After the diagnosis: How cancer affects sexual functioning

A cancer diagnosis disrupts a person's life in many ways, including sexually. A study led by the University of Houston found that more than half of young cancer patients reported problems with sexual function, with the probability of reporting sexual dysfunction increasing over time.

The study, recently published in the American Cancer Society journal Cancer, discovered that two years after their initial cancer diagnosis, nearly 53 percent of young adults 18 to 39 years old still reported some degree of affected sexual function.

While cancer-related sexual dysfunction has been studied among adolescents and young adults with cancer, the study is the first to establish its prevalence and to identify variables that contribute to reporting sexual problems over time.

"We wanted to increase our understanding of what it's like to adjust to cancer as a young adult but also the complexity of it over time," said Chiara Acquati, lead author and assistant professor at the UH Graduate College of Social Work. "Cancer can put a patient's life on hold, especially among young adults who are just starting their careers or families."

The study also found that for women, being in a relationship increased the probability of reporting sexual problems over time; for men, the probability of reporting sexual problems increased regardless of their relationship status.

"We concluded that sexual functioning is experienced differently among males and females. For a young woman, especially, a cancer diagnosis can disrupt her body image, the intimacy with the partner and the ability to engage in sex," Acquati said.

At the beginning of the two-year study, almost 58 percent of the participants were involved in a romantic relationship. Two years after diagnosis, only 43 percent had a partner. In addition, psychological distress increased over time.

For Acquati, studying the effects of cancer on relationships and families is personal. Several family members have died after a cancer diagnosis, including two of her grandparents, and a close friend at age 16. These experiences shaped her interest in studying the impact of cancer on patients and informal caregivers, with the goal of improving psychosocial care for both.

She says it's important to research how psychological and emotional development are effected so tailored interventions and strategies can be created. Detecting changes in the rate of sexual dysfunction over time may help to identify the appropriate timing to deliver interventions.

Failure to address sexual health, the study concludes, could put young adults at risk for long-term consequences related to sexual functioning and identity development, interpersonal relationships and quality of life.

Acquati said health care providers might find it challenging to discuss intimacy and sex because of embarrassment or lack of training, but she believes addressing sexual functioning is vital soon after diagnosis and throughout the continuum of care.

"Results from this study emphasize the need to monitor sexual functioning over time and to train health care providers serving young adults with cancer in sexual health," said Acquati. "Furthermore, patients should be connected to psychosocial interventions to alleviate the multiple life disruptions caused by the illness and its treatment."