Changes in Sexual Function of Patients with Cancer in Turkey

  • Ayse Cil Akinci
  • Fatma Cosar Cetin
  • Rujnan TunaEmail author
  • Neriman Zengin
  • Mahmut Gumus
Original Paper


This study was carried out to determine the changes in sexual functioning of patients with cancer. We identified the frequency and causes of changes in sexual functioning among patients with cancer, and determined whether this change differed according to age, type of cancer, type of treatment, side effects of drugs, anxiety, depression, and perceived social support. The study was conducted with 192 patients with cancer. Data were collected using the data collection form which included questions about socio-demographic, disease-related characteristics as well as those related to changes in sexual functioning. In addition, the Hospital Anxiety and Depression Scale and the Multidimensional Scale of Perceived Social Support Scale were used. Data were analyzed using the SPSS 15.0 software. For analyzing the data, means, frequencies, percentages, t test and Pearson’s Chi square test were used. Of the patients with cancer, 69.3% were experiencing changes in sexual functioning, where 75.9% of those began to have changes in sexual functioning only after the cancer. Experiencing changes in sexual functioning after cancer did not differ according to the type of cancer (when genitourinary cancers and breast cancer were compared to the other cancer types) (p > 0.05). Experiencing changes in sexual functioning after cancer significantly differed according to age, the presence of fatigue, and depression scores (p < 0.05). The mean age of those who experienced changes in sexual functioning after the cancer was lower than those who did not, their fatigue rate and depression scores were higher. It is suggested that healthcare professionals should view sexual functions as vital functions such as movement, eating, and respiration and evaluate patients with regard to those functions.


Cancer Changes in sexual functioning Social support Anxiety Depression Turkey 



We are thankful to the nurses who participated to this study. Authors did not accept any funding from public or private facilities for performing this study.

Compliance with Ethical Standards

Conflict of interest

No restrictions and no conflict of interest. This manuscript and the content of this manuscript have not been published elsewhere. The study has been approved by the Ethical Committee of the Non-Invasive Clinical Research at Bezmialem Foundation University (Decision No: 1/47, Date: 24.06.2016).

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.


