The course of sexual interest and enjoyment in head and neck cancer patients treated with primary (chemo)radiotherapy

H C Melissant; F Jansen; L E R Schutte; B I Lissenberg-Witte; J Buter; C R Leemans; M A Sprangers; M R Vergeer; E T M Laan; I M Verdonck-de Leeuw

doi:10.1016/j.oraloncology.2018.06.016

The course of sexual interest and enjoyment in head and neck cancer patients treated with primary (chemo)radiotherapy

Oral Oncol. 2018 Aug:83:120-126. doi: 10.1016/j.oraloncology.2018.06.016. Epub 2018 Jun 22.

Authors

H C Melissant¹, F Jansen², L E R Schutte³, B I Lissenberg-Witte⁴, J Buter⁵, C R Leemans⁶, M A Sprangers⁷, M R Vergeer⁸, E T M Laan⁹, I M Verdonck-de Leeuw¹⁰

Affiliations

¹ Department of Clinical, Neuro- and Developmental Psychology, Faculty of Behavioral and Movement Sciences, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, van der Boechorststraat 1, 1081 BT Amsterdam, The Netherlands; Cancer Center Amsterdam (CCA), VU University Medical Center, De Boelelaan 1118, 1081 HV Amsterdam, The Netherlands. Electronic address: h.c.melissant@vu.nl.
² Department of Clinical, Neuro- and Developmental Psychology, Faculty of Behavioral and Movement Sciences, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, van der Boechorststraat 1, 1081 BT Amsterdam, The Netherlands; Department of Otolaryngology-Head and Neck Surgery, Amsterdam Public Health Research Institute, VU University Medical Center, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands; Cancer Center Amsterdam (CCA), VU University Medical Center, De Boelelaan 1118, 1081 HV Amsterdam, The Netherlands. Electronic address: f.jansen1@vumc.nl.
³ Department of Sexology and Psychosomatic OBGYN, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
⁴ Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Center, De Boelelaan 1089a, 1081 HV Amsterdam, The Netherlands. Electronic address: b.lissenberg@vumc.nl.
⁵ Department of Medical Oncology, VU University Medical Center, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands. Electronic address: j.buter@vumc.nl.
⁶ Department of Otolaryngology-Head and Neck Surgery, Amsterdam Public Health Research Institute, VU University Medical Center, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands. Electronic address: cr.leemans@vumc.nl.
⁷ Department of Medical Psychology, Academic Medical Center, Meibergdreef 15, 1105 AZ Amsterdam, The Netherlands; Cancer Center Amsterdam (CCA), VU University Medical Center, De Boelelaan 1118, 1081 HV Amsterdam, The Netherlands. Electronic address: m.a.sprangers@amc.uva.nl.
⁸ Department of Radiation Oncology, VU University Medical Center, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands. Electronic address: mr.vergeer@vumc.nl.
⁹ Department of Sexology and Psychosomatic OBGYN, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands. Electronic address: e.t.laan@amc.uva.nl.
¹⁰ Department of Clinical, Neuro- and Developmental Psychology, Faculty of Behavioral and Movement Sciences, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, van der Boechorststraat 1, 1081 BT Amsterdam, The Netherlands; Department of Otolaryngology-Head and Neck Surgery, Amsterdam Public Health Research Institute, VU University Medical Center, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands; Cancer Center Amsterdam (CCA), VU University Medical Center, De Boelelaan 1118, 1081 HV Amsterdam, The Netherlands. Electronic address: im.verdonck@vumc.nl.

PMID: 30098767
DOI: 10.1016/j.oraloncology.2018.06.016

Abstract

Introduction: The aim of this prospective study was to investigate the course of sexual interest and enjoyment in relation to sociodemographic and clinical factors, health-related quality of life (HRQOL), and symptoms of psychological distress in head and neck cancer (HNC) patients treated with primary (chemo)radiotherapy.

Methods: HNC patients (n = 354) completed patient-reported outcome measures (PROMs) on HRQOL (EORTC QLQ-C30 and QLQ-H&N35, including the sexuality subscale covering less sexual interest and enjoyment), and psychological distress (HADS) pretreatment, at 6-week follow-up and at 3-, 6-, 12-, 18-, and 24-month follow-up (i.e., after treatment). Linear mixed models were used to analyze the course of sexuality from pretreatment to 24-month follow-up, and to investigate its relation to sociodemographic and clinical factors, HRQOL, and psychological distress as measured at baseline, and to investigate the course of sexuality from 6- to 24-month follow-up in relation to these factors measured at 6-month follow-up.

Results: Before start of treatment, 37% of patients reported having less sexuality, which increased to 60% at 6-week follow-up, and returned to baseline level from 12-month follow-up onwards. Older age (p = 0.037) and trouble with social contact (p < 0.001), weight loss (p = 0.013), and constipation (p = 0.041) before treatment were associated with less sexuality over time. Female gender (p = 0.021) and poor social functioning (p < 0.001) at 6-month follow-up were associated with less sexuality from 6- to 24-month follow-up.

Discussion: Less sexuality is often reported in HNC patients treated with (chemo)radiotherapy. Using PROMs in clinical practice may help identify patients who might benefit from supportive care targeting sexuality.

Keywords: Chemotherapy; Head and Neck Cancer; Longitudinal; Oncology; Patient-Reported Outcome Measures; Psychology; Quality of Life; Radiotherapy; Sexual Interest; Sexuality.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Aged
Chemoradiotherapy*
Constipation
Female
Head and Neck Neoplasms / physiopathology
Head and Neck Neoplasms / psychology*
Head and Neck Neoplasms / therapy*
Humans
Male
Middle Aged
Quality of Life
Sexuality*
Weight Loss