Sexual Function, Quality of Life, and Mood After Radiation Therapy in Patients with Anal Cancer

  • Divya YerramilliEmail author
  • Lorraine Drapek
  • Ryan D. Nipp
  • Nora Horick
  • Samantha M. C. Moran
  • Bridget Noé
  • Sara M. D’Arpino
  • Devarati Mitra
  • Theodore S. Hong
  • David P. Ryan
  • Don S. Dizon
  • Jennifer Wo
Original Research



Definitive chemoradiation (CRT) results in high cure rates of anal cancer, with advanced radiation (RT) techniques improving toxicity. However, there is limited data regarding these patients’ sexual function (SF), quality of life (QOL), and mood. We hypothesized that anal cancer treatment would result in detrimental effects on SF, QOL, and mood.


We prospectively surveyed patients with anal cancer treated with definitive CRT. We assessed SF for women with the Female Sexual Function Index (FSFI) and for men with the International Index of Erectile Function (IIEF). For all patients, we assessed QOL using EORTC QLQ-C30 and CR29 and mood using the Hospital Anxiety and Depression Scale (HADS). We reported descriptive statistics for SF, QOL, and mood and used univariate analysis to evaluate predictors of SF for women.


Of 50 eligible patients, 84% completed the surveys. Median time from RT until survey was 36 months (1–97 months). Women (n = 34) reported poor SF overall (mean FSFI score = 15, scale 2–36, standard deviation (SD) 10.4). Most women reported poor SF related to satisfaction, desire, orgasm, arousal, pain, and lubrication. Men (n = 8) also had poor overall satisfaction (mean IIEF score = 6.1, scale 2–10, SD 3.6). Men reported poor erectile function and lower satisfaction with intercourse. Mean QLQ-C30 QOL score was 86.5 (SD 16.3). Results from EORTC QLQ-CR-20 demonstrated patients experienced poor sexual interest. Per HADS, 2.5% reported depression and 18% anxiety.


Patients with anal cancer experience sexual dysfunction after RT, with QOL and mood symptoms similar to patients with other cancers. Our data support the need for ongoing efforts to understand and address issues with SF, QOL, and mood following RT for these patients.


Anal cancer Sexual function Quality of life Mood Depression Anxiety 



This study is supported by the Patty Brisben Foundation (awarded to JYW and LCD) and a Rare Cancer Genetics Registry Grant (NIH 4R01CA160233-05, PI: Dianne Finkelstein).

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Divya Yerramilli
    • 1
    Email author
  • Lorraine Drapek
    • 1
  • Ryan D. Nipp
    • 2
  • Nora Horick
    • 3
  • Samantha M. C. Moran
    • 2
  • Bridget Noé
    • 1
  • Sara M. D’Arpino
    • 2
  • Devarati Mitra
    • 1
  • Theodore S. Hong
    • 1
  • David P. Ryan
    • 2
  • Don S. Dizon
    • 4
  • Jennifer Wo
    • 1
  1. 1.Department of Radiation OncologyMassachusetts General HospitalBostonUSA
  2. 2.Division of Medical OncologyMassachusetts General Hospital Cancer CenterBostonUSA
  3. 3.Massachusetts General Hospital Biostatistics CenterBostonUSA
  4. 4.Division of Medical Oncology, Department of Medicine, Lifespan Cancer InstituteRhode Island HospitalProvidenceUSA

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