Sexual Function in Childhood Cancer Survivors: A Report from Project REACH

Abstract

Introduction Of the approximately 12,000 children and adolescents that will be diagnosed with cancer in 2013, it is expected that over 80% of them will become long-term adult survivors of childhood cancer. Although it has been well established that cancer treatment often has profound negative impact on sexual functioning, sexual functioning in adult survivors of childhood cancer is not well understood. Aim The aim of the current study was to examine the report of sexual function in adult survivors of childhood cancer in relationship to both physical and emotional functioning. Methods Two hundred ninety-one participants enrolled in Project REACH, a longitudinal study of childhood cancer survivors, completed questionnaires as part of an annual health survey. Main Outcome Measure Primary outcome measures included the sexual functioning subscale of the Swedish Health-Related Quality of Life Survey, the SF-12, and the BSI-18. Results Results indicate that 29% of young adult survivors reported two or more discrete symptoms of sexual dysfunction. Females were twice as likely to report sexual problems. Sexual problems were not related to specific types of childhood cancer treatments such as type of chemotherapy or radiation. Young adults with sexual dysfunction did report poorer functioning across the range of SF-12 subscales including physical functioning, general health, fatigue, and mental health. Conclusions Significant sexual dysfunction is common in adult survivors of childhood cancer. A greater understanding of the particular relationship between sexual dysfunction and both physical and emotional well-being in this relatively young population is needed. Even when long-term cancer survivors are young adults and report generally good health, results underscore the need for clinicians to specifically assess sexual functioning.

Sexual function in male long‐term survivors of childhood acute lymphoblastic leukemia

“…Poorer sexual health has been reported among male survivors who had a diagnosis of central nervous system (CNS) tumors compared with those who had other cancer types 9 and among survivors who received treatment during adolescence compared with those who were younger at the time of treatment. 12 The only study that analyzed the association between exposure to cancer therapy and sexual dysfunction did not report an association.7 Previous studies have reported differences in sexual health and its predictive factors between male and female survivors, 3,[7][8][9] indicating that sexual outcomes need to be analyzed within sexes.To better understand the extent and quality of the sexual problems faced by adult male survivors of childhood ALL, we conducted a study on the first large cohort of adult long-term survivors (10 years) of childhood ALL at the Helsinki University Central Hospital. A well validated and comprehensive self-report measure of sexual function was used, and the results were compared with those from an age-matched and sex-matched control group.…”

“…7 Previous studies have reported differences in sexual health and its predictive factors between male and female survivors, 3,[7][8][9] indicating that sexual outcomes need to be analyzed within sexes.…”

“…7,8 However, medical predictive factors have been studied less extensively. Poorer sexual health has been reported among male survivors who had a diagnosis of central nervous system (CNS) tumors compared with those who had other cancer types 9 and among survivors who received treatment during adolescence compared with those who were younger at the time of treatment.…”

“…12 The only study that analyzed the association between exposure to cancer therapy and sexual dysfunction did not report an association. 7 Previous studies have reported differences in sexual health and its predictive factors between male and female survivors, 3,[7][8][9] indicating that sexual outcomes need to be analyzed within sexes.…”

“…3,7,8 Those studies relied on questionnaires that focused on 1 or a few overarching questions. In 1 study that used a larger array of questions to compare sexual functioning in childhood cancer survivors with that in a group of healthy controls, more frequent low sexual interest, low sexual satisfaction, feeling sexually unattractive, orgasmic difficulty during intercourse, and a lower total number of sexual partners were reported among the survivors.…”