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Archives of Gynecology and Obstetrics

, Volume 299, Issue 1, pp 191–201 | Cite as

Sexual activity and quality of life in patients after treatment for breast and ovarian cancer

  • Sebastian Mayer
  • Severine Iborra
  • Donata Grimm
  • Lisa Steinsiek
  • Sven Mahner
  • Michaela Bossart
  • Linn Woelber
  • Pit Jacob Voss
  • Gerald Gitsch
  • Annette HasenburgEmail author
Gynecologic Oncology

Abstract

Objective

Sexual activity (SA) and functioning (SF) are important factors influencing quality of life (QoL). Anticancer treatment can cause or promote sexual dysfunctions. In this study we analyzed the SA, SF and QoL in patients after completion of treatment for breast cancer (BC) and ovarian cancer (OC).

Methods

In this retrospective multicenter study 396 BC patients and 93 OC patients aged between 18 and 70 years were surveyed at least 24 months after cancer diagnosis and compared to 60 healthy women. Data were collected through validated questionnaires (Sexual Activity Questionnaire, Female Sexual Function Index-d, EORTC Quality of Life Questionnaire-C30).

Results

45.9% of BC patients and 56.5% of OC patients reported SA. SF and well-being of sexually active BC patients were not influenced by the type and radicality of surgery or the administration of chemotherapy. Patients who received antihormonal therapy at the time of evaluation showed a lower frequency of SA (p = 0.007), less satisfaction (p = 0.003) and more discomfort during SA (p = < 0.001) compared to healthy controls but no differences in experiencing orgasms, health status, QoL and global health status. In contrast, BC patients without antihormonal therapy showed only a higher discomfort score (p = 0.028) than healthy controls and estimated their health status and QoL significantly better than patients who received antihormonal therapy (p = 0006). In general, SA was associated with a better health status (p = 0.007), a better QoL (p = 0.004) and a better global health status (p = 0.004) in BC patients. Sexually active OC patients showed no significant differences in SF, QoL and health status compared to healthy controls.

Conclusions

Compared to healthy controls BC patients showed limitations in SF with a lower SA rate and more discomfort. Antihormonal therapy was an important factor influencing SF and well-being. Breast and OC survivors reported good physical and psychical health without differences in QoL and health status compared to controls. This might be explained by a change of perspective on life difficulties and altered priorities through a life threatening disease.

Keywords

Quality of life Sexual activity Sexual function Breast cancer Ovarian cancer 

Notes

Author contributions

SM protocol/project development, data collection, data analysis, manuscript writing/editing. SI data collection, data analysis. DG data collection, manuscript editing. LS data collection. SM Protocol/project development, data collection. MB data collection, manuscript writing/editing. LW Protocol/project development, data collection, manuscript editing. PJV data collection. GG data collection. AH Protocol/project development, data collection, manuscript writing/editing

Compliance with ethical standards

Conflict of interest

The authors declare no potential conlicts of interest.

Supplementary material

404_2018_4922_MOESM1_ESM.pdf (13 kb)
Supplementary material 1 (PDF 12 kb)
404_2018_4922_MOESM2_ESM.pdf (318 kb)
Supplementary material 2 (PDF 317 kb)
404_2018_4922_MOESM3_ESM.pdf (348 kb)
Supplementary material 3 (PDF 347 kb)

