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Top Takeaways from ASCO: Gynecologic cancers and sexual dysfunction
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Women with gynecologic cancer demonstrated an increased risk for sexual dysfunction, according to results of a multi-institutional, cross-sectional study.
Those who were younger, premenopausal, in committed relationships or undergoing chemotherapy appeared most likely to experience these issues.
The study also showed women with sexual dysfunction had a larger drop in sexual activity and sought more counseling than those with no sexual impairment.
“The results of this … study show that, across the board, regardless of disease site, women with gynecologic cancer suffer from significant sexual dysfunction,” Saketh Guntupalli, MD, FACOG, FACS, of University of Colorado Anschutz, Aurora, told Healio.com. “Given that early-stage women’s cancers have high rates of survivorship, it is important for providers to discuss these issues.”
Guntupalli and colleagues assessed sexual and marital dysfunction in 290 women with gynecologic cancer through a 181-item survey. Diagnoses included uterine/endometrial cancer (41%), ovarian cancer (37%) and cervical/other cancer (22%). The most common treatments received were surgery (92%), chemotherapy (62%) and radiation (30%).
Sexual dysfunction was quantified based on change in Female Sexual Function Index, with a drop of 7.6 points using a Reliable Change Index Statistic representing a significant decline. Marital relationships were evaluated based on Intimate Bond Measure scores. The investigators applied standard statistical analyses.
Overall, women demonstrated a decline in sexual function from 23.2 ± 11.2 before diagnosis to 15.2 ± 10.2 after treatment. They also demonstrated a decrease in sexual activity, from 6.1 ± 6.8 times/month before diagnosis to 2.6 ± 4.9 times/month after treatment; P < .001 for both).
The investigators observed associations between sexual dysfunction after treatment and younger age (51.8 ± 12.2 to 57.3 ± 12.1, P = .004), pre-menopause (27% vs. 13.5%, OR = 2.38; 95% CI, 1.23-4.71), chemotherapy receipt (69.8% vs. 51.9%, OR = 2.05; 95% CI, 1.1-3.84) and being in a committed relationships (97.3% vs. 82.7%, OR = 7.43; 95% CI, 1.67-33.11).
However, sexual dysfunction did not appear to be associated with marital relationship scores, length of relationship, surgery and radiation therapies, cancer site or stage, or race.
Compared with women with no impairment, patients with sexual dysfunction had diminished sexual activity (change, 5.3 ± 4.8 vs. change, 2.1 ± 3.8, P < .001) and more relationship counseling (13.7% vs. 4.9%, OR = 3.11; 95% CI, 1.02-9.53).
“It is distressing to know that up to 16% of women with gynecologic cancer seek relationship counseling as a result of their treatment,” Guntupalli said. “Intimate partners should also be included in treatment planning so they are aware of the physical and psychological stresses of women with gynecologic cancers.” – by Allegra Tiver
For more information: Guntupalli S, et al. Abstract 9592. Presented at: ASCO Annual Meeting. May 29-June 2, 2015; Chicago.
Disclosure: Guntupalli reports no relevant financial disclosures.