February 27, 2018
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Most young adults report sexual dysfunction following cancer diagnosis

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Chiara Acquati

More than half of young adults with cancer reported ongoing problems with sexual functioning in the first 2 years following their diagnosis, according to an investigational study published in Cancer.

For women, being in a relationship increased the likelihood of reporting sexual dysfunction; for men, the likelihood increased regardless of their relationship status.

“Sexual functioning among young adults with cancer is significantly affected by the illness and continues to be problematic over time,” Chiara Acquati, PhD, MSW, assistant professor at Graduate College of Social Work at University of Houston, told HemOnc Today. “Also, there are sociodemographic, clinical and psychosocial variables that contribute to the probability of reporting sexual dysfunction. In this sense, our findings highlight that it’s important for cancer health care providers to have open discussions with young people about how cancer is affecting them in multiple areas of their lives.

“When it comes to sexual functioning, this conversation should occur at various times throughout treatment and, to do this, we need to build trust between health care providers and young adults with cancer,” Acquati added.

Prior to the study, the prevalence of cancer-related sexual dysfunction had not been examined in a longitudinal study. Acquati and colleagues analyzed data from 123 adults aged 18 years to 39 years (66% male; 53% white; 35% Hispanic/Latino) who had been diagnosed with leukemia (15.4%), breast cancer (14.6%), soft tissue sarcoma (12.2%), non-Hodgkin lymphoma (10.6%), bone cancer (8.1%), testicular cancer (8.1%), Hodgkin lymphoma (7.3%), female genital cancer (5.7%), brain cancer (4.9%) or other (12.3%).

All patients completed a Medical Outcomes Study Sexual Functioning Scale within the first 4 months of their diagnosis, 107 patients completed the same survey at 6 months and 95 patients completed the survey at 24 months.

Most participants were diagnosed with cancer in their late 20s (mean age, 29.2 years); had received treatment, including chemotherapy (71.5%); and were involved in a romantic relationship at baseline (57.7%).

“Few studies have examined sexual functioning and patients’ needs in the context of emotional intimacy and sexual relationships,” Acquati said. “However, it is well-established that cancer symptoms and treatment-related consequences may affect sexual functioning and sexual satisfaction. Failure to address sexual health may place younger patients at risk for long-term consequences related to identity development, interpersonal relationships and quality of life.”

More than half of all young adult patients reported some degree of problem with sexual functioning at baseline (52%) and at 6-month follow-up (54.2%).

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After 2 years, 52% of the participants still reported some degree of affected sexual functioning.

The probability of reporting sexual dysfunction increased over time (P < .01) and was greater for women (P < .001), older patients (P < .01), patients married or in a committed relationship (P < .001), and those treated with chemotherapy (P < .05).

In addition, young adults who were involved in a relationship with a partner were estimated to have higher probabilities of experiencing sexual dysfunction (P < .001).

Researchers noted the rates of sexual dysfunction were consistent with those reported in previous studies. Among male survivors of lymphoma, sexual dysfunction ranged from 20% to 54% across studies and for men with testicular cancer, and percentages varied from 11% for loss of desire to 51% for ejaculation problems. Up to 52% of young breast cancer patients have reported sexual problems.

“This study and other research articles recently published in the literature are contributing to a body of knowledge that can guide us in understanding what interventions might be helpful for young cancer patients,” Acquati said. “It is important to remember that needs and desire for support may be different across genders, age groups or by relationship status.”

Acquati noted the need to develop interventions centered around patients’ preferences, along with additional research to examine the differential effects of cancer on sexuality for men, women and transgender young people. Research also is needed to train health care providers serving young adults with cancer in sexual health to increase their confidence initiating these conversations, she noted.

“If a patient doesn’t feel comfortable discussing sex with the provider or if the doctor doesn’t address sex, it may be helpful having a conversation with a trained mental health professional, such as an oncology social worker, a psychologist or sex therapist,” Acquati said. “We hope that our study will contribute to the discussion about the development of interventions for young adults by identifying the patients who are most likely to benefit from different types of psychosocial support and when support is mostly needed throughout the continuum of care.” – by Chuck Gormley

 

For more information:

Chiara Acquati , PhD, MSW, can be reached at Graduate College of Social Work, University of Houston, 3511 Cullen Boulevard, Room 110HA, Houston, TX 77204-4013; email: cacquati@central.uh.edu.

 

Disclosures: HopeLab, Inc helped fund this study. The authors report no relevant financial disclosures.

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