Abstract Introduction Advances in prostate cancer detection and treatment have significantly improved survival rates, yet many survivors and their partners continue to experience profound challenges in sexual and relational well-being. Sexual function changes following cancer treatment-ranging from altered desire and arousal to loss of spontaneity and intimacy-often evoke a grief response and mourning of one’s pre-illness sexual self and relationship. Grief can challenge adjustment and disrupt emotional closeness. Supportive coping behaviors between partners typically strengthen intimacy and sexual satisfaction; however, when grief is unaddressed, these relational resources may lose effectiveness. Objective This study investigated changes in satisfaction, interest, and grief over time and whether grief related to the loss of sexual function moderated the relationship between couples’ coping and sexual satisfaction among PCa survivors and partners. Methods A sample of 80 couples (n=160) completed baseline, 3-month, and 6-month post-treatment assessments. Grief was measured using the Prolonged Grief about the Loss of Sexual Function scale. Dyadic coping was assessed via the Dyadic Coping Inventory–Short Form (DCI-SF), sexual interest with the PROMIS Interest in Sex Life questionnaire, and the PROMIS Global Satisfaction with Sex Life (GSSL) scale was utilized to examine sexual satisfaction. Longitudinal within-person analyses using paired-samples t-tests were conducted to assess change over time, complemented by t-tests to compare groups at each timepoint. Moderation analysis was then conducted to examine whether grief influenced the relationship between baseline dyadic coping strategies and sexual satisfaction at 6 months. Results Patients had a median age of 61 years, were predominantly White (75%) and treated with radical prostatectomy (81%) for localized (T1/T2, 86%) PCa. Partners were primarily female (96%), with a median age of 59 years and similar racial and socioeconomic background. Sexual satisfaction declined over time for both patients and partners (p .001). For patients, sexual interest decreased significantly from baseline to 3 months (p .001) and from baseline to 6 months (p .001). For partners, interest decreased modestly from baseline to 3 months (p = .028) and from baseline to 6 months (p = .004). Overall, grief remained stable for both, though patients reported higher grief scores at 3 months (p = .006). Among patients, grief significantly moderated the associations of baseline supportive (b = −0.07, p = .048) and negative dyadic coping (b = 0.12, p = .015) with sexual satisfaction. Higher grief attenuated the favorable association of supportive coping with sexual satisfaction and buffered the detrimental impact of negative self-reported dyadic coping behaviors. No significant moderation effect was found for partners. Conclusions Patients and partners experienced declines in sexual satisfaction and interest following prostate cancer treatment, with patients reporting greater grief related to sexual losses. Grief moderated the effects of self-reported coping, weakening the benefits of supportive coping and buffering the harms of negative dyadic coping behaviors on sexual satisfaction. These findings underscore the importance of integrating loss-responsive components into interventions aimed at promoting coping and sexual recovery after prostate cancer treatment. Disclosure No
Acquati et al. (Mon,) studied this question.