Male identity, couple sexual satisfaction and genital cancer

Abstract

Carcinoma of the penis is a rare malignancy, comprising less than 1% of all male cancers. The conventional treatment for this cancer is partial or total penile amputation, radiation or laser. It appears that most patients can still enjoy a sexual life if laser treatment is used; more invasive procedures reduce this likelihood. Germ cell tumors of the testis appear to be increasing over the last two decades. The long-term survival for early disease approaches 100%. Since most patients undergo treatment during the most sexually active period of their life, the impact of therapy on sexual functioning, fertility, and body image is very important. Self-report measures of sexual function conducted soon after treatment indicate high levels of sexual dysfunction (reduction in orgasm, in libido, and in interest in sex) that tend to improve over time. More than half of testicular cancer patients reported that their body image had changed after treatment. Negative emotional states such as anxiety, depression, and anger may contribute to the disruption of sexual activity and problems in the sexual relationship. Other important psychological factors associated with sexual dysfunction are financial difficulties and occupational changes often related to the general effects of any serious illness. The stability of sexual function in husbands and wives of cancer patients suggests that the sexual problems developing after cancer treatment in the patients are caused as much by the emotional and medical impact of the illness as by the stress in the couple's relationship.