Romantic and sexual relationships, body image, and fertility in adolescent and young adult testicular cancer survivors: a review of the literature

Sexuality and body image in long-term survivors of testicular cancer

OBJECTIVE

This study explores sexual function and the influence of different treatment modalities on sexual function and body image among long-term survivors of testicular cancer (TCSs).

METHODS

A long-term follow-up assessment of all testicular cancer patients treated at Aarhus University Hospital, Denmark, from 1990 to 2000 was conducted. A total of 401 survivors (mean age: 46.6years; response rate: 66%) completed questionnaires concerning sexuality and changes in body image. Based on the treatment received, patients were categorised into one of four groups: surveillance, radiotherapy, chemotherapy, or chemotherapy supplemented with retroperitoneal lymph node dissection (RPLND).

RESULTS

Sexual dysfunctions were reported: 24% reduced sexual interest, 43% reduced sexual activity, 14% reduced sexual enjoyment, 18% erectile dysfunction, 7% ejaculatory problems and 3% increased sexual discomfort. Seventeen percent of the long-term TCSs reported changes in body image, and this was significantly associated with all six parameters of sexual dysfunction. When comparing treatments, only the RPLND procedure was associated with sexual dysfunction in the form of ejaculatory dysfunction.

CONCLUSION

Apart from RPLND, which was associated with ejaculatory dysfunction, treatment strategies for testicular cancer appeared not to influence sexual dysfunction. The level of erectile dysfunction seen in this sample of TCSs seemed to be higher than the level observed in the general male population and high levels of erectile dysfunction were associated with negative changes in body image. The results suggest that changes in body image are of importance when explaining the variation in sexual dysfunctions, but further prospective studies are needed to clarify this issue.

Sexual functioning of testicular cancer survivors and their partners - A review of literature

BACKGROUND

Testicular cancer (TC) is the most common cancer in the 25-40 age group, with peak morbidity at around 30 years of age. It is a period of highest productivity, when sexual sphere is an important aspect of life. The disease, invasive treatment and its consequences interfere with this sphere.

AIM

The aim of this paper was to review the most recent studies on the sexual functioning of patients treated for testicular cancer and their partners published in English language scientific journals in the period of 1989-2010.

RESULTS

Numerous studies report that men cured from testicular cancer are at risk of sexual disorders. Agents of psychological nature play an important role in the occurrence and persistence of sexual dysfunctions. Being in permanent relationship is a protective factor, while single persons are marked with particular predisposition to such dysfunctions. Sexual and marital satisfaction of TC survivors and their partners are mutually correlated.

CONCLUSION

With a growing number of TC survivors, a thorough investigation is required into their sexuality, both in an individual and dyadic dimension, so as to improve the quality of life of the affected young men, who take on their new social and professional roles in the period of highest reproductiveness.