TY - JOUR
T1 - Sexual Function and Health-Related Quality of Life in Long-Term Rectal Cancer Survivors
AU - Sun, Virginia
AU - Grant, Marcia
AU - Wendel, Christopher S.
AU - McMullen, Carmit K.
AU - Bulkley, Joanna E.
AU - Herrinton, Lisa J.
AU - Hornbrook, Mark C.
AU - Krouse, Robert S.
N1 - Funding Information:
Funding: This research was supported by R01 CA106912 from the National Cancer Institute and Arizona Cancer Center Support Grant CA023074. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the National Cancer Institute or the National Institutes of Health or any other funders.
Funding Information:
Conflicts of Interest: Dr Herrinton receives research funding support from Centocor, Proctor and Gamble, Genentech, and Medimmune. Other authors have no disclosures to report.
Funding Information:
Funding: This research was supported by R01 CA106912 from the National Cancer Institute and Arizona Cancer Center Support Grant CA023074 . Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the National Cancer Institute or the National Institutes of Health or any other funders.
Publisher Copyright:
© 2016 International Society for Sexual Medicine
PY - 2016/7
Y1 - 2016/7
N2 - Introduction: Sexual dysfunction is a treatment sequela in survivors of rectal cancer (RC). Differences in health-related quality of life (HRQOL) can occur based on ostomy status (permanent ostomy vs anastomosis). Aim: To describe alterations in sexual function and HRQOL based on ostomy status in long-term (≥5 years) survivors of RC. Methods: Survivors of RC with an ostomy (n = 181) or anastomosis (n = 394) were surveyed using validated HRQOL and functional status tools. We compared sexuality outcomes between the ostomy and anastomosis groups and reported differences adjusted for clinical and demographic characteristics. Qualitative data from one open-ended question on survivors’ greatest challenges since their surgery were analyzed to explore sexuality, symptoms, and relationships. Main Outcome Measures: Whether sexually active, satisfaction with sexual activity, and select sexual dysfunction items from the Modified City of Hope Quality of Life-Colorectal. Results: Survivors with a permanent ostomy were more likely to have been sexually inactive after surgery if it occurred before 2000 and experience dissatisfaction with appearance, interference with personal relationships and intimacy, and lower overall HRQOL. Female survivors of RC with an ostomy were more likely to have problems with vaginal strictures and vaginal pain after surgery that persisted at the time of the survey (≥5 years later). Radiation treatment, tumor stage, soilage of garments in bed, and higher Charlson-Deyo comorbidity scores were negatively associated with outcomes. Six qualitative themes emerged: loss of and decreased sexual activity, psychological issues with sexual activity, physical issues with sexual activity, partner rejection, ostomy interference with sexual activity, and positive experiences with sexuality. Conclusion: Sexual dysfunction is a common long-term sequela of RC treatment, with more problems observed in survivors with a permanent ostomy. This warrants widespread implementation of targeted interventions to manage sexual dysfunction and improve HRQOL for these survivors.
AB - Introduction: Sexual dysfunction is a treatment sequela in survivors of rectal cancer (RC). Differences in health-related quality of life (HRQOL) can occur based on ostomy status (permanent ostomy vs anastomosis). Aim: To describe alterations in sexual function and HRQOL based on ostomy status in long-term (≥5 years) survivors of RC. Methods: Survivors of RC with an ostomy (n = 181) or anastomosis (n = 394) were surveyed using validated HRQOL and functional status tools. We compared sexuality outcomes between the ostomy and anastomosis groups and reported differences adjusted for clinical and demographic characteristics. Qualitative data from one open-ended question on survivors’ greatest challenges since their surgery were analyzed to explore sexuality, symptoms, and relationships. Main Outcome Measures: Whether sexually active, satisfaction with sexual activity, and select sexual dysfunction items from the Modified City of Hope Quality of Life-Colorectal. Results: Survivors with a permanent ostomy were more likely to have been sexually inactive after surgery if it occurred before 2000 and experience dissatisfaction with appearance, interference with personal relationships and intimacy, and lower overall HRQOL. Female survivors of RC with an ostomy were more likely to have problems with vaginal strictures and vaginal pain after surgery that persisted at the time of the survey (≥5 years later). Radiation treatment, tumor stage, soilage of garments in bed, and higher Charlson-Deyo comorbidity scores were negatively associated with outcomes. Six qualitative themes emerged: loss of and decreased sexual activity, psychological issues with sexual activity, physical issues with sexual activity, partner rejection, ostomy interference with sexual activity, and positive experiences with sexuality. Conclusion: Sexual dysfunction is a common long-term sequela of RC treatment, with more problems observed in survivors with a permanent ostomy. This warrants widespread implementation of targeted interventions to manage sexual dysfunction and improve HRQOL for these survivors.
KW - Quality of Life
KW - Rectal Cancer
KW - Sexuality
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U2 - 10.1016/j.jsxm.2016.05.005
DO - 10.1016/j.jsxm.2016.05.005
M3 - Article
C2 - 27318020
AN - SCOPUS:85020915915
SN - 1743-6095
VL - 13
SP - 1071
EP - 1079
JO - Journal of Sexual Medicine
JF - Journal of Sexual Medicine
IS - 7
ER -