Annals of Hematology

, Volume 96, Issue 5, pp 739–747 | Cite as

Sexual problems in male vs. female non-Hodgkin lymphoma survivors: prevalence, correlates, and associations with health-related quality of life

  • Im-Ryung Kim
  • Soo Hyun Kim
  • Oh Nam Ok
  • So Hee Kim
  • Suyeon Lee
  • Eunju Choi
  • Seok Jin Kim
  • Dok Hyun Yoon
  • Moon Hee Lee
Original Article

Abstract

The objective of this study was to examine the prevalence and factors associated with sexual problems and their relationship to health-related quality of life (HRQOL) in male and female non-Hodgkin lymphoma (NHL) survivors. In this cross-sectional study, 738 NHL survivors (425 men and 313 women; mean time since diagnosis, 6.2 years) in South Korea completed the six-item instrument of adult sexual behavior used by the National Health and Social Life Survey in the United States. HRQOL was measured by two subscales of the EORTC QLQ-C30. Sexual problems were reported by a greater proportion of women (range, 31.9 to 64.4%) than men (range, 23.3 to 49.1%). Among four items common to both sexes, three (lacking interest in sex, unable to achieve orgasm, sex not pleasurable) were significantly more prevalent in women. Significant factors associated with multiple sexual problems in men were older age and being unemployed; in women, they were marital status and comorbidity. Lastly, more significant associations between sexual problems and HRQOL were observed in men than in women. Male and female NHL survivors differ in the prevalence of sexual problems and the factors associated with them as well as their associations with HRQOL. These findings can be used to develop sex-specific interventions to improve sexual function in this population.

Keywords

Sex Lymphoma Sexual problems Survivors 

Notes

Acknowledgements

This paper was supported by the Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education (grant number 2016R1D1A1B04932171).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

