The impact of diagnosis and treatment of penile cancer on intimacy: a qualitative assessment.

Abstract

Penile cancer is a rare malignancy (0.5-0.93/100,000 in Western countries) with significant psychosocial and sexual repercussions. This qualitative study explored the impact of penile cancer diagnosis and treatment on intimacy. A convenience sample was identified of 20 potential candidates who were at least 5 months post penile cancer surgery at a hospital centralizing penile cancer care. Participants were recruited by telephone and admitted until data saturation was reached, resulting in a sample of nine men (44-74 years old), none withdrew from participation. All interviews were performed by the same female researcher with no prior relationship to the men. The one-time interviews (35-61 min) followed a semi-structured interview guide, were audio-recorded and transcribed verbatim. Three researchers analysed the data independently using descriptive phenomenological analysis, resulting in a gradually drawn up coding tree mapping out the patient's journey. The central themes that emerged were: (1) Intimate area led to diagnostic delays, intensified diagnosis and induced secrecy; (2) Impact on sexuality prior to surgery; (3) The voyage of sexual re-discovery; (4) A partnered voyage of sexual discovery; (5) Care needs related to intimate area. This study highlights the need for comprehensive and personalized care, including pre-surgical information provision and post-surgical psychosexual support. Addressing the current unmet needs of men with penile cancer requires guidelines for psychosexual interventions and proactive efforts to reduce stigma and to raise awareness.