Sexual health in long-term breast cancer survivors

Soldera, Sara V.; Ennis, Marguerite; Lohmann, Ana Elisa; Goodwin, Pamela J.

doi:10.1007/s10549-018-4894-8

Cited by 40 publications

(50 citation statements)

References 31 publications

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“…Younger survivors may focus on breast loss with mastectomy, on the other hand, the body feeling of attractiveness affected on the sexuality. In addition, psychological status also play a critical role in sexuality and the understanding and concerning help to improve sexual satisfaction with closer sexual partners [38]. Sexuality issues are complex for young cancer survivors and can be in uenced by physical issues, such as vaginal dryness and dyspareunia and psychological issues.…”

Section: Discussionmentioning

confidence: 99%

Depression, Sexual dysfunction and Quality of Life Among Breast Cancer Patients with Ovarian Function Suppression: A Cross Sectional Study between Ovarian Ablation Verse GnRH Agonists

Jiang

Cai

et al. 2020

Preprint

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Background: Ovarian function suppression is being widely utilized as endocrine therapy to reduce estrogen release in premenopausal breast cancer patients and was achieved either by medical treatment with bilateral oophorectomy, irradiation, or the Gonadotropin releasing hormone (GnRH) agonist. This study aimed to examine whether GnRHa differed from ovarian ablation on depression, sexual dysfunction and quality of life.Methods: The premenopausal breast cancer patients who received ovarian function suppression were enrolled from seven hospital between June 2019 and June 2020. Our independent variable was the type of ovarian suppression, categorized as Ovarian Ablation (OA cohort, n=174) and medical GnRH agonist (GnRHa cohort, n=389). The self-administered questionnaire (OFS-Q5) was developed and used in this study aimed to assess the depression (PHQ-9), sexual dysfunction (FSFI) and quality of life (EORTC QLQ-BR23).Results: In this cross-sectional study, 563 patients with ovarian function suppression completed surveys were collected. The mean sum score of the PHQ-9 tend to be slight decrease in GnRHa cohort than that in ovarian ablation (OA) cohort (11.4 ±5.7 vs. 12.8 ±5.8, OR=1.910, P=0.079). Patients with major depression (PHQ-9≧15) was indicated significantly fewer in GnRHa cohort (31.1% vs 40.2%, P=0.025). The more surprising correlation is less patients with sexual dysfunction (61.5%, FSFI< 23) in OA cohort, a remarkable increase in GnRHa cohort (72.2%, P = 0.011). The ratio of sexual dysfunction remained lower for ovarian ablation women in long-term ovarian suppression (duration of ovarian suppression > 2 years: OA vs GnRHa, OR=1.555, P=0.037). No significantly difference for most subscales of QLQ-BR23 between two cohorts was evident.Conclusions: Our current investigation demonstrate here for the first time that medical GnRHa resulted in favour depression, worse sexual function than those with ovarian ablation, with similar quality of life. This new understanding should help to improve and alleviate adverse effect in patients with diverse ovarian function suppression.

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Section: Discussionmentioning

confidence: 99%

Depression, Sexual dysfunction and Quality of Life Among Breast Cancer Patients with Ovarian Function Suppression: A Cross Sectional Study between Ovarian Ablation Verse GnRH Agonists

Jiang

Cai

et al. 2020

Preprint

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“…Sexual functioning is an important element contributing to the quality of life. Disturbances in sexual function were reported in breast cancer survivors previously [9,10]. The psychosexual health was also reported to be a serious issue in young male adults cured from a malignancy [11].…”

