Sexual health-a topic for cancer patients receiving oncological treatment with palliative intent

Claudia Schmalz; Anne S Oberguggenberger; Eva Nagele; Brigitte Bliem; Anne Lanceley; Andy Nordin; Karin Kuljanic; Pernille T Jensen; Vesna Bjelic-Radisic; Alexander Fabian; Juan I Arraras; Chie Wei-Chu; Carien L Creutzberg; Razvan Galalae; Hilde Toelen; Kristin Zimmermann; Anna Costantini; Thierry Almont; Samantha Serpentini; Ligita Paskeviciute Frøding; Ingvild Vistad; Krzysztof A Tomaszewski; Elisabeth Inwald; Elfriede Greimel; EORTC Quality of Life Group

doi:10.1186/s12904-024-01513-4

Sexual health-a topic for cancer patients receiving oncological treatment with palliative intent

BMC Palliat Care. 2024 Jul 29;23(1):189. doi: 10.1186/s12904-024-01513-4.

Authors

Claudia Schmalz¹, Anne S Oberguggenberger², Eva Nagele³, Brigitte Bliem³, Anne Lanceley⁴, Andy Nordin⁵, Karin Kuljanic⁶, Pernille T Jensen⁷, Vesna Bjelic-Radisic⁸, Alexander Fabian⁹, Juan I Arraras¹⁰, Chie Wei-Chu¹¹, Carien L Creutzberg¹², Razvan Galalae¹³, Hilde Toelen¹⁴, Kristin Zimmermann¹⁵, Anna Costantini¹⁶, Thierry Almont¹⁷, Samantha Serpentini¹⁸, Ligita Paskeviciute Frøding¹⁹, Ingvild Vistad²⁰, Krzysztof A Tomaszewski²¹, Elisabeth Inwald²², Elfriede Greimel³; EORTC Quality of Life Group

Affiliations

¹ Department for Radiation Oncology, University Clinic Schleswig Holstein, Campus Kiel, Arnold-Heller Str. 3, Kiel, 24105, Germany. [email protected].
² Medical University of Innsbruck, Innsbruck, Austria.
³ Medical University of Graz, Graz, Austria.
⁴ University College London, London, UK.
⁵ East Kent Gynaecological Oncology Centre, Elizabeth the Queen Mother Hospital, Margate Kent, Queen, CT94AN, UK.
⁶ Clinical University Hospital Centre Rijeka, Rijeka, Croatia.
⁷ Department of Gynecology, Aarhus University Hospital, Aarhus, Denmark.
⁸ Helios University Clinic, University Witten/Herdecke, Wuppertal, Germany.
⁹ Department for Radiation Oncology, University Clinic Schleswig Holstein, Campus Kiel, Arnold-Heller Str. 3, Kiel, 24105, Germany.
¹⁰ Complejo Hospitalario de Navarra, Pamplona, Spain.
¹¹ Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei, 100, Taiwan.
¹² Department of Radiation Oncology, Leiden University Medical Center, Leiden, Netherlands.
¹³ Department for Radiation Oncology, Klinikum Bremerhaven, Bremerhaven, Germany.
¹⁴ University Hospitals Leuven, UZ Campus Gasthuisberg, Louvain, Belgium.
¹⁵ Bundeswehrzentralkrankenhaus Koblenz, Klinik Für Urologie, Koblenz, Germany.
¹⁶ Psychoncology Unit, Sant'Andrea Universitary Hospital, Rome, Italy.
¹⁷ Institut Universitaire du Cancer, Toulouse, France.
¹⁸ Veneto Institute of Oncology IOV - IRCCS, Padua, Italy.
¹⁹ Department of Gynecology, Copenhagen University Hospital, Copenhagen, Denmark.
²⁰ Sørlandet Hospital, Kristiansand, Norway.
²¹ Faculty of Medicine and Health Sciences, Andrzej Frycz Modrzewski Krako´W University, Krako´W, Poland.
²² University Medical Center Regensburg, Regensburg, Germany.

Abstract

Objectives: Sexuality is an important dimension of health-related quality of life (HRQOL) in cancer patients. Studies evidence that most patients report impairments of their sexual health related to their disease or its treatment. The Quality of Life Group of the European Organization for the Research and Treatment of Cancer (EORTC) developed a patient reported outcome measure assessing multidimensional aspects of sexual health. The validation study for this instrument revealed heterogenous results for patients in palliative oncological treatment. The aim of this secondary analyses is to examine differences in patient related sexual health outcomes between palliative patients with good performance status (GPS) and those with poor performance status (PPS).

Methods: In this observational cohort study, self-reported sexual health issue scores were compared between the two groups of patients in palliative oncological treatment with GPS vs PPS status.

Results: Patients with GPS experienced significantly more sexual satisfaction than patients with PPS (p = 0.015). They reported significantly more treatment effects on their sexual activity (p = 0.005) and suffer more from decreased libido (p = 0.008). Patients with PPS reported significantly more fatigue (p = 0.03) and regarded preservation of sexual activity of higher importance than did patients with GPS (p = 0.049).

Conclusions: Our study demonstrates the importance of sexuality for patients in palliative oncological treatment, especially for those with limited performance status. Considering the patients´ perspective, sexual health reaches beyond physical functioning. Patients in a palliative phase of disease report high levels of psychosexual problems while sexual performance deteriorates. Sexuality is an important aspect of HRQOL for these patients, needs to be addressed by health care providers and sensitively integrated into palliative care plans.

Keywords: Neoplasms; Palliative care; Patient reported outcome measure; Patient satisfaction; Sexuality.

Publication types

Observational Study

MeSH terms

Adult
Aged
Aged, 80 and over
Cohort Studies
Female
Humans
Male
Middle Aged
Neoplasms* / complications
Neoplasms* / psychology
Neoplasms* / therapy
Palliative Care* / methods
Palliative Care* / psychology
Palliative Care* / standards
Quality of Life* / psychology
Sexual Health*
Surveys and Questionnaires