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Five years after a cancer diagnosis, the sexuality of more than half of the patients remains disrupted. A survey revealed by the VICAN5 study, conducted in 2015 by the National Cancer Institute (INCa).

 

Life five years after a cancer diagnosis (1). This is the title of the report by the National Cancer Institute (INCa), which examined the traces left by the disease in the lives of patients. Among the aspects surveyed: sexuality. Because "after the diagnosis, stress, anxiety and fatigue often lead to a decrease in desire", explains INCa, which conducted the VICAN5 national survey in 2015, following on from the 2012 survey (VICAN2), among 4,179 people aged 23 to 87 living in France.

 

A decrease in sexual desire in 56.8% of patients at 5 years of age

The literature has already reported the significant impact of cancer and treatments undertaken on patients' sexuality (2), particularly when the genitals (3) are preserved. Among patients who participated in both VICAN2 and VICAN5, sexual dysfunction tends to increase between the 2nd and 5th years following diagnosis, except for those aged 18 to 40. 56.8% report a decrease in sexual desire, 64.8% report a reduction in the frequency of their intimate relationships and 53.8% have difficulty having an orgasm. However, only men between 71 and 82 years of age would be affected by this orgasmic disability (1).

 

The importance of appropriate support

While the results of the VICAN5 survey confirmed that patients' sexual lives were altered by cancer and treatment, it appears that sexual disorders tend to become entrenched over time and have an impact on patients' long-term quality of life after diagnosis and treatment completion. "For many patients, sexuality may seem unimportant during the illness, but neglecting this aspect means risking to find yourself without sexuality afterwards, with a very impaired quality of life," says Madeleine Gerardin-Toran, a sexologist. For INCa, "a multidisciplinary approach, combining pharmacological management with psychosocial actions, could be the most effective strategy to manage these disorders (5, 6, 7)".

 

Being able to talk about sexuality with your doctor

However, if support can be provided, these sexual disorders must still be identified. INCa deplores a lack of discussion between patients and healthcare teams (4) on this issue. However, "according to a study (8), nearly 90% of patients would like to discuss it with a doctor, yet only 40% have the opportunity to do so," says Dr Pierre Desvaux, President of the National Union of Sexologists. It is therefore essential to discuss sexuality with patients during and after a cancer.

 

Sources

(1) La vie cinq ans après un diagnostic de cancer – Rapport. Collection-État des lieux et des connaissances / Recherche. Juin 2018.

(2) Bober SL, Varela VS. Sexuality in adult cancer survivors : challenges and intervention. J Clin Oncol Off J Am Soc Clin Oncol. 2012; 30: 3712–3719. Doi : 10.1200/JCO.2012.41.7915.

(3) Ben Charif A. et al. Sexual health problems in French cancer survivors 2 years after diagnosis-the national VICAN survey. J Cancer Surviv. 2016b; 10: 600–609. Doi : 10.1007/s11764-015-0506-3.

(4) Ben Charif A. et al. Patient Discussion About Sexual Health With Health Care Providers After Cancer-A National Survey. J Sex Med. 2016a; 13: 1686–1694. Doi : 10.1016/j.jsxm.2016.09.005.

(5) Zhou ES, Nekhlyudov L, Bober SL. The primary health care physician and the cancer patient: tips and strategies for managing sexual health. Transl Androl Urol. 2015; 4: 218–231. Doi : 10.3978/j.issn.2223- 4683.2014.11.07.

(6) Candy B, Jones L, Vickerstaff V, Tookman A, King M. Interventions

for sexual dysfunction following treatments for cancer in women. Cochrane Database Syst Rev. 2016; 2: CD005540. Doi : 10.1002/14651858.CD005540.pub3.

(7) Hungr C, Sanchez-Varela V, Bober SL. Self-Image and Sexuality Issues among Young Women with Breast Cancer: Practical Recommendations. Rev Investig Clin Organo Hosp Enfermedades Nutr. 2017; 69: 114–122.

(8) Giovanna MA. et al. Talking about sexuality with the physician: are patients receiving what they wish ? Swiss Med Wkly. 2011;141:w13178. DOI : https://doi.org/10.4414/smw.2011.13178.