Section: Introductionmentioning

confidence: 99%

Long-term sexual functioning in germ-cell tumor survivors

et al. 2020

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Background: Survivors of germ-cell tumors (GCT) may suffer from long-term adverse consequences. Our study was conducted to assess a long-term sexual functioning in GCT survivors. Methods: GCT survivors (N = 170) from the National Cancer Institute in Slovakia completed a Sexual Function Questionnaire that was modified from PROMIS Sexual Function and Satisfaction Questionnaire 9-year median follow up (range 5-32) as a primary exploratory aim. Study groups consisted of 17 survivors (10%) who had active surveillance (AS, controls), and 153 (90%) survivors who received treatment beyond orchiectomy (Tx), including cisplatin-based chemotherapy (CT, N = 132; 78%), radiotherapy to the retroperitoneal lymph nodes (RT, N = 12; 7%) or both (CTRT, N = 9; 5%). Results: In univariate analysis, treatment of any type resulted in difficulty to maintain erection during sexual intercourse compared to patients treated with AS (P = 0.04). Survivors who received CTRT had lower ability to achieve orgasm during sexual activities (P = 0.04) and they reported disappointment with their overall quality of sex life (P = 0.002). The number of attempts to initiate sexual intercourse did not differ. Sexual relationships caused none or mild anxiety and the desire to be sexually active was higher after CTRT (P = 0.05). Multivariable analysis confirmed that orgasmic dysfunction after ≥400 mg/m 2 of cisplatin and issues in maintaining erection after Tx were independent of retroperitoneal lymph-node dissection (P = 0.03 and P = 0.04, respectively). Survivors were disappointed with the quality of sex life and had stronger desire to be sexually active independent of age, (P = 0.01 and P = 0.05, respectively). Conclusions: This study identified an impairment in sexual function may represent an issue for long-term GCT survivors. Treatment with chemotherapy plus radiotherapy were associated with disappointment and stronger sexual desire, while a higher cumulative dose of cisplatin may be responsible for orgasmic dysfunction.

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“…In recent decades, the number of patients who survive breast cancer has increased 1 . The results of this increase are partly due to the greater effectiveness of adjuvant treatments 1 .…”

Section: Introductionmentioning

confidence: 99%

“…In recent decades, the number of patients who survive breast cancer has increased 1 . The results of this increase are partly due to the greater effectiveness of adjuvant treatments 1 . According to data from the National Cancer Institute (INCA), breast cancer is the leading cause of death due to cancer among women in Brazil 2 .…”

Section: Introductionmentioning

confidence: 99%

“…According to the World Health Organization (WHO), quality of life is defined as: "The individual's perception of their position in life in the context of the culture and value systems in which they live and in relation to their goals, expectations, standards and concerns" 2 . Sexual health is directly related to quality of life and must be addressed with specialized approach 1 . Sexual dysfunction is frequent among women, and the prevalence rate ranges between 9% and 43% 7 .…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of sexual dysfunction in Brazilian women with breast cancer: partial results

et al. 2020

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Objective: To assess the pattern of sexual performance in women treated for breast cancer. Methods: This is a cross-sectional study on women treated for breast cancer. Inclusion criteria: to have undergone the first-line therapy for cancer and the cancer not being classified as stage IV. Data on cancer were collected by the analysis of medical records. For the evaluation of sexual performance, women were submitted to individual interviews, with the application of the Quociente Sexual – Versão Feminina (QS F) questionnaire. Sexual performance was classified as: bad, unfavorable, regular, good, and excellent. The diagnosis of sexual dysfunction was established to women with score ≤ 60. For descriptive analyses, absolute (n) and relative (%) frequencies were performed, and for the comparison between the quantitative variables the Student’s t-test was used. Results: 31 women with a mean age of 55.2 years were included, 35% were classified as clinical stage II, 84% underwent conservative surgery, 65% underwent chemotherapy, and 80% used endocrinotherapy. Regarding sexual performance, 62% spontaneously think about sex, 35% are always interested in sex, and 51.7% have some degree of pain during intercourse. After calculating the score, it was concluded that 6.5% had bad sexual performance; 19.4%, unfavorable; 19.4%, regular; 41.9%, good; and 12.8%, excellent. The mean score was 58.7 points (standard deviation = 21.4, median of 64, minimum of 16, and maximum of 90 points), and 45.2% of women were diagnosed with sexual dysfunction. The provided treatments and the length of follow-up did not have a significant correlation with sexual performance. Conclusion: Most women treated for breast cancer had sexual performance classified as “good and excellent,” although a significant percentage had a diagnosis of sexual dysfunction.

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Sexual health in long-term breast cancer survivors

Abstract: Sexual health and uro-genital symptom counseling should be provided to BCS, particularly pre/peri-menopausal patients, even at long-term follow-up.

Cited by 40 publications

References 31 publications

Depression, Sexual dysfunction and Quality of Life Among Breast Cancer Patients with Ovarian Function Suppression: A Cross Sectional Study between Ovarian Ablation Verse GnRH Agonists

Depression, Sexual dysfunction and Quality of Life Among Breast Cancer Patients with Ovarian Function Suppression: A Cross Sectional Study between Ovarian Ablation Verse GnRH Agonists

Long-term sexual functioning in germ-cell tumor survivors

Evaluation of sexual dysfunction in Brazilian women with breast cancer: partial results

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