Changes in Sexuality, Body Image and Health Related Quality of Life in Patients Treated for Hematologic Malignancies: A Longitudinal Study

Abstract

Longitudinal studies exploring sexuality, body image and health-related quality of life (HRQoL) are lacking in patients treated with chemo- or chemoimmuno-therapy for hematologic malignancies. The aim was to describe and explore changes in sexuality, body image and HRQoL in patients treated for hematologic malignancies, from baseline until 6 months after treatment. Twenty patients above 45 years (median age 62) treated for DLBCL, CLL or AML participated. Data were collected at baseline, 1- and 6-months after treatment by means of three instruments: SAQ-S, BIS and EORTC QLQ-C30. The results showed that patients’ sexuality was negatively affected 1 month after treatment, but after 6 months the patient reported scores had returned almost entirely to baseline scores. Body image was slight negatively affected after 1 month and after 6 months, 50 % reported that body image was not affected at all. Regarding HRQoL, patients reported gradually improved scores during the study period. Regression analysis showed that changes in sexuality and body image seemed to influence changes in HRQoL. This study has shown changes in sexuality, body image and HRQoL over time in patients above age 45 treated for hematologic malignancies. One month after treatment all three areas becomes negatively affected, and thereafter the patients’ scores recovered to a great extent regarding these issues within 6 months. Sexuality and body image seem to be important aspects of HRQoL for these patients and need to be integrated in the cancer rehabilitation during and after treatment.

Sexuality and cancer: The experience of adolescents and young adults

“…This inadvertently places them at higher risk and greater potential harm from STIs, high‐risk sexual behaviors, and unintended pregnancy. During treatment, AYA have expressed a desire for more information on sexual health, expecting HCPs would raise the subjects, but were often bemused to find it was never discussed . In a retrospective audit of young adults’ (20‐39 years) medical records ( n = 427), 58% of patients received a discussion about their reproductive health but only 7% discussed sexual health (sexual function, activity and contraception).…”

“…Current guidelines encourage highly flexible settings for transitioning AYAs from treatment to survivorship. However, few mention sexual health provision even though sexuality may have changed since diagnosis and its importance likely to have increased . Bolte's conceptual model of sexual self with 113 young adult (18‐39 years) cancer survivors and 54 healthy peers found 77% of cancer patients received information on the potential impact of cancer/treatment on fertility but only 13% received information relating to sexual well‐being.…”

“…Both sexes reported feeling less attractive due to scars; feelings of attractiveness were negatively related to the size of scars. 23 Bone sarcoma [18][19][20][21][22][23][24][25][26][27][28][29][30][31][32] Results suggest male survivors of lower extremity bone tumors experience better sexual functioning than female survivors. Survivors of limb sparing surgeries experienced worse sexual function, more depressive symptoms and poor self-esteem compared to Van-Nes rotationplasty and amputation survivors.…”

“…During treatment, AYA have expressed a desire for more information on sexual health, expecting HCPs would raise the subjects, but were often bemused to find it was never discussed. 23 In a retrospective audit 35 of young adults' (20-39 years) medical records (n = 427), 58% of patients received a discussion about their reproductive health but only 7% discussed sexual health (sexual function, activity and contraception). There was a significant association that conversations on reproductive or sexual health would trigger the other linked topic to be addressed.…”

“…However, few mention sexual health provision even though sexuality may have changed since diagnosis and its importance likely to have increased. 23 Bolte's 36…”