Sexual Dysfunction of Patients with Diffuse Low-Grade Glioma: A Qualitative Review of a Neglected Concern

Abstract

Diffuse low-grade gliomas (LGG) commonly affect young adults and display a slow evolution, with a life expectancy that can surpass 15 years, thanks to multimodal therapeutic management. Therefore, preservation of quality of life (QoL), including sexual health, is mandatory. We systematically searched available medical databases of Pubmed, Cochrane, and Scopus for studies that reported data on sexual activity or dysfunction (SD) in LGG patients. We analyzed results to determine incidence of SD and its association with QoL in this population. Three studies focused on SD incidence in patients presenting specifically LGG, or brain tumors including LGG. They comprised 124 brain tumor patients, including 62 LGG, with SD incidence ranging from 44 to 63%. SD was reported by more than 50% of interrogated women in the three studies. Regarding QoL, two out of the three studies found significant associations between SD and alterations of QoL parameters, particularly in the field of social and functional wellbeing. Finally, we discussed those results regarding methods of evaluation, inherent biases, and therapeutic implications regarding antiseizure medications and also planning of surgery, chemo-, and radiotherapy. Our review showed that SD is highly prevalent but still poorly studied in LGG patients. As those patients are usually young and enjoy an active life, there is a need to assess more systematically the occurrence of SD in clinical routine, in order to adapt cancer treatments accordingly, to manage actively these troubles, and finally to improve patients’ QoL in the long run.

Oncological Outcomes, Long-Term Toxicities, Quality of Life and Sexual Health after Pencil-Beam Scanning Proton Therapy in Patients with Low-Grade Glioma

“…SH is a neglected concern in young patients with brain tumors in general, and with LGG in particular. According to a recent systematic review of the limited literature available on SH in neurooncological patients-three studies were found that covered 124 brain tumor patients, of which 62 (50%) had LGG-the incidence of sexual dysfunction ranged from 44 to 63% [19]. The potentially high prevalence of sexual dysfunction among LGG patients, coupled with their young age and extended life expectancy, emphasizes the need for more robust investigations of SH and tailored therapeutic strategies to improve long-term QoL.…”

“…Frequently used instruments to measure the patient-reported outcomes of health-related quality of life (QoL) in brain tumor patients include the patient questionnaires European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ) Core 30 (C30) and Brain 20 (BN20) [18]. Sexual dysfunction as a domain of QoL has been recognized as a neglected concern in young brain tumor patients such as those with LGG [19]. The EORTC has recently validated the EORTC QLQ-SH22 questionnaire to assess the sexual health of patients with cancer at different treatment stages and during survivorship for clinical trials and for clinical practice [20].…”

A Personalized Longitudinal Strategy in Low-Grade Glioma Patients: Predicting Oncological and Neural Interindividual Variability and Its Changes over Years to Think One Step Ahead

“…As well as cognition, emotional status can also be altered by LGG, e.g., deficit of empathy due the invasion of the right arcuate fasciculus or cingulum [ 115 , 116 ], or heightened schizotypal traits related to damage of the left uncinate fasciculus [ 117 ]. This can result in changes of mood or even personality in LGG patients [ 118 ], which may explain possible changes in their social interactions [ 119 ] or sexual activity [ 120 , 121 ]. Therefore, in practice, movement and conation (i.e., the willingness which leads to action) [ 122 ], visuo-spatial cognition, language, executive functions, attention, memory, semantic processing [ 123 , 124 ], mentalizing, metacognition (knowing of knowing) [ 125 ], emotion, personality, and behavior [ 118 ] must be systematically and carefully evaluated in clinical routine at diagnosis, as well as before and after each treatment in LGG patients [ 4 ].…”

Estimating the Prognosis of Low-Grade Glioma with Gene Attention Using Multi-Omics and Multi-Modal Schemes

“…In contrast, grade II LGG tumors do involve the aforementioned histologic features [ 19 ]. Symptoms of LGG include headaches, vomiting, blurry vision, memory loss, nausea, and weakness on one side of the body [ 20 , 21 , 22 , 23 ]. LGG causes seizures more frequently than other brain cancers because it is produced in the cerebral cortex.…”