The Prevalence and Types of Sexual Dysfunction in People With Cancer
In this summary, unless otherwise stated, evidence and practice issues as they relate to adults are discussed. The evidence and application to practice related to children may differ significantly from information related to adults. When specific information about the care of children is available, it is summarized under its own heading.
In a qualitative study of 48 men (130 approached) with erectile dysfunction after treatment for early prostate cancer, quality of life was significantly affected in areas such as the following:
- The quality of sexual intimacy.
- Everyday interactions with women.
- Sexual fantasy life.
- Perceptions of their masculinity.
Patients who participated in a randomized trial that compared radical prostatectomy with watchful waiting were asked to complete a questionnaire regarding symptoms, psychological functioning, and quality of life. Although the frequency of sexual thoughts was similar in both groups, the prevalence of erectile dysfunction (changes in voluntary erection in sexual situations, erection on awakening, and spontaneous erections) was higher in the radical prostatectomy group (80%) than in the watchful-waiting group (45%). Among men who underwent radical prostatectomy, 56% were moderately or greatly distressed by the decline in sexual function, as compared with 40% of men in the watchful-waiting group.
In a different population-that of male lymphoma survivors-a cross-sectional study of 15-year survivors of both Hodgkin and non-Hodgkin lymphoma compared sexual function and hormone levels with those of age-matched controls. Overall, the authors concluded that sexual function (as measured by the Brief Sexual Function Inventory [BSFI]) was significantly worse in the lymphoma survivors than in controls. In univariate analysis, lower functioning was attributed to the following:
There are several cautions in interpreting these results:
- The types of comorbidities are not listed; hence, it is not known whether cardiovascular disease was prevalent.
- Multivariate analyses to look at the relative impact of the various contributing factors to lower functioning were not performed.
- Considering the overall mean scores, the BSFI subscale scores were neither that low nor that different from the scores of controls (a difference of <0.5) even though they were statistically significantly different, likely because of the large sample size.
Although the authors concluded that sexual function was worse, it was only slightly worse; however, it reached statistical significance. Therefore, it is not clear from this study how much sexual functioning contributed to distress or decreased quality of life.
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