Priviero Fernanda, Webb Clinton
Departament of Physiology, Medical College of Georgia, Augusta University, Augusta, GA; Cardiovascular Translational Research Center, School of Medicine, University of South Carolina, Columbia, SC.
Cardiovascular Translational Research Center, School of Medicine, University of South Carolina, Columbia, SC.
Urol Oncol. 2022 Aug;40(8):366-371. doi: 10.1016/j.urolonc.2021.01.017. Epub 2021 Feb 7.
Sexual dysfunction (SD) is widely reported by cancer survivors. However, this is an issue underestimated by doctors and the contribution of anticancer therapies for the development of SD in cancer survivors is understudied and poorly understood. Sexual function involves the activation of a neurovascular system that leads to penile erection in males and clitoral engorgement in females. Anticancer therapies can cause damage to the neurovascular circuit responsible for normal sexual function and thus, individual or combined therapies could play a role in the development of SD in all types of cancer survivors and not only those affected by genital cancers. In this review, the pathophysiology of SD and possible mechanisms underlying SD induced by anticancer therapies will be discussed. The effects of chemotherapy, radiotherapy and surgical interventions on the vasculature and nerves as well as their effects on sex hormones and inflammatory processes could link the biological effects of these interventions with SD. In conclusion, this review reports evidence that, despite psychological aspects and the disease itself, anticancer therapies are able to induce direct and indirect effects in males and females that could lead to SD in cancer survivors even after the end of the treatment.
癌症幸存者中普遍存在性功能障碍（SD）的情况。然而，这是一个被医生低估的问题，而且抗癌治疗对癌症幸存者性功能障碍发生发展的影响尚未得到充分研究，人们对此了解甚少。性功能涉及一个神经血管系统的激活，该系统会导致男性阴茎勃起和女性阴蒂充血。抗癌治疗可能会损害负责正常性功能的神经血管回路，因此，单一或联合治疗可能在各类癌症幸存者性功能障碍的发生发展中起作用，而不仅仅是那些受生殖系统癌症影响的幸存者。在本综述中，将讨论性功能障碍的病理生理学以及抗癌治疗诱发性功能障碍的可能机制。化疗、放疗和手术干预对血管和神经的影响，以及它们对性激素和炎症过程的影响，可能将这些干预的生物学效应与性功能障碍联系起来。总之，本综述报告的证据表明，尽管存在心理因素和疾病本身，但抗癌治疗能够在男性和女性中产生直接和间接影响，即使在治疗结束后，也可能导致癌症幸存者出现性功能障碍。
