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Chevalier LL, McCormick K, Cooney TM, Recklitis CJ, Bober SL. Sexual health in adult survivors of childhood cancer: A Project REACH study. Cancer 2024; 130:3023-3033. [PMID: 38804691 DOI: 10.1002/cncr.35363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 03/28/2024] [Accepted: 04/22/2024] [Indexed: 05/29/2024]
Abstract
BACKGROUND Sexual dysfunction is a significant complication of treatment for many adult-onset cancers. However, comparatively less is known about sexual dysfunction in adult childhood cancer survivors (CCSs). Research has been limited by the exclusion of specific cancers (e.g., central nervous system [CNS] tumors) and the lack of validated measures, which makes it difficult to understand the nature and prevalence of sexual dysfunction in CCSs. METHODS A total of 249 adult CCSs (aged 18-65 years) enrolled in Project REACH, a prospective cohort study, and completed measures of physical and mental health, including sexual dysfunction. Participants scoring ≤19 on the Female Sexual Function Index 6 or ≤21 on the International Index of Erectile Function 5 were classified as experiencing sexual dysfunction. Analyses examined the relationships between sexual dysfunction and demographic, disease, treatment, and health variables. RESULTS A total of 78 participants (32%) experienced clinically significant sexual dysfunction. In univariate analysis, sexual dysfunction was significantly associated with CNS tumor diagnosis (odds ratio [OR], 2.56) and surgery (OR, 1.96) as well as with health variables such as fatigue (OR, 3.00), poor sleep (OR, 2.84), pain (OR, 2.04), depression (OR, 2.64), poor physical health (OR, 2.45), and poor mental health (OR, 2.21). Adjusted analyses found that CNS tumor diagnosis (p = .001) and health variables (p = .025) contribute significantly to sexual dysfunction in CCSs. CONCLUSIONS Approximately one third of adult CCSs report clinically significant sexual dysfunction, which underscores a significant screening and treatment need. However, because available measures were developed for survivors of adult cancers, research to create a sexual health measure specifically for adult CCSs is necessary to better identify the sexual health concerns of this vulnerable population.
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Affiliation(s)
- Lydia L Chevalier
- Department of Pediatric Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, USA
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - Katherine McCormick
- Department of Pediatric Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Tabitha M Cooney
- Department of Pediatric Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Christopher J Recklitis
- Department of Pediatric Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - Sharon L Bober
- Department of Pediatric Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, USA
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
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Rainer QC, Dubin JM, Balaji NC, Troesch V, Terry W, Monga V, Clifford L, Shoag J, Greer A, Nackeeran S, Rodriguez AA, Patel P, Paz L, Kava BR, Alperstein W, Pearlman AM, Ramasamy R. Sexual Dysfunction Among Adolescent and Young Adult Men Diagnosed with Cancer. J Adolesc Young Adult Oncol 2023; 12:93-100. [PMID: 35319264 DOI: 10.1089/jayao.2021.0211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Purpose: Adolescent and young adult (AYA) cancer patients frequently demonstrate sexual dysfunction; however, there is a lack of data quantifying the severity and frequency. Methods: Males aged 18-39 years, diagnosed with cancer of any kind and who were scheduled to begin, were actively receiving, or had completed cancer treatment within 6 months, were offered validated surveys during their oncology appointment. These surveys included the International Index of Erectile Function (IIEF-6), Masturbation Erection Index (MEI), 36-Item Short Form Survey, and 5-point Likert scales to assess their desire and ability to engage in sex and masturbation. Results: Forty subjects completed the IIEF survey with a mean score of 17.7 ± 11, erectile dysfunction (ED) prevalence accordingly was 58%. Thirty-eight subjects completed the MEI with a mean score of 25.3 ± 5.3, ED prevalence was again 58%. Age and IIEF scores demonstrated a statistically significant (p < 0.05, n = 38) Pearson's correlation coefficient of 0.40, patients younger than 30 years had an ED prevalence of 72% (mean IIEF 13), whereas patients aged 30 years and older had an ED prevalence of 45% (mean IIEF 22). All treatment modalities had ED rates >30%: chemotherapy demonstrated the highest prevalence at 64% (mean IIEF 17), whereas radiation therapy had the lowest prevalence at 33% (mean IIEF 23). Conclusion: This study demonstrates that the prevalence of sexual dysfunction among male AYA patients undergoing treatment for cancer is high. AYA oncologists should discuss potential sexual health concerns when treating this population. The exact cause of ED (non-organic vs. organic) within this group should be explored further.
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Affiliation(s)
- Quinn Carroll Rainer
- Department of Urology, Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Justin Michael Dubin
- Department of Urology, Miller School of Medicine, University of Miami, Miami, Florida, USA.,Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | | | - Victoria Troesch
- Department of Urology, University of Texas Southwestern, Dallas, Texas, USA.,Department of Urology, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | - William Terry
- Department of Pediatrics, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | - Varun Monga
- Department of Medicine, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | - Lindsey Clifford
- Department of Oncology, The University of Iowa Holden Comprehensive Cancer Center, Iowa City, Iowa, USA
| | - Jamie Shoag
- Department of Pediatric Hematology and Oncology, Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Aubrey Greer
- Department of Urology, Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Sirpi Nackeeran
- Department of Urology, Miller School of Medicine, University of Miami, Miami, Florida, USA
| | | | - Premal Patel
- Department of Urology, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Lisa Paz
- Department of Urology, Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Bruce Richard Kava
- Department of Urology, Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Warren Alperstein
- Department of Pediatric Hematology and Oncology, Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Amy Marcia Pearlman
- Department of Urology, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | - Ranjith Ramasamy
- Department of Urology, Miller School of Medicine, University of Miami, Miami, Florida, USA
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