Sexual Function of Patients With Endometrial Cancer Enrolled in the Gynecologic Oncology Group LAP2 Study

Abstract

Objectives To present responses to sexual function items contained within the quality of life (QOL) survey of the Gynecologic Oncology Group (GOG) LAP2 study, to investigate associations between sexual function and other factors such as relationship quality and body image), and to explore patterns of response in endometrial cancer patients. Methods Participants enrolled on the LAP2 QOL study arm completed a self-report QOL survey, which contained sexual function items, before surgery, and at 1, 3, 6-weeks and 6-months post surgery. Responses to sexual function questions were classified into three patterns—responder, intermittent responder and non-responder—based on whether the sexual function items were answered when the QOL survey was completed. Results Of 752 patients who completed the QOL survey, 225 completed the sexual function items within the QOL survey, 224 responded intermittently, and 303 did not respond at all. No significant differences of sexual function were found between the patients randomized to laparoscopy compared to laparotomy. Among those who responded completely or intermittently, sexual function scores declined after surgery and recovered to pre-surgery levels at 6 months. Sexual function was positively associated with better quality of relationship (P<0.001), body image (P<0.001), and QOL (P<0.001), and negatively associated with fear of sex (P<0.001). Conclusion Our findings suggest that younger patients, those who were married, and those who had quality relationships were more likely to answer the sexual function items and have better quality of sexual function. Factors such as age, relationship quality, body image, and pain may place women with endometrial cancer at risk for sexual difficulties in the immediate recovery period; however, sexual function improved by 6-months postoperatively in our cohort of early-stage endometrial cancer patients.

Sexual health of endometrial cancer survivors before and after a physical activity intervention: A retrospective cohort analysis

“…Endometrial cancer survivor's sexual health can improve after the completion of treatment due to time alone (11, 31), potentially confounding the findings of longitudinal trials. Two prospective randomized trials for ECS demonstrated improvement in sexual health, with the first showing sexual function returning to baseline 6 months after surgery (11) and the second reporting that sexual activity and interest in patients receiving either external beam pelvic radiotherapy or vaginal brachytherapy increased for 6 month after starting treatment and plateaued thereafter (31).…”

“…Two prospective randomized trials for ECS demonstrated improvement in sexual health, with the first showing sexual function returning to baseline 6 months after surgery (11) and the second reporting that sexual activity and interest in patients receiving either external beam pelvic radiotherapy or vaginal brachytherapy increased for 6 month after starting treatment and plateaued thereafter (31). As our patients were recruited 6 months after completing therapy, the impact of the duration of time after diagnosis on sexual health should be minimal, which is supported by our participants’ similar baseline sexual health scores regardless of their time since diagnosis.…”

“…Thus, several authors have recommended including sexuality as a component of cancer survivorship (7, 8). Risk factors for poor sexual function include: relationship/partner status, mental health, diabetes, age, education level, body mass index, quality of life, and tumor grade (5, 6, 9-11). However, once these women are identified, clinicians have limited treatment options to offer (12).…”

Independent psychometric validation of European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Endometrial Cancer Module (EORTC QLQ-EN24)

“…They concluded that menopausal and lymphedema symptoms heavily affect QOL in EC patients. Sexual Activity scores improved until the 12-month evaluation (p = .048), and showed a return to baseline levels at the last assessment (p = .025) (Ferrandina et al, 2014 (Carter et al, 2012).…”

“…However, there was a problem with missing data and low comprehension of items related to sexuality. In our previous study (Stukan et al, 2014) (Carter et al, 2012). In the original study by Greimel et al (2011) 26% of the patients reported being sexually active.…”