Cancer Diagnosis and Treatment Leaves Young Adults Vulnerable to Sexual Dysfunction

MedicalResearch.com Interview with:

Chiara Acquati, Ph.D., MSW Assistant Professor Graduate College of Social Work University of Houston Houston, TX  

Dr. Acquati

Chiara Acquati, Ph.D., MSW
Assistant Professor
Graduate College of Social Work
University of Houston
Houston, TX  

MedicalResearch.com: What is the background for this study?

Response: Adolescents and young adults (AYAs) with cancer are individuals between the ages of 15 and 39 years at diagnosis, as defined by the National Cancer Institute. Considerable research has unveiled unique psychosocial challenges experienced by AYAs, including poor quality of life, an altered body image, and social isolation.

As a result of these life disruptions, normative psychological and emotional development is affected by the disease and its treatment, particularly with respect to sexual identity, development, and behavior. However, few studies have examined sexual functioning and AYA patients’ needs with respect to emotional intimacy and sexual relationships. Estimates of the prevalence of sexual dysfunction in AYAs are limited to date and vary because of data derived from mixed-age groups, single items instead of standardized instruments, and cross-sectional designs. Yet, the state of the science suggests that one-third to two-thirds of cancer patients experience sexual dissatisfaction and a reduced frequency of intercourse. Furthermore, failure to address sexual health may place AYAs at risk for long-term consequences related to sexual functioning and identity development, interpersonal relationships, and quality of life. Hence, detecting changes in the rate of sexual dysfunction over time may help in identifying the appropriate timing for interventions to be delivered.

This study was conceptualized to increase our current knowledge of sexual functioning among AYAs by examining the prevalence of sexual dysfunction over the course of 2 years after the initial cancer diagnosis and the identification of variables that contribute to the probability of reporting sexual dysfunction in order to recognize individuals at higher risk. Young adult patients (≥18 years old) were administered the sexual functioning scale as part of a larger longitudinal multisite survey, and only those who completed the instrument at least once were included in this analysis; for this reason the article focuses on the experience of “young adults”.

MedicalResearch.com: What are the main findings?

Response: In this sample, more than half of the participants reported sexual functioning to be problematic at each assessment. The probability of reporting sexual dysfunction increased over time and was greater for cancer patients who were female, older, married or in a committed relationship, treated with chemotherapy, and reporting comorbid psychological distress and lower social support. For women, being in a relationship increased the likelihood of reporting sexual problems over time; for men, the likelihood of reporting sexual problems increased regardless of their relationship status.

MedicalResearch.com: What should readers take away from your report? 

Response: The study highlights the complexity of adjusting to cancer as a young adult, by providing further evidence that a substantial proportion of young adults report ongoing problem with sexual functioning in the first 2 years after their cancer diagnosis. Furthermore, the study revealed that there are groups of patients more vulnerable to the impact of cancer symptoms and treatment-related difficulties on their sexual function. Results from this study emphasize the need to monitor sexual functioning over time throughout the continuum of care and to connect patients to psychosocial interventions alleviating the multiple life disruptions caused by the illness and its treatment.

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

Response: Additional research is needed to examine the differential effects of cancer on sex and sexuality for men, women, and transgender young people so that tailored interventions can be developed and implemented. Finally, health care providers serving young adults with cancer should be trained in sexual health to increase their confidence initiating conversations about sex and sexual function.

MedicalResearch.com: Is there anything else you would like to add?

Response: Other researchers involved in the study include Brad J. Zebrack, University of Michigan; Anna C. Faul, University of Louisville; Leanne Embry and Christine Aguilar, The University of Texas Health Science Center San Antonio; Rebecca Block, MNR Analytics; Brandon Hayes-Lattin, Oregon Health and Science University; David Freyer, Children’s Hospital Los Angeles and the University of Southern California, Los Angeles; and Steve Cole, University of California-Los Angeles.

The study was funded by Hopelab, Inc. of San Francisco. 

Citations:

Acquati, C., Zebrack, B. J., Faul, A. C., Embry, L., Aguilar, C., Block, R., Hayes-Lattin, B., Freyer, D. R. and Cole, S. (2018), Sexual functioning among young adult cancer patients: A 2-year longitudinal study. Cancer, 124: 398–405. doi:10.1002/cncr.31030

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