PHOENIXA self-administered questionnaire that measures
patients sexual problems after radiation therapy for prostate
cancer has now been validated and could provide a means of
standardizing reports of sexual dysfunction after prostate cancer treatment.
The degree of sexual dysfunction after prostate cancer therapy
varies widely in the literature, Deborah Watkins Bruner, RN,
said at the American Society of Therapeutic Radiology and Oncology
(ASTRO) annual meeting. This may be because we are all using
very different scales or ways to measure sexual function.
When the Radiation Therapy Oncology Group (RTOG) began to examine
available instruments a decade ago, it found that some were
ridiculously long, with 150 or 200 items on sexual adjustment, and
some were ridiculously expensive, Ms. Bruner said. RTOG found
the Sexual Adjustment Questionnaire (SAQ), developed by Metcalfe and
Waterhouse in 1986, to be the most user-friendly, and
began using it in some of its trials.
Ms. Bruner reported results of a validation study in 471 patients of
a modified 16-item version of the SAQ, measuring five factors: sexual
dysfunction, satisfaction, activity, desire, and fatigue (see table
for sample questions). Patients were given the SAQ pretreatment and
Sample Questions from the Five-Factor Sexual Adjustment Questionnaire
Dysfunction: When sexually excited, are you able to get an erection?
Satisfaction: Are you satisfied with the frequency of sexual
Activity: Are you having sexual relations with anyone?
Desire: Do you have a desire for sexual activity?
Fatigue: Are you too tired for sexual activity?
The RTOG-modified SAQ proved to be a valid and reliable
measure of sexual function, Ms. Bruner said. She pointed out
that this patient self-assessment, which asked about degrees of
erectile function (never, sometimes, always), was more reliable than
physician assessment, which asked a yes or no question about erectile
dysfunction, in the same study.
Physicians are right only about 50% of the time in assessing
erectile function, she said. An erection is not an all or
nothing phenomenon, and we are not very good at assessing
patients capabilities in areas of quality of life.
She noted that the modified SAQ will be used in RTOG trials of
prostate cancer, including an upcoming Viagra study. The SAQ is both
sensitive and specific, she said, meaning that we can delineate
patients on different treatments by their SAQ scores.