Department of Radiation Oncology, Princess Alexandra Hospital, Brisbane, Australia; Faculty of Medicine, University of Queensland, Brisbane, Australia.
Department of Cancer Experiences, Peter MacCallum Cancer Centre, Melbourne, Australia; Department of Nursing, Faculty of Medicine, Dentistry, and Health Sciences, The University of Melbourne, Melbourne, Australia.
Oral Oncol. 2024 Oct;157:106975. doi: 10.1016/j.oraloncology.2024.106975. Epub 2024 Jul 30.
Sexuality and sexual intimacy are important aspects of cancer survivorship. In head and neck cancer (HNC), concerns around sexual health, sexuality and sexual intimacy are infrequently raised or addressed in standard HNC consultations, either before embarking on treatment or during survivorship. The changing demographic of HNC patients, largely due to the increasing proportion of patients with human papillomavirus-associated oropharyngeal squamous cell carcinoma (HPVOPSCC), has driven renewed interest in some specific survivorship issues, including sexual behaviours and lifestyles, which may account for both the primary mode of HPV transmission and the younger and less comorbid population affected by this disease. While HNC survivors may have many complex needs in the short and longer term, some patients may prioritise preserving sexual function above other more HNC-specific issues, such as swallowing and xerostomia. Beyond HPVOPSCC, there is evidence to suggest that impairment of sexual health is a pervasive survivorship issue across all HNC cancer types, and this narrative review article highlights publications reporting quantitative assessments of sexual health outcomes in HNC patients. There are also limited studies evaluating whether current sexual health models of care are adequate for HNC patients or whether new or adapted models are needed. Future research will also need to define the impact of our treatments on the sexuality and sexual intimacy concerns of specific HNC cohorts with more granularity to enhance pre- and post-treatment counselling.
性行为和性亲密是癌症生存者的重要方面。在头颈部癌症（HNC）中，在开始治疗之前或在生存期间，很少在标准的 HNC 咨询中提出或解决与性健康、性行为和性亲密相关的问题。由于人乳头瘤病毒相关口咽鳞状细胞癌（HPV-OPSCC）患者比例的增加，HNC 患者的人口统计学发生了变化，这引发了人们对一些特定生存问题的重新关注，包括性行为和生活方式，这些因素可能是 HPV 主要传播途径以及受这种疾病影响的年轻和合并症较少的人群的原因。虽然 HNC 幸存者在短期和长期内可能有许多复杂的需求，但有些患者可能会优先考虑保持性功能，而不是其他更针对 HNC 的问题，如吞咽和口干。除了 HPV-OPSCC 之外，有证据表明，性功能障碍是所有 HNC 癌症类型普遍存在的生存问题，本叙述性综述文章重点介绍了报告 HNC 患者性健康结果定量评估的出版物。也有一些有限的研究评估了当前的性健康护理模式是否足以满足 HNC 患者的需求，或者是否需要新的或适应性的模式。未来的研究还需要更细致地定义我们的治疗对特定 HNC 患者群体的性行为和性亲密问题的影响，以加强治疗前和治疗后的咨询。
