ADT Erectile Dysfunction — SCE Medical Oncology MCQ
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Correct answer: E — Discuss likely sexual effects and offer a PDE5 inhibitor through erectile-dysfunction services before escalation
Explanation lettering: C = shown as A · E = shown as B · B = shown as C · A = shown as E
A is correct. NICE recommends discussing reduction in libido, possible sexual dysfunction, ejaculation and fertility before long-term ADT, with partner involvement if desired. Men should have access to erectile-dysfunction services and be offered a PDE5 inhibitor; vacuum devices, intraurethral treatment, injections or prosthesis are options if tablets fail or are contraindicated, and psychosexual counselling can help. B delays anticipatory counselling and interrupts cancer treatment. C opposes the therapeutic goal of ADT. D reverses the treatment sequence. E incorrectly makes one response pattern universal. Numeric incidence estimates are unnecessary and vary by definition and population.
Reference: NICE NG131 prostate-cancer recommendations: https://www.nice.org.uk/guidance/ng131/chapter/Recommendations