About the “Perspectives on Cancer Survivorship” Researcher Series 

What is cancer survivorship? By definition, survivorship is the absence of cancer after the completion of treatment or living with, through, and beyond cancer [1]. The majority of the research focuses on survival, but there has been a push to expand research to include the post-cancer journey. The intention of this series is to highlight those doing research on survivorship and quality of life, as well as the implications for their work.

[1] According to https://www.cancer.net/survivorship/what-survivorship

Innovations in the Treatment of Sexual Dysfunction and Couple Intimacy after Prostate Cancer: A Randomized Clinical Trial of Mindfulness versus Cognitive Behavioural Therapy

Authors: Bibiana Kemerer, Dr. Lori Brotto

Funding: Movember foundation

Affiliation: UBC, UBC Sexual Health Lab, Vancouver Prostate Centre, UBC Department of Urologic Sciences, Prostate Cancer Canada, VCHRI, Prostate Cancer Supportive Care Program (VGH), Women’s Health Research Institute (WHRI) 

1/9 Canadian men will be diagnosed with Prostate Cancer in their lifetimes. Fortunately, the current survival rate is 93%, however, most treatments do not address the sexual dysfunction of survivors that can become permanent. Sexual dysfunction after Prostate Cancer (PC) is related to a lower quality of life and psychological wellbeing in survivors. As well, partners of survivors have lower quality of life, more depression and distress, and more sexual dysfunction than their same aged peers. To date, there lacks evidence-based psychosexual treatments for both survivors and partners.

The UBC sexual health lab conducted a clinical trial, the Innovations in the Treatment of Sexual Health Post Prostate Cancer Treatment (INTROSPPECT) project, where 77 prostate cancer survivor partner couples underwent 4 weeks of Mindfulness-based therapy or Cognitive Behavioural Therapy (or control). These therapies were in group sessions and sex-based with activities for participants to complete as a couple and individually. We measured sexual outcomes, relationship outcomes and psychological outcomes at baseline, 6-weeks, and 6-month follow-ups. Data analysis is underway.

Q: What inspired you to do this research? 

I’ve always had an interest in sexuality research because I felt it was often understudied. I also enjoy biology and pursued that as my undergraduate degree, but I still wanted to find a way to intersect my two interests. During my undergrad, I was able to connect with a sexuality researcher, Dr. Robin Milhausen, to help guide my academic career and build my portfolio for grad school. Dr. Milhausen also recommended I apply to Dr. Lori Brotto’s lab for my Masters since it aligned with by interests in health and biology. Now, I am currently working on my Masters of Science with Dr. Brotto and my research is focused on data analysis for the Innovations in the Treatment of Sexual Health Post Prostate Cancer Treatment (INTROSPPECT) study.  

Q: What implications does your research have for gynecologic cancer survivors?*

In general, this research helps to expand the important conversation of cancer survivorship. The focus is to empower survivors, and their partners, to face the psychosexual challenges after treatment. It is really important to look at both the survivor and their partner because sexual dysfunctions affect everyone in the relationship and thus should be managed together, instead of individually. Dr. Brotto has done incredible work on developing interventions to help with sexual dysfunction among gynecologic cancer survivors. She has found that components of mindfulness really help to address sexual function and distress. Previously, mindfulness and cognitive-behavioral therapy (CBT) interventions have shown to improve sexual functioning in gynecological cancer survivors who experience sexual dysfunction after treatments. However, this therapy has not been examined for survivors and their partners together. Applying similar couple’s-based mindfulness or CBT could address sex in the context of the relationship, and improve sexual function and quality of life in both survivors and partners. 

Q: What is the most valuable thing you’ve learned about survivorship from your research?

My mom is a breast cancer survivor and has faced many challenges beyond cancer and her treatments that aren’t really addressed long term. Since her diagnosis, she continues to experience chronic arm pain and has had to change her life around that. Based on my mom’s experience and my research, the most valuable thing I’ve learned is that survivorship is forever. After someone survives cancer, there are still many side effects that the patient continues to deal with. Survivorship is an ongoing and continuous journey for many patients. 

Q: What’s next for your research?

I’m really excited about the knowledge translation component! The study is partnered with the Prostate Cancer Supportive Care program at Vancouver General Hospital and we hope to implement CBT and mindfulness education as part of their program, such as online learning materials. It would be really interesting and beneficial to have those programs in the long run. We are also aiming to share this information with PC Health Care providers in the province, including at a Cancer Survivorship conference, at Urologic Department grand rounds, and other cancer clinician talks. I’ve also applied to a couple of grants to develop additional sexual rehabilitation modules and videos focused on survivorship experiences in collaboration with patient partners.  

* To learn more about Dr. Brotto’s research of using mindfulness to address the sexual dysfunction of gynecological cancer survivors, listen to Episode 8 of the GOSH Podcast 

Bibiana Kemerer presented on the Gynecologic Cancer Initiative Trainee Research Day between June 3rd – 4th, 2021 on the topic of Survivorship and Quality of Life. She is an MSc student in the Department of Reproductive and Developmental Sciences at UBC. She is currently completing her master’s research in UBC’s Sexual Health Research Lab supervised by Dr. Lori Brotto. Currently, she is involved in the INTROSPPECT study, which examines the use of Mindfulness and CBT interventions for prostate cancer survivors and their partners who are experiencing sexual dysfunction. The goal of her thesis is to translate the study findings into a useful format for prostate cancer survivors, their partners, and the medical professionals who treat them.