Sexual morbidity, quality of life, and patient-provider communication among ovarian cancer patients and survivors

Abstract

Objectives: As survival rates increase among women in the U.S. living with ovarian cancer (OC), quality of life (QOL) needs become more salient. Women treated for OC often report adverse sexual effects, yet evidence suggests oncology providers rarely discuss sexual health with their patients. We characterized sexual morbidity, QOL, and health care team (HCT) communication among a community sample of OC patients. Methods: 60 OC patients and survivors who enrolled in a cancer experience registry completed questions to assess sexual morbidity (6 items tallied to create a sexual morbidity score; range: 0-6) and its impact. Frequencies and correlations between sexual morbidity measures, HCT communication, QOL indices (assessed using PROMIS-29 v2.0 symptom burden subscales), and socio-demographics were examined. Results: Participants were 83% non-Hispanic White, 7% Hispanic, and 5% Black/African American; mean age was 58 years (SD=11.3). Median time since diagnosis was 4 years (range: 0-25), 51% reported diagnosis in past 2 years, 35% were ever metastatic, 32% experienced a recurrence. 83% reported total abdominal hysterectomy with bilateral salpingo-oophorectomy. 70% of OC participants reported at least 1 sexual difficulty, 55% reported 2 or more of the following: 55% vaginal dryness, 52% no interest in sex, 39% anxious about having sex, 27% difficulty having an orgasm, 27% did not enjoy sex, and 25% pain during or after sex. Further, 47% reported OC negatively impacted their sexual life, 35% indicated sexual activity was a source of distress. 71% felt they could talk to a member of their HCT about sexual concerns; 49% indicated a member of their HCT offered help in coordinating distress-related care, but only 32% reported that a member of their HCT ever asked about sexual function. Greater sexual morbidity was positively correlated with PROMIS depression (r=.31, p Conclusions: OC patients report substantial concerns related to sexual function and well-being, with greater sexual morbidity associated with poorer emotional well-being, fatigue, and sleep disturbance. Few OC patients indicate being asked about sexual function by their HCT, despite a general willingness to talk about sexual concerns. Findings highlight a need for oncology care providers to initiate conversations surrounding sexual function and for the development of relevant evidence-based supportive care programs.