Department of Mental Health, Medical Psychology and Medical Sociology, University of Leipzig, Philipp-Rosenthal-Str. 55, 04103, Leipzig, Germany.
Departments of Medical Psychology and Medical Sociology and Psychosomatic Medicine and Psychotherapy, Integrated Research and Treatment Center AdiposityDiseases, Behavioral Medicine, University of Leipzig, Philipp-Rosenthal-Str. 27, 04103, Leipzig, Germany.
BMC Cancer. 2019 Aug 22;19(1):828. doi: 10.1186/s12885-019-6009-2.
Sexuality is an important aspect of quality of life for adolescent and young adults that remains understudied in cancer patients. Most current knowledge about how cancer and cancer treatments can affect patients' sexuality pertains to reproductive cancer patients (breast, gynecological, male reproductive organs), whereas only little is known about how the disease affects the sex lives of patients with other types of cancer. This study examined sexual satisfaction and sexual supportive care needs among adolescent and young adult cancer patients, with a particular focus on how the type of cancer a person has is associated with these issues differently.
Five hundred seventy-seven (n = 424 females, 73.5%) patients between 18 and 39 years of age at diagnosis and representing all major tumor entities completed the standardized questionnaire. The analysis addressed the following topics: sexual satisfaction (Life Satisfaction Questionnaire), sexual supportive care needs (Supportive Care Needs Survey), and changes in sexuality (Questions on Life Satisfaction Modules). These topics were tested by mean differences between reproductive and non-reproductive cancer, equivalence testing and regression analyses.
About one third of the patients reported being dissatisfied with their sexuality and having supportive care needs in this area. Changes in sexuality were significantly more common in women with reproductive cancers than in those who had other types of cancer (t = - 2.693, p = .007), while both groups had equivalence in scores for sexual satisfaction and sexual supportive care needs. Reproductive cancers are not more associated with deterioration of sexual satisfaction (R = .002, p = .243), changes in sexuality (R = .006, p = .070) or increased sexual supportive care needs than non-reproductive cancers (R = .004, p = .131).
The results indicate that about a third of adolescents and young adults with both reproductive but also with non-reproductive cancer experience sexual dissatisfaction in similar measure. An equal percentage of these patients also express a desire to receive supportive care in this area. Consequently, health care professionals should address issues of sexuality and cancer as a matter of routine when caring for young adults even when patients have a non-reproductive cancer.
性行为是青少年和年轻人生活质量的一个重要方面，但在癌症患者中研究不足。目前关于癌症和癌症治疗如何影响患者性行为的大多数知识都与生殖系统癌症患者（乳腺癌、妇科癌症、男性生殖器官癌症）有关，而对于其他类型的癌症如何影响患者的性生活，人们知之甚少。本研究检查了青少年和年轻癌症患者的性满意度和性支持性护理需求，特别关注一个人所患癌症的类型如何以不同的方式与这些问题相关。
577 名（n=424 名女性，73.5%）诊断时年龄在 18 至 39 岁之间的患者代表了所有主要肿瘤实体，完成了标准化问卷。分析涉及以下主题：性满意度（生活满意度问卷）、性支持性护理需求（支持性护理需求调查）和性行为变化（生活满意度模块问题）。通过生殖性癌症与非生殖性癌症之间的平均差异、等效性检验和回归分析来检验这些主题。
大约三分之一的患者报告对自己的性行为不满意，并且在这方面有支持性护理需求。生殖性癌症患者的性行为变化明显比其他类型癌症患者更为常见（t=-2.693，p=0.007），而两组在性满意度和性支持性护理需求方面的得分相当。生殖性癌症与性满意度恶化（R=0.002，p=0.243）、性行为变化（R=0.006，p=0.070）或对性支持性护理需求的增加的相关性并不比非生殖性癌症更强（R=0.004，p=0.131）。
结果表明，约三分之一的生殖性和非生殖性癌症的青少年和年轻人都经历了类似程度的性不满。同样比例的这些患者也表示希望在这方面得到支持性护理。因此，即使患者患有非生殖性癌症，医护人员也应将性行为和癌症问题作为常规护理的一部分来关注年轻患者。
