Understanding the Effects of Prostate Cancer on Gay and Bisexual Men

描述(由申请人提供)：本申请是对PA-12-113《LGBTI人群健康研究》的回应，PA-12-113《关于LGBTI人群健康的研究》“鼓励研究人员调查与LGBTI健康相关的新问题”，“高度重视针对[LGBTI]个体的干预研究”。前列腺癌的存活率(PCA)就是这样一个领域。在一生中，六分之一的男同性恋者和双性恋者(GBM)和三分之一的男性夫妇将被诊断为前列腺癌，使PCA成为影响GBM的最常见癌症。然而，几乎没有研究考察PCA治疗对GBM性功能的影响。性功能障碍是PCA治疗的主要后遗症，本身就令人深感痛苦，并对治疗后的生活质量产生负面影响，导致严重的负面心理健康后果。最近的研究表明，对于GBM来说，PCA治疗的性结果明显比异性恋男性更差。肛交和阴道性交之间的生理差异可能至少在一定程度上解释了这种健康差异。需要开发量身定制的治疗方法，但几乎完全没有探索。缺少的是评估PCA治疗对GBM性功能的影响的研究，关于康复结果的研究，以及指导开发针对GBM和男性之间的性行为的新治疗方法的研究。本研究的长期目标是开发第一个为GBM量身定做的循证PCA康复课程。作为第一步，在本R21中，我们将进行必要的形成性研究，以估计不良结果的程度，确认需要，并评估可接受性和可行性。有三个具体目标。在目标1中，我们将深入调查PCA治疗对GBM及其伴侣的性生活和他们的关系的影响。我们将在全国范围内对多达48名GBM PCA患者、伴侣和夫妇进行半结构化、聊天或电话采访研究。在目标2中，我们将完善定义并制定评估GBM性功能障碍所需的措施。在目标3中，我们将与PCA一起对220名GBM进行在线定量调查，这将a)量化治疗后的性挑战，b)评估康复的需求和优先事项，c)开发新的量表来衡量GBM的性功能，以及d)评估与PCA一起为GBM设置新的康复课程的可接受性和可行性。

DESCRIPTION (provided by applicant): This application is in response to PA-12-113, Research on the Health of LGBTI Populations, which "encourages researchers to investigate new questions related to LGBTI health" with "high priority placed on research on interventions for [LGBTI] individuals." Survivorship of prostate cancer (PCa) is one such area. Across the lifespan, 1-in-6 gay and bisexual men (GBM) and 1-in-3 male couples will be diagnosed with PCa, making PCa the most common cancer affecting GBM. Yet, almost no research has examined the effects of PCa treatment on GBM's sexual functioning. Sexual dysfunction is the major sequela of PCa treatment, which is deeply distressing in itself, and negatively impacts quality of life post-treatment, resulting in serious negative mental health outcomes. Recent studies indicate sexual outcomes of PCa treatment are significantly worse for GBM than heterosexual men. Physiological differences between anal sex and vaginal sex likely explain, at least in part, this health disparity. Tailored treatment needs to be developed, but is almost entirely unexplored. Missing is research to evaluate the effects of PCa treatment on GBM sexual functioning, research on rehabilitation outcomes, and research to guide development of new treatments tailored to GBM and sex between men. The long-term objective of this research is to develop the first evidence-based PCa rehabilitation curriculum tailored for GBM. As a first step, in this R21 we will conduct the formative research needed to estimate the extent of poor outcomes, confirm need, and assess acceptability and feasibility. There are three specific aims. In Aim 1, we will investigate, in-depth, the experience of PCa treatment on the sexual lives of GBM, their partners, and their relationships. We will conduct a semi-structured, chat or phone interview study of up to 48 GBM PCa patients, partners, and couples, nationally. In Aim 2, we will refine definitions and develop the measures needed to assess sexual dysfunction in GBM. In Aim 3, we will conduct an online quantitative survey of 220 GBM with PCa, which will a) quantify sexual challenges post-treatment, b) assess needs and priorities for rehabilitation, c) develop a new scale to measure sexual functioning in GBM and d) assess the acceptability and feasibility of a new rehabilitation curriculum for GBM with PCa.