References

  1. 1.
    Chopra I, Kamal KM (2012) A systematic review of quality of life instruments in long-term breast cancer survivors. Health Qual Life Outcomes 10:14PubMedPubMedCentralGoogle Scholar
  2. 2.
    Hasenburg A, Schröck R, Schmalfeldt B, Ortmann A (2008) Nachsorge und rehabilitation nach therapie eines ovarialkarzinoms. Onkologe 14:1172–1178Google Scholar
  3. 3.
    Thors CL, Broeckel JA, Jacobsen PB (2001) Sexual functioning in breast cancer survivors. Cancer Control 8(5):442–448PubMedGoogle Scholar
  4. 4.
    Audette C, Waterman J (2010) The sexual health of women after gynecologic malignancy. J Midwifery Womens Health 55(4):357–362PubMedGoogle Scholar
  5. 5.
    Ganz PA, Rowland JH, Desmond K, Meyerowitz BE, Wyatt GE (1998) Life after breast cancer: understanding women’s health-related quality of life and sexual functioning. J Clin Oncol 16(2):501–514Google Scholar
  6. 6.
    Ganz PA, Greendale GA, Petersen L, Kahn B, Bower JE (2003) Breast cancer in younger women: reproductive and late health effects of treatment. J Clin Oncol 21(22):4184–4193PubMedGoogle Scholar
  7. 7.
    Al-Ghazal SK, Fallowfield L, Blamey RW (2000) Comparison of psychological aspects and patient satisfaction following breast conserving surgery, simple mastectomy and breast reconstruction. Eur J Cancer 36(15):1938–1943PubMedGoogle Scholar
  8. 8.
    Ohsumi S, Shimozuma K, Kuroi K, Ono M, Imai H (2007) Quality of life of breast cancer patients and types of surgery for breast cancer—current status and unresolved issues. Breast Cancer 14(1):66–73PubMedGoogle Scholar
  9. 9.
    Fobair P, Stewart SL, Chang S, D’Onofrio C, Banks PJ, Bloom JR (2006) Body image and sexual problems in young women with breast cancer. Psychooncology 15(7):579–594PubMedGoogle Scholar
  10. 10.
    Cavalheiro JA, da Bittelbrunn A, Menke CH, Biazús JV, Xavier NL, Cericatto R (2012) Sexual function and chemotherapy in postmenopausal women with breast cancer. BMC Womens Health 12:28PubMedPubMedCentralGoogle Scholar
  11. 11.
    Schover LR, Yetman RJ, Tuason LJ, Meisler E, Esselstyn CB, Hermann RE (1995) Partial mastectomy and breast reconstruction. A comparison of their effects on psychosocial adjustment, body image, and sexuality. Cancer 75(1):54–64PubMedGoogle Scholar
  12. 12.
    Aerts L, Christiaens MR, Enzlin P, Neven P, Amant F (2014) Sexual functioning in women after mastectomy versus breast conserving therapy for early-stage breast cancer: a prospective controlled study. Breast 23(5):629–636PubMedGoogle Scholar
  13. 13.
    Pusic AL, Matros E, Fine N, Buchel E, Gordillo GM, Hamill JB (2017) Patient-reported outcomes 1 year after immediate breast reconstruction: results of the mastectomy reconstruction outcomes consortium study. J Clin Oncol 35(22):2499–2506PubMedPubMedCentralGoogle Scholar
  14. 14.
    Cortés-Flores AO, Vargas-Meza A, Morgan-Villela G, Jiménez-Tornero J, del Valle CJZ-F, Solano-Genesta M (2017) Sexuality among women treated for breast cancer: a survey of three surgical procedures. Aesthetic Plast Surg 41(6):1275–1279PubMedGoogle Scholar
  15. 15.
    Kim SI, Lee Y, Lim MC, Joo J, Park K, Lee DO (2015) Quality of life and sexuality comparison between sexually active ovarian cancer survivors and healthy women. J Gynecol Oncol 26(2):148–154PubMedPubMedCentralGoogle Scholar
  16. 16.
    Li C-C, Rew L, Chen L (2014) Factors affecting sexual function: a comparison between women with gynecological or rectal cancer and healthy controls. Nurs Health Sci 17(1):105–111PubMedGoogle Scholar
  17. 17.
    Stabile C, Goldfarb S, Baser RE, Goldfrank DJ, Abu-Rustum NR, Barakat RR (2017) Sexual health needs and educational intervention preferences for women with cancer. Breast Cancer Res Treat 165(1):77–84PubMedPubMedCentralGoogle Scholar
  18. 18.
    Thirlaway K, Fallowfield L, Cuzick J (1995) The sexual activity questionnaire: a measure of women’s sexual functioning. Qual Life Res 5(1):81–90Google Scholar
  19. 19.
