncol Nurs Forum.. 2009; 36:(2)167-172

Hedestig O, Sandman PO, Tomic R, Widmark A. Living after external beam radiotherapy of localized prostate cancer: a qualitative analysis of patient narratives. Cancer Nurs.. 2005; 28:(4)310-317

Hopfgarten T, Adolfsson J, Henningsohn L, Onelöv E, Steineck G. The choice between a therapy-induced long-term symptom and shortened survival due to prostate cancer. Eur Urol.. 2006; 50:(2)280-289

Hopwood P, Fletcher I, Lee A, Al Ghazal S. A body image scale for use with cancer patients. Eur J Cancer.. 2001; 37:(2)189-197

Hosain GMM, Sanderson M, Du XL, Chan W, Strom SS. Racial/ethnic differences in treatment discussed, preferred, and received for prostate cancer in a tri-ethnic population. Am J Men Health.. 2012; 6:(3)249-257

Lee JK, Assel M, Thong AE Unexpected long-term improvements in urinary and erectile function in a large cohort of men with self-reported outcomes following radical prostatectomy. Eur Urol.. 2015; 68:(5)899-905

Levinson AW, Lavery HJ, Ward NT, Su LM, Pavlovich CP. Is a return to baseline sexual function possible? An analysis of sexual function outcomes following laparoscopic radical prostatectomy. World J Urol.. 2011; 29:(1)29-34

Lin YH. Treatment decision regret and related factors following radical prostatectomy. Cancer Nurs.. 2011; 34:(5)417-422

Manne S, Badr H, Zaider T, Nelson C, Kissane D. Cancer-related communication, relationship intimacy, and psychological distress among couples coping with localized prostate cancer. J Cancer Surviv.. 2010; 4:(1)74-85

Morris BB, Farnan L, Song L Treatment decisional regret among men with prostate cancer: Racial differences and influential factors in the North Carolina Health Access and Prostate Cancer Treatment Project (HCaP-NC). Cancer.. 2015; 121:(12)2029-2035

National Institute for Health and Care Excellence. Prostate cancer: diagnosis and management. NICE guideline 131. 2019. (accessed 24 September 2020)

Nelson CJ, Deveci S, Stasi J, Scardino PT, Mulhall JP. Sexual bother following radical prostatectomyjsm. J Sex Med.. 2010; 7:(1)129-135

O'Connor A. Using patient decision aids to promote evidence-based decision making. Evid Based Med.. 2001; 6:(4)100-102

Oliffe J. Constructions of masculinity following prostatectomy-induced impotence. Soc Sci Med.. 2005; 60:(10)2249-2259

Parekh A, Chen MH, Hoffman KE Reduced penile size and treatment regret in men with recurrent prostate cancer after surgery, radiotherapy plus androgen deprivation, or radiotherapy alone. Urology.. 2013; 81:(1)130-135

Persad R, Jefferson K, Bahl A, Smith J. Prostate cancer: A comprehensive guide, 2nd edn. Bristol: PH publishing; 2010

Prostate Cancer UK. About prostate cancer. 2019. (accessed 24 September 2020)

Salonia A, Burnett AL, Graefen M Prevention and management of postprostatectomy sexual dysfunctions. Part 1: choosing the right patient at the right time for the right surgery. Eur Urol.. 2012; 62:(2)261-272

Siegel T, Moul JW, Spevak M, Alvord WG, Costabile RA. The development of erectile dysfunction in men treated for prostate cancer. J Urol.. 2001; 165:(2)430-435

Tal R, Valenzuela R, Aviv N Persistent erectile dysfunction following radical prostatectomy: the association between nerve-sparing status and the prevalence and chronology of venous leak. J Sex Med.. 2009; 6:(10)2813-2819

Taylor SE, Lobel M. Social comparison activity under threat: downward evaluation and upward contacts. Psychol Rev.. 1989; 96:(4)569-575

Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Health Care.. 2007; 19:(6)349-357

Walsh DMJ, Morrison TG, Conway RJ, Rogers E, Sullivan FJ, Groarke A. A model to predict psychological and health realted adjustment in men with prostate cancer: the role of post traumatic growth, physical post traumatic growth, resilience and mindfulness. Front Psychol.. 2018; 9

Wellam F, Degner LF, Hack T, Schroeder G. Penile length shortening after radical prostatectomy: men's responses. Eur J Oncol Nurs.. 2010; 14:(2)160-165

White CA. Body image dimensions and cancer: a heuristic cognitive behavioural model. Psychooncology. 2000; 9:(3)183-192<183::aid-pon446>;2-l

The role of body image in treatment decision-making and post-treatment regret following prostatectomy

08 October 2020
14 min read
Volume 29 · Issue 18


Three main treatments are offered to men with localised prostate cancer: active monitoring, radiotherapy and prostatectomy. The aim of this research was to explore the role of body image in treatment decision-making and post-treatment regret following prostatectomy for localised prostate cancer. Data were collected via nine semi-structured interviews. Interviews underwent thematic analysis and four themes emerged: need to prolong life, loss of function and self, post-surgery effects on body image and confidence, and coping strategies. Participants revealed that loss of erectile function following surgery resulted in reduced self-confidence, and changes in their perception of their body.

More than 47 500 men in the UK are diagnosed with prostate cancer every year (Prostate Cancer UK, 2019). Prostate cancer is formed by uncontrolled division of cells within the prostate gland that produces swelling, which is known as adenocarcinoma (Persad et al. 2010). Risk factors for prostate cancer include age, ethnicity, hereditary/genes and lifestyle (Persad et al, 2010).

Treatment for prostate cancer may vary depending on personal preferences and clinical factors. Clinical factors include size of tumour, grading of the tumour on both the magnetic resonance imaging (MRI) scan and biopsies, and risk of spread (National Institute for Health and Care Excellence (NICE), 2019). Men with prostate cancer that is still contained within the prostate capsule are offered three treatment options: radical prostatectomy, active surveillance, and radiotherapy. The research presented here focuses on prostatectomy as sole treatment option. The aim was to explore whether known side-effects of prostatectomy impact on body image, and their role in men's treatment decision and post-treatment regret.

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