References

  1. 1.
    Ferlay J, Soerjomataram I, Dikshit R, Eser S, Mathers C, Rebelo M, Parkin DM, Forman D, Bray F (2015) Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer 136:E359–E386. doi: 10.1002/ijc.29210 CrossRefPubMedGoogle Scholar
  2. 2.
    Jung KW, Won YJ, Kong HJ, Oh CM, Cho H, Lee DH, Lee KH (2015) Cancer statistics in Korea: incidence, mortality, survival, and prevalence in 2012. Cancer Res Treat 47:127–141. doi: 10.4143/crt.2015.060 CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Bober SL, Varela VS (2012) Sexuality in adult cancer survivors: challenges and intervention. J Clin Oncol 30:3712–3719. doi: 10.1200/JCO.2012.41.7915 CrossRefPubMedGoogle Scholar
  4. 4.
    Kiserud CE, Schover LR, Dahl AA, Fossa A, Bjoro T, Loge JH, Holte H, Yuan Y, Fossa SD (2009) Do male lymphoma survivors have impaired sexual function? J Clin Oncol 27:6019–6026. doi: 10.1200/JCO.2009.23.2280 CrossRefPubMedGoogle Scholar
  5. 5.
    Recklitis CJ, Sanchez Varela V, Ng A, Mauch P, Bober S (2010) Sexual functioning in long-term survivors of Hodgkin’s lymphoma. Psychooncology 19:1229–1233. doi: 10.1002/pon.1679 CrossRefPubMedGoogle Scholar
  6. 6.
    Arden-Close E, Eiser C, Pacey A (2011) Sexual functioning in male survivors of lymphoma: a systematic review (CME). J Sex Med 8:1833–1841. doi: 10.1111/j.1743-6109.2011.02209.x CrossRefPubMedGoogle Scholar
  7. 7.
    Beckjord EB, Arora NK, Bellizzi K, Hamilton AS, Rowland JH (2011) Sexual well-being among survivors of non-Hodgkin lymphoma. Oncol Nurs Forum 38:E351–E359. doi: 10.1188/11.ONF.E351-E359 CrossRefPubMedGoogle Scholar
  8. 8.
    Jonker-Pool G, Hoekstra HJ, van Imhoff GW, Sonneveld DJ, Sleijfer DT, van Driel MF, Koops HS, van de Wiel HB (2004) Male sexuality after cancer treatment—needs for information and support: testicular cancer compared to malignant lymphoma. Patient Educ Couns 52:143–150CrossRefPubMedGoogle Scholar
  9. 9.
    O’Leary MP, Fowler FJ, Lenderking WR, Barber B, Sagnier PP, Guess HA, Barry MJ (1995) A brief male sexual function inventory for urology. Urology 46:697–706CrossRefPubMedGoogle Scholar
  10. 10.
    Howell SJ, Shalet SM (2001) Testicular function following chemotherapy. Hum Reprod Update 7:363–369CrossRefPubMedGoogle Scholar
  11. 11.
    Qureshi MS, Pennington JH, Goldsmith HJ, Cox PE (1972) Cyclophosphamide therapy and sterility. Lancet 2:1290–1291CrossRefPubMedGoogle Scholar
  12. 12.
    Miller JJ, Williams GF, Leissring JC (1971) Multiple late complications of therapy with cyclophosphamide, including ovarian destruction. Am J Med 50:530–535CrossRefPubMedGoogle Scholar
  13. 13.
    Monga U (2002) Sexual functioning in cancer patients. Sex Disabil 20:277–295CrossRefGoogle Scholar
  14. 14.
    Greaves P, Sarker SJ, Chowdhury K, Johnson R, Matthews J, Matthews R, Smith M, Korszun A, Gribben JG, Lister TA (2014) Fertility and sexual function in long-term survivors of haematological malignancy: using patient-reported outcome measures to assess a neglected area of need in the late effects clinic. Br J Haematol 164:526–535. doi: 10.1111/bjh.12651 CrossRefPubMedGoogle Scholar
  15. 15.
    Bloom JR, Fobair P, Gritz E, Wellisch D, Spiegel D, Varghese A, Hoppe R (1993) Psychosocial outcomes of cancer: a comparative analysis of Hodgkin’s disease and testicular cancer. J Clin Oncol 11:979–988CrossRefPubMedGoogle Scholar
  16. 16.
    Kornblith AB, Anderson J, Cella DF, Tross S, Zuckerman E, Cherin E, Henderson ES, Weiss RB, Cooper MR, Silver RT (1990) Quality of life assessment of Hodgkin’s disease survivors: a model for cooperative clinical trials. Oncology (Williston Park) 4:93–101 discussion 104Google Scholar
  17. 17.
    Eeltink CM, Incrocci L, Witte BI, Meurs S, Visser O, Huijgens P, Verdonck-de Leeuw IM (2013) Fertility and sexual function in female Hodgkin lymphoma survivors of reproductive age. J Clin Nurs 22:3513–3521. doi: 10.1111/jocn.12354 CrossRefPubMedGoogle Scholar
  18. 18.
    Kiserud CE, Fossa A, Bjoro T, Holte H, Cvancarova M, Fossa SD (2009) Gonadal function in male patients after treatment for malignant lymphomas, with emphasis on chemotherapy. Br J Cancer 100:455–463. doi: 10.1038/sj.bjc.6604892 CrossRefPubMedPubMedCentralGoogle Scholar
  19. 19.