    Rosen R, Brown C, Heiman J, Leiblum S, Meston C, Shabsigh R (2000) The female sexual function index (FSFI): a multidimensional self-report instrument for the assessment of female sexual function. J Sex Marital Ther 26(2):191–208Google Scholar
  20. 20.
    Aaronson NK, Ahmedzai S, Bergman B, Bullinger M, Cull A, Duez NJ (1993) The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst 85(5):365–376Google Scholar
  21. 21.
    Oberguggenberger A, Martini C, Huber N, Fallowfield L, Hubalek M, Daniaux M (2017) Self-reported sexual health: breast cancer survivors compared to women from the general population—an observational study. BMC Cancer 17(1):599PubMedPubMedCentralGoogle Scholar
  22. 22.
    Candy B, Jones L, Vickerstaff V, Tookman A, King M (2016) Interventions for sexual dysfunction following treatments for cancer in women. In: The Cochrane Library [Internet]. John Wiley & Sons, Ltd. Verfügbar unter. http://cochranelibrary-wiley.com/doi/10.1002/14651858.CD005540.pub3/full. zitiert 20. März 2018
  23. 23.
    Broeckel JA, Thors CL, Jacobsen PB, Small M, Cox CE (2002) Sexual functioning in long-term breast cancer survivors treated with adjuvant chemotherapy. Breast Cancer Res Treat 75(3):241–248PubMedGoogle Scholar
  24. 24.
    Panjari M, Bell RJ, Davis SR (2011) Sexual function after breast cancer. J Sex Med 8(1):294–302PubMedGoogle Scholar
  25. 25.
    Avis NE, Johnson A, Canzona MR, Levine BJ (2018) Sexual functioning among early post-treatment breast cancer survivors. Support Care Cancer 26(8):2605–2613PubMedPubMedCentralGoogle Scholar
  26. 26.
    Mortimer JE, Boucher L, Baty J, Knapp DL, Ryan E, Rowland JH (1999) Effect of tamoxifen on sexual functioning in patients with breast cancer. J Clin Oncol 17(5):1488PubMedGoogle Scholar
  27. 27.
    Day R, Ganz PA, Costantino JP, Cronin WM, Wickerham DL, Fisher B (2016) Health-related quality of life and tamoxifen in breast cancer prevention: a report from the National Surgical Adjuvant Breast and Bowel Project P-1 study. J Clin Oncol [Internet]. Verfügbar unter. http://ascopubs.org/doi/abs/10.1200/JCO.1999.17.9.2659?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%3dpubmed. zitiert 29 März 2018
  28. 28.
    Bradford A (2013) Sexual outcomes of aromatase inhibitor therapy in women with breast cancer: time for intervention. Menopause 20(2):128–129PubMedGoogle Scholar
  29. 29.
    Baumgart J, Nilsson K, Evers AS, Kallak TK, Poromaa IS (2013) Sexual dysfunction in women on adjuvant endocrine therapy after breast cancer. Menopause 20(2):162–168PubMedGoogle Scholar
  30. 30.
    Taylor CLC, Basen-Engquist K, Shinn EH, Bodurka DC (2004) Predictors of sexual functioning in ovarian cancer patients. J Clin 22(5):881–889Google Scholar
  31. 31.
    Zhou Y, Irwin ML, Ferrucci LM, McCorkle R, Ercolano EA, Li F (2016) Health-related quality of life in ovarian cancer survivors: Results from the American Cancer Society’s Study of Cancer Survivors—I. Gynecol Oncol 141(3):543–549PubMedPubMedCentralGoogle Scholar
  32. 32.
    Ersek M, Ferrell BR, Dow KH, Melancon CH (1997) Quality of life in women with ovarian cancer. West J Nurs Res 19(3):334–350PubMedGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Sebastian Mayer
    • 1
  • Severine Iborra
    • 6
  • Donata Grimm
    • 3
  • Lisa Steinsiek
    • 3
  • Sven Mahner
    • 4
  • Michaela Bossart
    • 1
  • Linn Woelber
    • 3
  • Pit Jacob Voss
    • 2
  • Gerald Gitsch
    • 1
  • Annette Hasenburg
    • 5
    Email author
  1. 1.Department of Obstetrics and GynecologyUniversity Medical Center FreiburgFreiburgGermany
  2. 2.Department of Oral and Maxillofacial SurgeryUniversity Medical Center FreiburgFreiburgGermany
  3. 3.Department of Gynecology and Gynecologic OncologyUniversity Medical Center Hamburg-EppendorfHamburgGermany
  4. 4.Department of Obstetrics and Gynecology, University HospitalLMU MunichMunichGermany
  5. 5.Department of Gynecology and ObstetricsUniversity Medical Center MainzMainzGermany
  6. 6.Department of Obstetrics and GynecologyUniversity Medical Center AachenAachenGermany

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