New research in Oral Oncology shows that almost two-thirds of patients with head and neck cancers experience sexual issues 6 weeks after treatment. But the situation may improve over time.
Much of the research on sexuality in cancer patients has focused on cancers that affect sex and reproductive organs. But head and neck cancers can impact sexuality, too. People with surgical scars or a stoma (opening) in the neck may have body image concerns and feel less attractive to partners. Pain, sores in the mouth, dry mouth, and restricted neck motion can occur. And patients might have difficulty talking, eating, socializing, and kissing.
For the current study, researchers investigated the frequency and time frames of sexual problems in a group of 354 patients who underwent (chemo)radiotherapy for head and neck cancer in the Netherlands.
In particular, four types of cancer were studied: cancers of the oral cavity (the mouth), the oropharynx (the portion of the throat located behind the mouth), the hypopharynx (the bottom portion of the throat), and the larynx (the “voice box”).
Seventy-four percent of the participants were men; the remaining 26% were women. The average age of the group was 61 years.
Before their cancer treatment, the participants completed a series of questionnaires concerning their quality of life, sexuality, and symptoms of anxiety or depression. These assessments were taken again 6 weeks after treatment and at 3-, 6-, 12-, 18-, and 24-month follow up points. Not all the participants were available for all of the follow-up assessments, however. For example, only 56% of the patients were assessed at the 6-month and 12-month follow-ups.
The researchers used the term sexuality to refer to sexual interest and enjoyment.
Before treatment, 37% of the participants said they had less sexuality. At the 6-week follow-up, the rate increased to 60%, but it decreased back to 37% at 12 months and stayed at this level through the rest of the study.
“The peak in less sexuality 6 weeks after treatment might be explained by side effects resulting from the treatment, such as fatigue, feeling ill, nausea and vomiting, sticky saliva, and a dry mouth, which have previously been shown to peak at 6-week follow up,” the authors explained.
“These symptoms may negatively impact sexual interest and enjoyment,” they added.
When the research team considered the entire study period – from pretreatment to 24 months – they found several factors that affected sexuality, including older age, trouble with social contact, weight loss, and constipation.
Between the 6-month and 24-month follow-ups, women and people who had trouble socializing tended to have less sexuality.
The authors recommended that clinicians use patient-reported outcome measures (such as questionnaires and surveys) to help head and neck cancer patients with sexual concerns.
“How Does Treatment Affect the Sexuality of Head and Neck Cancer Patients?”
(August 27, 2018)
National Cancer Institute
“Head and Neck Cancers – What Are the Side Effects of Treatment?”
(Reviewed: March 29, 2017)
Melissant, H.C., et al.
“The course of sexual interest and enjoyment in head and neck cancer patients treated with primary (chemo)radiotherapy”
(Full-text. August 2018)