Sexual dysfunction is one of the more common consequences of cancer treatment. Men are less likely than women to seek professional help for mental and physical health problems. Sexual dysfunction in cancer patients may result from biological, psychological and social factors, just as they do in healthy men. Biological factors such as anatomic alterations (rectum or penile amputation), physiological changes (hormonal status) and secondary effect of medical intervention may preclude normal sexual functioning even when sex desire is intact. Side effects of the treatment such as nausea, vomiting, fatigue, hair loss can result in adverse effects on sexuality together with disfiguring surgery. Negative emotional states such as anxiety, depression, anger may disrupt sexual activity. Disturbances of body image can contribute to the development of sexual dysfunction: orchiectomy is such an example. Radiotherapy and surgery are the most effective treatments for prostate cancer. Erectile dysfunction (ED) is reported in 6-80% after external-beam radiotherapy and 2-61% after brachytherapy. ED after surgery is reported in 40-100%. Ejaculation problems and a decrease in libido occur in up to 80%. Testicular cancer affects mostly young men in their fertile and sexually active life. ED, loss of libido, decreased orgasm have been reported in 20% of these patients. Surgery and radiation therapy for gynaecological cancer can alter vaginal sensation and may cause stenosis leading to painful penetration. Cytotoxic and hormonal therapy in men can result in loss of libido and ED. In women these treatments lead to ovarian suppression, with vaginal discharge, dryness, dyspareunia and a loss of sexual interest. Evaluating sexual functioning in an oncology population is different from evaluating it in a healthy population because of its specific medical, psychological and social factors. A large number of instruments already exist to assess sexuality. It is important to standardize procedures and to use validated questionnaires.
Conflict of Interest: None disclosed
Financial Support/Funding: None disclosed
Recorded: Sydney, Australia, April 2007
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