"It's Killed My Sex Life": Veteran Bladder Cancer Survivors' Perspectives on Sexual Problems and Intimacy

Bladder cancer survivors may be at particular risk for cancer-related sexual problems, given the direct impacts of cancer management on genitalia and internal sex organs. Sexual problems in bladder cancer survivors have received comparatively less attention than those found in other malignancies. We addressed this gap through interviews with male U.S. Veteran bladder cancer survivors (N = 14) in which they described their experiences navigating cancer-related sexual problems as a population with potentially unique experiences and needs. Participants perceived that their sexual problems originated from a complex interplay of factors related to aging, medical comorbidities, and bladder cancer treatments. Nearly all with sexual problems acknowledged the negative impact these problems had on their intimate relationships and expressed surprise or frustration at the changes in sexual functioning they experienced post-diagnosis. While some recalled having received information from their healthcare team about sexual problems associated with bladder cancer treatment, they recommended more information be shared. Others indicated that they had been offered several medical interventions for sexual problems but were either uncomfortable with trying the treatments or had used them unsuccessfully. Many expressed a sense of acceptance of their sexual problems. Veterans' experiences signal a need for targeted, interdisciplinary support including patient education and resources for managing sexual problems in Veteran bladder cancer survivors. Our findings provide valuable information on survivors' experiences and unmet needs and present insights into opportunities to enhance their care.