    Hammond CT, Beckjord EB, Arora NK, Bellizzi KM, Jeffery DD, Aziz NM (2008) Non-Hodgkin’s lymphoma survivors’ fertility and sexual function-related information needs. Fertil Steril 90:1256–1258CrossRefPubMedGoogle Scholar
  20. 20.
    Kim SH, Kim IR, Kim SH, Lee S, Ok O, Kim WS, Suh C, Lee MH (2014) Health-related quality of life in Korean lymphoma survivors compared with the general population. Ann Hematol 93:1531–1540. doi: 10.1007/s00277-014-2091-3 CrossRefPubMedGoogle Scholar
  21. 21.
    Laumann EO, Gagnon JH, Michael RT, Michaels S (1994) The social organization of sexuality: sexual practices in the United States. University of Chicago Press, ChicagoGoogle Scholar
  22. 22.
    Laumann EO, Brauer M, Laan E (1999) Sexual sysfunction in the United States: prevalence and predictors. JAMA 281:537–544CrossRefPubMedGoogle Scholar
  23. 23.
    Park SY, Bae DS, Nam JH, Park CT, Cho CH, Lee JM, Lee MK, Kim SH, Park SM, Yun YH (2007) Quality of life and sexual problems in disease-free survivors of cervical cancer compared with the general population. Cancer 110:2716–2725CrossRefPubMedGoogle Scholar
  24. 24.
    Aaronson NK, Ahmedzai S, Bergman B, Bullinger M, Cull A, Duez NJ, Filiberti A, Flechtner H, Fleishman SB, de Haes JC (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 85:365–376CrossRefPubMedGoogle Scholar
  25. 25.
    Yun YH, Park YS, Lee ES, Bang SM, Heo DS, Park SY, You CH, West K (2004) Validation of the Korean version of the EORTC QLQ-C30. Qual Life Res 13:863–868CrossRefPubMedGoogle Scholar
  26. 26.
    Ganz PA, Desmond KA, Belin TR, Meyerowitz BE, Rowland JH (1999) Predictors of sexual health in women after a breast cancer diagnosis. J Clin Oncol 17:2371–2380CrossRefPubMedGoogle Scholar
  27. 27.
    Moreira ED, Kim SC, Glasser D, Gingell C (2006) Sexual activity, prevalence of sexual problems, and associated help-seeking patterns in men and women aged 40-80 years in Korea: data from the Global Study of Sexual Attitudes and Behaviors (GSSAB). J Sex Med 3:201–211CrossRefPubMedGoogle Scholar
  28. 28.
    Hewitt M, Greenfield S, Stovall E (2006) From cancer patients to cancer survivors: lost in transition. National Academy Press, Washington DCGoogle Scholar
  29. 29.
    Shell JA (2002) Evidence-based practice for symptom management in adults with cancer: sexual dysfunction. Oncol Nurs Forum 29:53–66 quiz 67-9CrossRefPubMedGoogle Scholar
  30. 30.
    Jim HS, Sutton SK, Jacobsen PB, Martin PJ, Flowers ME, Lee SJ (2016) Risk factors for depression and fatigue among survivors of hematopoietic cell transplantation. Cancer 122:1290–1297. doi: 10.1002/cncr.29877 CrossRefPubMedGoogle Scholar
  31. 31.
    Behringer K, Müller H, Görgen H, Flechtner HH, Brillant C, Halbsguth TV, Thielen I, Eichenauer DA, Schober T, Nisters-Backes H, Fuchs M, Engert A, Borchmann P (2013) Sexual quality of life in Hodgkin lymphoma: a longitudinal analysis by the German Hodgkin Study Group. Br J Cancer 108:49–57. doi: 10.1038/bjc.2012.550 PubMedPubMedCentralGoogle Scholar
  32. 32.
  33. 33.
    Cancer Care (2016) http://chemocare.com/chemotherapy/side-effects/impotence.aspx. Accessed 29 Dec 2016
  34. 34.
    Benedict C, Philip EJ, Baser RE, Carter J, Schuler TA, Jandorf L, DuHamel K, Nelson C (2016) Body image and sexual function in women after treatment for anal and rectal cancer. Psychooncology 25:316–323. doi: 10.1002/pon.3847 CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2017

Authors and Affiliations

  • Im-Ryung Kim
    • 1
  • Soo Hyun Kim
    • 2
  • Oh Nam Ok
    • 3
  • So Hee Kim
    • 4
  • Suyeon Lee
    • 5
  • Eunju Choi
    • 2
  • Seok Jin Kim
    • 6
  • Dok Hyun Yoon
    • 7
  • Moon Hee Lee
    • 8
  1. 1.Cancer Education CenterSamsung Medical CenterSeoulSouth Korea
  2. 2.Department of NursingInha UniversityIncheonSouth Korea
  3. 3.Division of Hematology-OncologySamsung Medical CenterSeoulSouth Korea
  4. 4.Cancer Edu-Info CenterAsan Medical CenterSeoulSouth Korea
  5. 5.Department of OncologyAsan Medical CenterSeoulSouth Korea
  6. 6.Division of Hematology-Oncology, Samsung Medical CenterSungkyunkwan University School of MedicineSeoulSouth Korea
  7. 7.Department of Oncology, Asan Medical CenterUniversity of Ulsan College of MedicineSeoulSouth Korea
  8. 8.Division of Hematology-OncologyInha University Hospital and College of MedicineIncheonSouth Korea

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