Cancer and Sexual Problems

Abstract

Introduction There are many data on sexual problems subsequent to cancer and its treatment, although the likelihood of problems in specific individuals depends on multiple variables. Aims To gain knowledge about the risks of sexual problems among persons with cancer and to provide recommendations concerning their prevention and optimal treatment. Methods A committee of multidisciplinary specialists was formed as part of a larger International Consultation working with urologic and sexual medicine societies over a 2-year period to review the result of chronic illness management on sexual function and satisfaction. The aims, goals, data collection techniques, and report format were defined by a central committee. Main Outcomes Measures Expert consensus was based on evidence-based medical and psychosocial literature review, extensive group discussion, and an open presentation with a substantial discussion period. Results Cancer and cancer treatments have both direct and indirect effects on physiologic, psychological, and interpersonal factors that can all impact negatively on sexual function and satisfaction. Data on the likelihood of specific sexual problems occurring with cancer and its management vary depending on prediagnosis function, patient response, support from the treatment team, specific treatments used, proactive counseling, and efforts to mitigate potential problems. This summary details available literature concerning the pathophysiologic and psychological impacts of cancer diagnosis and treatment on sexual function, plus recommendations for their prevention and management. Conclusions Cancer and its management have a significant negative impact on sexual function and satisfaction. These negative effects can be somewhat mitigated by understanding prediagnosis sexual functioning level, counseling, careful treatment choices, and, when indicated, therapy post-treatment using educational, psychological, pharmacologic, and mechanical modalities.

The impact of hematopoietic stem cell transplantation on sexuality: a systematic review of the literature

“…This is consistent with studies of sexual function in the general population and among cancer survivors, where men reported better sexual function compared to women. 32,33 As differences, both in problem rates and satisfaction, are marked between males and females, it is necessary to consider the effects on these survivors separately.…”

“…37 Poorer sexual function correlated significantly with decreased emotional functioning and global QOL. 6,28,32 This indicates that sexual function is an important aspect of QOL, and it is important to recognize whether a patient is experiencing sexual problems. In this context, it is necessary to emphasize that QOL was significantly poorer in allogeneic HSCT patients as compared with autologous patients.…”

“…The extent of symptoms is not surprisingly correlated to the intensity of treatment with chemotherapy, total-body irradiation and medications for side effects. 1,32 High-dose chemotherapy, especially alkylating agents and total-body irradiation, are toxic to gonadal function and can contribute to genital tissue sensitivity, atrophy or scarring. 34 Psychosexual functioning, impotence-related difficulties and altered body image were significantly correlated with the type of chemotherapy administered.…”

Effects of radiation therapy on the structure and function of the pelvic floor muscles of patients with cancer in the pelvic area: a systematic review

“…Few articles measured the impacts of RT on the PFM structure or function in women treated for gynecological cancers, even though there are many studies reporting urinary, sexual, or fecal problems after radiotherapy versus surgery alone [4,6,9,12,11,3,52,53]. In this review, only two papers met our criteria and could be included.…”

“…Lesions such as stenosis, agglutination, or shortening of the vagina have been detailed for women after gynecological cancers [3]. Furthermore, a high prevalence of pelvic floor dysfunctions following radiotherapy for pelvic neoplasms has also been reported: urinary incontinence and urgency [4,5], sexual dysfunction and dyspareunia [6][7][8], and fecal urgency and incontinence [9,10]. Such dysfunctions have been demonstrated not only to cause distress to cancer survivors [11], but also to diminish their participation in activities of daily living and social activities, leading to an overall decreased quality of life [12].…”