Sexual function in long-term male lymphoma survivors after high-dose therapy with autologous stem-cell transplantation

Abstract

Reduced sexual function may have negative implications on health related quality of life among lymphoma survivors. A national cross-sectional study among long-term lymphoma survivors after high-dose therapy with autologous stem-cell transplantation auto-SCT treated during 1987-2008 was conducted in 2012-2014. The current study explored sexual functioning among these survivors. Sixty-six percent (n=159) of eligible men with complete questionnaire data were included, median age was 55 years. The Brief Sexual Function Inventory (BSFI) was used to assess sexual function and sexual satisfaction, compared with age-matched controls. In addition, sexual problems were defined based on predetermined cutoff values for BSFI domain scores. Sexual drive and erections firm enough to have sexual intercourse were reported to be present only a few days or less last month among 30% and 41% of survivors, respectively. Sexual satisfaction was reported by 39% of survivors. The survivors had significantly lower scores on all BSFI domains and an increased risk of problems with sexual drive and erection compared with controls. In multivariable models, cardiovascular disease was significantly associated with worse erectile function, while age >55 years, chronic fatigue, and physical inactivity were significantly associated with lower sexual functioning overall. Chronic fatigue and anxiety were related to lower sexual satisfaction.

Sexual function in male cancer survivors is not correlated to sperm quality

“…Independently of cancer type, most studies described a correlation between age at cancer diagnosis and the prevalence or degree of sexual dysfunction, with an increased risk of persisting sexual problems for older patients [6,8,21]. This may partially be explained by the fact that sexual activity in general decreases with advancing age.…”

“…However, fertility is only one facet of sexual function that is possibly impacted by cancer therapies, and few studies have aimed to understand the association between cancer and sexual function besides fertility, such as erectile dysfunction (ED). Male cancer survivors frequently suffer from ED [5], which depends on the type of cancer, and treatment regimes, but also age and comorbidities [6][7][8]. In testicular cancer patients, for example, the rate of ED was reported to be as high as 37% [9].…”

Long‐term Follow‐up of Hematopoietic Stem Cell Transplant Survivors: A Focus on Screening, Monitoring, and Therapeutics

“…A recent study by Bersvendsen and colleagues evaluated sexual function and sexual satisfaction in long-term lymphoma survivors after autologous HCT via the Brief Sexual Function Inventory (BSFI) and compared them to aged-matched controls. 167 The investigators found that CVD was significantly associated with worse erectile function, whereas age > 55 years, chronic fatigue, and physical inactivity were significantly associated with lower sexual functioning overall; chronic fatigue and anxiety were related to lower sexual satisfaction. 167 Surveillance of long-term survivors of HCT includes not only patient examination for epithelial changes of the genitalia (at the annual gynecologic examination for women and by a dermatologist for men) but also asking directly about genital epithelium symptoms, and at 1 year post-HCT, obtaining serum FSH, LH, and estradiol levels for women and serum FSH, LH, and testosterone for men if clinical symptoms of hypogonadism are present.…”

“…167 The investigators found that CVD was significantly associated with worse erectile function, whereas age > 55 years, chronic fatigue, and physical inactivity were significantly associated with lower sexual functioning overall; chronic fatigue and anxiety were related to lower sexual satisfaction. 167 Surveillance of long-term survivors of HCT includes not only patient examination for epithelial changes of the genitalia (at the annual gynecologic examination for women and by a dermatologist for men) but also asking directly about genital epithelium symptoms, and at 1 year post-HCT, obtaining serum FSH, LH, and estradiol levels for women and serum FSH, LH, and testosterone for men if clinical symptoms of hypogonadism are present. 166 Sexual function should be evaluated using a validated questionnaire (i.e., BSFI), at 6 months, 1 year, and annually after HCT.…”

“…Of note, use of phosphodiesterase type 5 inhibitors is contraindicated with concomitant nitrates and bremelanotide is contraindicated in patients with uncontrolled hypertension or known CVD. 167,169 Finally, all HCT recipients should receive comprehensive contraceptive counseling with gonadal function recovery, if fertility status is unknown, or pregnancy is not desired. 2…”