  1. 1.
    Goncalves, P., Groninger, H.: Sexual dysfunction in cancer patients and survivors #293. J. Palliat. Med. (2015). Google Scholar
  2. 2.
    Stuhlfauth, S., Melby, L., Hellesø, R.: Everyday life after colon cancer: the visible and invisible challenges. Cancer Nurs. (2017). Google Scholar
  3. 3.
    Oberguggenberger, A., Martini, C., Huber, H., Fallowfield, L., Hubalek, M., Daniaux, M., Sperner-Unterweger, B., Holzner, B., Sztankay, M., Gamper, E., Meraner, V.: Self-reported sexual health: breast cancer survivors compared to women from the general population—an observational study. BMC Cancer (2017). Google Scholar
  4. 4.
    Lindau, S.T., Surawska, H., Paice, J., Baron, S.R.: Communication about sexuality and intimacy in couples affected by lung cancer and their clinical care providers. Psychooncology (2011). Google Scholar
  5. 5.
    Sadovsky, R., Basson, R., Krychman, M., Morales, A.M., Schover, L., Wang, R., Incrocci, L.: Cancer and sexual problems. J. Sex. Med. (2010). Google Scholar
  6. 6.
    Katz, A.: The sounds of silence: sexuality information for cancer patients. J. Clin. Oncol. (2005). Google Scholar
  7. 7.
    Mills, L.: Sexual and reproductive dysfunction in women with diabetes. J. Diabetes Nurs. 19(7), 272–275 (2015)Google Scholar
  8. 8.
    Eker, F., Acikgoz, F.: The impact of cancer and its treatment on sexual desire, satisfaction and functioning: findings from an exploratory study in rural Turkey. Eur. J. Cancer Care (2011). Google Scholar
  9. 9.
    Brandenburg, D.: Intimacy and sexuality for cancer patients and their partners a booklet of tips and ideas for your journey of recovery. (2005). Accessed 15 Apr 2018
  10. 10.
    Ben Charif, A., Bouhnik, A.D., Courbière, B., Rey, D., Préau, M., Bendiane, M.K., Peretti-Watel, P., Mancini, J.: Sexual health problems in French cancer survivors 2 years after diagnosis-the national VICAN survey. J. Cancer Surviv. (2016). Google Scholar
  11. 11.
    Bober, S.L., Sanchez Varela, V.: Sexuality in adult cancer survivors: challenges and intervention. J. Clin. Oncol. (2012). Google Scholar
  12. 12.
    Flynn, K.E., Barsky Reese, J., Jeffery, D.D., Abernethy, A.P., Lin, L., Shelby, R.A., Porter, L.S., Dombeck, C.B., Weinfurt, K.P.: Patient experiences with communication about sex during and after treatment for cancer. Psychooncology 21(6), 594–601 (2012)CrossRefGoogle Scholar
  13. 13.
    Magnan, M.A., Reynolds, K.E., Galvin, E.A.: Barriers to addressing patient sexuality in nursing practice. Medsurg. Nurs. 14(5), 282–289 (2005)Google Scholar
  14. 14.
    Reynolds, K.E., Magnan, M.A.: Nursing attitudes and beliefs toward human sexuality: collaborative research promoting evidence-based practice. Clin. Nurse Spec. 19(5), 255–259 (2005)CrossRefGoogle Scholar
  15. 15.
    Jaarsma, T., Strömberg, A., Fridlund, B., De Geest, S., Mårtensson, J., Moons, P., Norekval, T.M., Smith, K., Steinke, E., Thompson, D.R.: Sexual counselling of cardiac patients: nurses’ perception of practice, responsibility and confidence. Eur. J. Cardiovasc. Nurs. (2010). Google Scholar
  16. 16.
    Haboubi, N.H., Lincoln, N.: Views of health professionals on discussing sexual issues with patients. Disabil. Rehabil. 25(6), 291–296 (2003)CrossRefGoogle Scholar
  17. 17.
    Kong, S.K., Wu, L.H., Loke, A.Y.: Nursing students’ knowledge, attitude and readiness to work for clients with sexual health concerns. J. Clin. Nurs. (2009). Google Scholar
  18. 18.
    Tsai, Y.F., Hsiung, P.C.: Aboriginal nurses’ perception of facilitators and barriers for taking a sexual history in Taiwan. Public Health Nurs. 20(4), 281–286 (2003)CrossRefGoogle Scholar
  19. 19.
    Demirgöz Bal, M.: Nurses’ attitudes and beliefs about sexual health care. Hemsirelikte Egitim ve Arastirma Derg. 11(3), 38–42 (2014)Google Scholar
  20. 20.
    Magnan, M.A., Norris, D.M.: Nursing students’ perceptions of barriers to addressing patient sexuality concerns. J. Nurs. Educ. 47(6), 260–268 (2008)CrossRefGoogle Scholar
  21. 21.
    Magnan, M.A., Reynolds, K.: Barriers to addressing patient sexuality concerns across five areas of specialization. Clin. Nurse Spec. 20(6), 285–292 (2006)CrossRefGoogle Scholar
  22. 22.
    Julien, J.O., Thom, B., Kline, N.E.: Identification of barriers to sexual health assessment in oncology nursing practice. Oncol. Nurs. Forum (2010). Google Scholar
  23. 23.
    Zeng, Y.C., Li, Q., Wang, N., Ching, S.S., Loke, A.Y.: Chinese nurses’ attitudes and beliefs toward sexuality care in cancer patients. Cancer Nurs. (2011). Google Scholar
  24. 24.
    Akkuzu, G., Ayhan, A.: Sexual functions of Turkish women with gynecologic cancer during the chemotherapy process. Asian Pac. J. Cancer Prev. 14(6), 3561–3564 (2013)CrossRefGoogle Scholar
  25. 25.
    Demirtas, B., Pinar, G.: Determination of sexual problems of Turkish patients receiving gynecologic cancer treatment: a cross-sectional study. Asian Pac. J. Cancer Prev. 15(16), 6657–6663 (2014)CrossRefGoogle Scholar
  26. 26.
    Eaton, L., Kueck, A., Maksut, J., Gordon, L., Metersky, K., Miga, A., Brewer, M., Siembida, E., Bradley, A.: Sexual health, mental health, and beliefs about cancer treatments among women attending a gynecologic oncology. Clinic. Sex. Med. (2017). Google Scholar
  27. 27.
    Karabulut, N., Erci, B.: Sexual desire and satisfaction in sexual life affecting factors in breast cancer survivors after mastectomy. J. Psychosoc. Oncol. (2009). Google Scholar
