Adolescents and Young Adults with Cancer Report Sexual Dissatisfaction

Adolescents and young adults with cancer are at risk of being dissatisfied with their sexuality, regardless of whether or not they have cancer of the reproductive organs, according to the results of a new study.

“Most current knowledge about how cancer and cancer treatments can affect patients’ sexuality pertains to reproductive cancer patients,” researchers wrote in the study which was published in BMC Cancer.

In contrast, very little is known about how cancer outside the reproductive organs affect patients’ sex lives. Study researchers assessed sexual satisfaction and supportive care needs in adolescents and young adults with cancer and compared the differences on the basis of reproductive vs non-reproductive cancer types.

Participants were between the ages of 18 and 39 years and asked about their sexual satisfaction, changes in sexuality, and sexual supportive care needs.

Of the 577 participants who completed the questionnaire, the majority were female (73.5%). Participants had been diagnosed with the following reproductive cancers: breast (26%), gynecological (8.8%), and testicular (8.7%). Non-reproductive cancer types represented included Hodgkin’s lymphoma (17.2%), non-Hodgkin’s lymphoma (7.3%), hematological (6.6%), thyroid (5.5%), gastrointestinal (5.0%), sarcoma (4.5%), and melanoma (3.3%).

Approximately one-third of participants were dissatisfied with their sexuality and expressed a desire for supportive care needs, suggesting that problems with sexuality are widespread among survivors of a variety of cancers.

The study revealed no significant difference in sexual satisfaction or desire for supportive care needs among female participants who had reproductive cancers versus non-reproductive cancers. However, female participants with reproductive cancers were more likely to have changes in sexuality compared with those with non-reproductive cancers (t = − 2.693; P = 0.007). For male participants, no significant differences were found across any of the variables.

In addition, a multivariate analysis showed that compared with male adolescents and young adults, females were more likely to report significantly lower sexual satisfaction scores (P ≤ 0.001) and higher changes in sexuality (P ≤ 0.001) and the desire for more supportive care needs (P = 0.01). In addition, being in a partnership increased satisfaction with sexuality whereas being older decreased satisfaction.

“These results show that there is a clear need for clinical teams to address sexuality in AYA [adolescent and young adult] cancer patients as a matter of routine,” wrote the study researchers.

During an interview with Cancer Network, Elana Evan, PhD, director of program development and research for the University of California Los Angeles’ Children’s Pain Comfort Care Program, said it makes sense that sexual satisfaction would be impacted for patients with reproductive cancer or non-reproductive cancer.

“It really points to the fact that preventative work has to be done in this area,” Evan said.

Evan said it would have been interesting had the study authors included body image as a variable because when a person is going through chemotherapy or radiation, certain parts of the body are going to change-such as loss of hair or development of moon face-even for patients with non-reproductive cancers.

“All of those elements affect body image and could affect the way that you feel sexually,” she said.