Sexual dysfunction common among women with lung cancer
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Most women with lung cancer reported some degree of sexual dysfunction following diagnosis, according to study results presented during International Association for the Study of Lung Cancer World Conference on Lung Cancer.
The findings of the cross-sectional, international Sexual Health Assessment in Women with Lung Cancer (SHAWL) survey study suggested the need for sexual health to be integrated into thoracic oncology care, Narjust Florez (Duma), MD, associate director of the Cancer Care Equity Program and thoracic medical oncologist at Lowe Center for Thoracic Oncology at Dana-Farber Cancer Institute, and member of the faculty at Harvard Medical School, said during her presentation.
Rationale and methods
Prior research has shown that as many as 95% of patients with lung cancer score below the 50th percentile on sexual function. However, research on this key quality-of-life component is lacking, Florez said.
“Women’s sexuality continues to be taboo and understudied, with millions of dollars invested in male sexuality for things like male enhancing drugs but the same cannot be said for women,” Florez told Healio. “Secondary to that, most of the data regarding sexual health among patients with lung cancer is from the early 2000s, before the approval of immunotherapy and targeted therapy. We had zero knowledge about the effects of these therapies on patient sexuality.”
For that reason, Florez and colleagues used the Patient-Reported Outcomes Measurement Information System (PROMIS) Sexual Function and Satisfaction Measures-validated questionnaire to assess the sexual health of 249 women (median age, 59.6 years; 88% white) diagnosed with lung cancer between June 2020 and June 2021. The questionnaire asked women about sexual activity before their lung cancer diagnosis and within 30 days before completing the survey.
Most of the women (64%) had stage IV lung cancer and 45% received treatment with targeted therapy, of whom 87% had been on treatment for more than 6 months. At the time of the survey, 33% of women used antidepressants and 14% used beta blockers.
Key findings
Results showed more than half (53%) of women reported sexual activity with themselves or with someone else within the previous 30 days. Among them, 59% reported significant issues with vaginal dryness and 26% reported vaginal pain/discomfort during sexual activity.
Overall, 77% of women reported little to no interest in sexual activity and 67% reported rarely or never wanting to have sexual activity. The most common reported factors that negatively impacted women’s satisfaction with their sex life included fatigue (40%), feeling sad/unhappy (28%), issues with their partners (22%) and shortness of breath (15%).
Researchers also observed marked differences in decreased sexual desire/interest before compared with after a lung cancer diagnosis (15% vs. 31%; P < .001) as well as vaginal pain/discomfort (13% vs. 43%; P < .001).
Implications
Florez reported several limitations of the study, including cultural beliefs around sexuality among the U.S.-based study sample and the fact that most participants were non-Hispanic white women.
“We need to incorporate sexual health into thoracic oncology just as it has already been incorporated into other types of malignancies. It is about time that we start working on this,” she said. “We have not been trained as oncologists to address sexual health — there’s a big taboo and a lack of comfort level for oncology providers, but it is our duty to ask patients about their sexual health. We don’t have to necessarily fix the sexual issues that patients have, but we must at least refer them to appropriate care. It is our hope that this research brings awareness to the issues around sexual health and lung cancer.”
Next steps include moving the study to international centers in different languages and interventions to improve the current status of sexual health in lung cancer, Florez told Healio.
For more information:
Narjust Florez (Duma), MD, can be reached at narjust_duma@dfci.harvard.edu.
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Florez N, et al. Abstract MA14. Presented at: International Association for the Study of Lung Cancer World Conference on Lung Cancer (hybrid meeting); Aug. 6-9, 2022; Vienna.
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