  28. 28.
    Alacacioglu, A., Ulger, E., Varol, U., Yavuzsen, T., Akyol, M., Yildiz, Y., Yildiz, I., Bayoglu, V., Dirican, A., Demir, L., Salman, T., Kucukzeybek, Y., Alacacioglu, I., Can, H., Tarhan, M.O.: Sexual satisfaction, anxiety, depression and quality of life in testicular cancer survivors. Med. Oncol. 31(7), 43 (2014)CrossRefGoogle Scholar
  29. 29.
    Akyol, M., Ulger, E., Alacacioglu, A., Kucukzeybek, Y., Yildiz, Y., Bayoglu, V., Gumus, Z., Yildiz, I., Salman, T., Varol, U., Ayakdas, S., Tarhan, M.O.: Sexual satisfaction, anxiety, depression and quality of life among Turkish colorectal cancer patients. Jpn. J. Clin. Oncol. (2015). Google Scholar
  30. 30.
    Attaallah, W., Ertekin, C., Tinay, I., Yegen, C.: High rate of sexual dysfunction following surgery for rectal cancer. Ann. Coloproctol. (2014). Google Scholar
  31. 31.
    Zigmond, A.S., Snaith, R.P.: The hospital anxiety and depression scale. Acta Psychiatr. Scand. 67(6), 361–370 (1983)CrossRefGoogle Scholar
  32. 32.
    Aydemir, Ö., Güvenir, T., Küey, L., Kültür, S.: Hastane anksiyete depresyon ölçeğinin geçerlilik ve güvenilirlik çalışması. Turk Psikiyatri Derg. 8(4), 280–287 (1997)Google Scholar
  33. 33.
    Eker, D., Arkar, H., Yaldız, H.: Factorial structure, validity, and reliability of revised form of the multidimensional scale of perceived social support. Turk Psikiyatri Derg. (2001). Google Scholar
  34. 34.
    SPSS Inc. SPSS for Windows-Release 15. Chicago: SPSS Inc. Accessed 15 Apr 2018
  35. 35.
    Acquati, C., Zebrack, B.J., Faul, A.C., Embry, L., Aguilar, C., Block, R., Hayes-Lattin, B., Freyer, D.R., Cole, S.: Sexual functioning among young adult cancer patients: a 2-year longitudinal study. Cancer 15, 398–405 (2018)CrossRefGoogle Scholar
  36. 36.
    Reese, J.B., Finan, P.H., Haythornthwaite, J.A., Kadan, M., Regan, K.R., Herman, J.M., Efron, J., Diaz, L.A., Azad, N.S.: Gastrointestinal ostomies and sexual outcomes: a comparison of colorectal cancer patients by ostomy status. Support. Care. Cancer (2014). Google Scholar
  37. 37.
    Benedict, C., Philip, E.J., Baser, R.E., Carter, J., Schuler, T.A., Jandorf, L., DuHamel, K., Nelson, C.: Body image and sexual function in women after treatment for anal and rectal cancer. Psychooncology (2016). Google Scholar
  38. 38.
    Philip, E.J., Nelson, C., Temple, L., Carter, J., Schover, L., Jennings, S., Jandorf, L., Starr, T., Baser, R., DuHamel, K.: Psychological correlates of sexual dysfunction in female rectal and anal cancer survivors: analysis of baseline intervention data. J. Sex. Med. (2013). Google Scholar
  39. 39.
    Ganz, P.A., Desmond, K.A., Belin, T.R., Meyerowitz, B.E., Rowland, J.H.: Predictors of sexual health in women after a breast cancer diagnosis. J. Clin. Oncol. (1999). Google Scholar
  40. 40.
    Barbera, L., Zwaal, C., Elterman, D., McPherson, K., Wolfman, W., Katz, A., Matthew, A.: Interventions to address sexual problems in people with cancer. Curr. Oncol. (2017). Google Scholar
  41. 41.
    Jonsdottir, J.I., Jonsdottir, H., Klinke, M.E.: A systematic review of characteristics of couple-based intervention studies addressing sexuality following cancer. J. Adv. Nurs. (2017). Google Scholar
  42. 42.
    Kim, S.I., Lee, Y., Lim, M.C., Joo, J., Park, K., Lee, D.O., Park, S.Y.: Quality of life and sexuality comparison between sexually active ovarian cancer survivors and healthy women. J. Gynecol. Oncol. (2015). Google Scholar
  43. 43.
    Harirchi, I., Montazeri, A., Zamani Bidokhti, F., Mamishi, N., Zendehdel, K.: Sexual function in breast cancer patients: a prospective study from Iran. J. Exp. Clin. Cancer Res. (2012). Google Scholar
  44. 44.
    Jennifer, L., Marino, C.M., Saunders, M.H.: Sexual inactivity in partnered female cancer survivors. Maturitas 105, 89–94 (2017)CrossRefGoogle Scholar
  45. 45.
    Bradford, A., Fellman, B., Urbauer, D., Gallegos, J., Meaders, K., Tung, C., Ramondetta, L.: Assessment of sexual activity and dysfunction in medically underserved women with gynecologic cancers. Gynecol. Oncol. (2015). Google Scholar
  46. 46.
    Dizon, D.S.: Quality of life after breast cancer: survivorship and sexuality. Breast J. (2009). Google Scholar
  47. 47.
    Ussher, J.M., Perz, J., Gilbert, E.: Perceived causes and consequences of sexual changes after cancer for women and men: a mixed method study. BMC Cancer (2015). Google Scholar
  48. 48.
    Milbury, K., Badr, H.: Sexual problems, communication patterns, and depressive symptoms in couples coping with metastatic breast cancer. Psychooncology (2013). Google Scholar
  49. 49.
    Oven Ustaalioglu, B., Acar, E., Caliskan, M.: The predictive factors for perceived social support among cancer patients and caregiver burden of their family caregivers in Turkish population. Int. J. Psychiatry Clin. Pract. (2017). Google Scholar

Copyright information

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

Authors and Affiliations

  1. 1.Department of Nursing, Faculty of Health SciencesIstanbul Medeniyet UniversityIstanbulTurkey
  2. 2.Department of Health Management, Faculty of Health SciencesIstanbul Medeniyet UniversityÜsküdar, IstanbulTurkey
  3. 3.Department of Midwifery, Faculty of Health SciencesIstanbul UniversityIstanbulTurkey
  4. 4.Department of Medical Oncology, Medical FacultyIstanbul Medeniyet UniversityIstanbulTurkey

Personalised recommendations