Psychosexual development and satisfaction in long‐term survivors of childhood cancer: Neurotoxic treatment intensity as a risk indicator

Abstract

BACKGROUND Risk factors for impairment in psychosexual development and satisfaction among adult survivors of childhood cancer are poorly understood. The authors compared psychosexual outcomes between survivors and healthy controls, and tested whether at‐risk survivors can be identified by 1) treatment neurotoxicity or 2) diagnosis. METHODS A total of 144 young adult survivors of childhood cancer and 144 matched controls completed questionnaires regarding psychosexual development, sexual satisfaction, and satisfaction with relationship status. Survivors were aged 20 to 40 years and were 5 to 34 years after diagnosis. Using medical chart data, survivors were divided into non‐neurotoxic (48 survivors), low‐dose (36 survivors), and high‐dose (58 survivors) neurotoxic treatment groups. RESULTS Apart from having fewer lifetime sex partners, survivors did not appear to differ from controls. However, survivors of brain tumors and any survivor who received high‐dose neurotoxic treatment reported the lowest rates of achieving milestones of psychosexual development, whereas sexual and relationship status satisfaction were found to be related to relationship status. Neurotoxic treatment intensity further distinguished between survivors of brain tumors with and without psychosexual impairment. CONCLUSIONS The intensity of neurotoxic treatment may be a valuable indicator of risk for psychosexual impairment relative to diagnosis alone. Health care providers should assess romantic/sexual problems among survivors at risk and make referrals if needed. Cancer 2017;123:1869–1876. © 2017 American Cancer Society.

Long‐term issues and supportive care needs of adolescent and young adult childhood brain tumour survivors and their caregivers: A systematic review

“…Survivors were likely to be sexually inactive . Reduced sexual activity was found when compared with other cancer groups and the general population . Survivors of a childhood brain tumour were also less likely to have children compared with general population controls and other cancer survivors …”

“…In romantic relationships, AYA survivors see themselves as less valuable mates to a prospective partner . Survivors were likely to be sexually inactive . Reduced sexual activity was found when compared with other cancer groups and the general population .…”

Psychosexual development and satisfaction with timing of developmental milestones among adult survivors of childhood cancer

“…The current study examined data from a follow‐up study of young adult survivors of childhood cancer who were previously surveyed about their romantic relationships . Data were initially collected from 2013 to 2015 from a cohort of 149 survivors who were (1) ages 20 to 40, (2) diagnosed at ages 5 to 18, (3) ≥5 years post diagnosis, and (4) treated at Nationwide Children's Hospital, Columbus, Ohio.…”

“…Of the 149 survivors, 2 died between assessments, and at least 28 had outdated contact information (although the actual number of survivors who did not receive the mailed invitation may be greater). Thus, a maximum of 119 survivors received our invitation letter, and 92 visited our homepage and completed the online survey (response rate: 77.3%; which corresponds to a maximum of 40% of originally contacted survivors) . Participants provided written informed consent online and could only proceed to the survey afterwards.…”

“…Initially, studies among childhood cancer survivors concluded that some had difficulty reaching certain milestones, such as sexual debut, or delayed milestones to a later age relative to peers . However, other studies described normative psychosexual development among most survivors or found no overall differences compared with controls . It has even been suggested that survivors may rush into romantic relationships as a means to achieve normalcy .…”