Abstract
BackgroundChanges to sexual wellbeing are acknowledged to be a long-term negative consequence of cancer and cancer treatment. These changes can have a negative effect on psychological well-being, quality of life and couple relationships. Whilst previous conclusions are based on univariate analysis, multivariate research can facilitate examination of the complex interaction between sexual function and psycho-social variables such as psychological wellbeing, quality of life, and relationship satisfaction and communication in the context of cancer, the aim of the present study.MethodSix hundred and fifty seven people with cancer (535 women, 122 men) and 148 partners (87 women, 61 men), across a range of sexual and non-sexual cancers, completed a survey consisting of standardized measures of sexual functioning, depression and anxiety, quality of life, relationship satisfaction, dyadic sexual communication, and self-silencing, as well as ratings of the importance of sex to life and relationships.ResultsMen and women participants, reported reductions in sexual functioning after cancer across cancer type, for both people with cancer and partners. Multiple regression analysis examined psycho-social predictors of sexual functioning. Physical quality of life was a predictor for men and women with cancer, and for male partners. Dyadic sexual communication was a predictor for women with cancer, and for men and women partners. Mental quality of life and depression were also predictors for women with cancer, and the lower self-sacrifice subscale of self-silencing a predictor for men with cancer.ConclusionThese results suggest that information and supportive interventions developed to alleviate sexual difficulties and facilitate sexual renegotiation should be offered to men and women with both sexual and non-sexual cancers, rather than primarily focused on individuals with sexual and reproductive cancers, as is the case currently. It is also important to include partners in supportive interventions. Interventions aimed at improving sexual functioning should include elements aimed at improving physical quality of life and sexual communication, with a focus on psychological wellbeing also being important for women with cancer.
Highlights
Changes to sexual wellbeing are acknowledged to be a long-term negative consequence of cancer and cancer treatment
Dyadic sexual communication was a predictor for women with cancer, and for men and women partners
Study aims and research questions The aim of this study is to examine the nature of changes in sexual functioning post-cancer and to evaluate the interaction between sexual function and psychological distress, quality of life, and relationship satisfaction and communication
Summary
Changes to sexual wellbeing are acknowledged to be a long-term negative consequence of cancer and cancer treatment. Negative body image or feelings of sexual un-attractiveness [6,20], concern about weight gain or loss [21], loss of femininity [22], as well as alterations to the sexual self [23], can exacerbate the impact of these physical changes In combination, this can result in changes to women’s response [18], including changes to: desire [18,24], orgasm [21,25], arousal [26], vaginal lubrication [15,17], genital swelling [16] and genital sensitivity [27], leading to decreased frequency of sex [28], and lack of sexual pleasure or satisfaction [29,30]. Rectal cancer has been associated with reductions in sexual functioning, for both women and men [45,46]
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