This article is more than 5 years old. Information may no longer be current.
Survivors of childhood cancer experience differences in psychosexual development
Click Here to Manage Email Alerts
Survivors of childhood cancer who received high-dose neurotoxic treatments while children or adolescents were less likely to have had intercourse, be in a relationship or have children compared with those never diagnosed with cancer, according to a study published in Cancer.
“Neurotoxic treatments can impair neurocognitive functioning among survivors, which could make navigating through more complex social interactions difficult for survivors throughout life, including their ability to engage in romantic relationships,” Vicky Lehmann, PhD, psychologist and former postdoctoral researcher at the Research Institute at Nationwide Children’s Hospital and The Ohio State University, told HemOnc Today.
“In this study, we found that young adult survivors of childhood cancer did not differ from controls in their psychosexual development, apart from having fewer lifetime sex partners, or in their sexual satisfaction, and relationship status satisfaction. While this is good news, it also bears risk of overlooking certain survivors who may be struggling after all.”
Lehmann and colleagues evaluated data from 144 adults (53.4% women; 91.6% white) aged 20 to 40 years (median age, 28 years) who were diagnosed with any malignancy between the ages of 5 and 18 years (median age at diagnosis, 11.7 years). Diagnoses included brain tumors (32.6%), leukemia (29.2%), lymphoma (21.5%) and other solid tumors (16.7%). All survivors were at least 5 years from their cancer diagnosis (median, 16.4 years).
Researchers compared the survivors with a 144-member control group with similar sociodemographic characteristics.
Participants were asked to provide information on: sexual debut (yes/no), age at sexual debut, number of lifetime sexual partners, relationship status (single/partnered) and whether they had biological children (yes/no). Sexual satisfaction was assessed through scaled responses of good–bad, pleasant–unpleasant and satisfying–unsatisfying; and relationship status satisfaction was assessed through scaled responses to questions such as, “How happy are you with your current relationship status?”
Researchers assessed the extent of neurotoxicity of the treatments survivors underwent based on whether they received craniospinal radiation, intrathecal chemotherapy, and IV chemotherapies that cross the blood–brain barrier, and at what dose.
The whole groups of survivors of childhood cancer did not differ from their peers with regard to sexual debut, age at sexual debut, relationship status and having children, but survivors reported having fewer sex partners (6.7 vs. 11.3).
Survivors who received high-dose neurotoxic treatment were least likely to be sexually experienced compared with the non-neurotoxic group (72% vs. 98%), as well as survivors in the low-dose group (86%) and controls (87%). The same pattern persisted for relationship status.
Both, the high-dose group and low-dose group (24% vs. 14%) were less likely to have children than the non-neurotoxic group (40%) and controls (34%).
Additionally, survivors of brain tumors were least likely to be sexually experienced (72%) and survivors of brain tumors and survivors of leukemia were least likely to be partnered compared with other cancers (brain tumors, 46%; leukemia, 57%, other cancers, 83%).
Researchers noted that, although the high-dose group had the lowest rates of being partnered, their status satisfaction was comparable to that of the low-dose group and controls.
“Interestingly, although these survivors did not achieve/delay psychosexual milestones, they were not necessarily less satisfied with their sex life, underlining the subjective nature of psychosexual issues,” Lehmann said.
Lehmann and colleagues noted that future studies focusing on self-perception and the attainment of psychosexual milestones are warranted.
“Sexuality and romantic relationships are an incremental part of overall quality of life and well-being,” Lehmann said. “Thus, survivorship care should also focus on those aspects, in order to provide comprehensive care. Our neurotoxicity rating, or at least an awareness of it, may help health care providers to identify those in need of additional support.” – by Chuck Gormley
Disclosure: Research Institute at Nationwide Children’s Hospital and a grant from the Dutch Cancer Society funded the study. The researchers report no relevant financial disclosures.
Click Here to Manage Email Alerts