Cancer survivors are more dissatisfied with their sex lives – despite normal levels of sexual activity and function for their age
By Sarah Jackson, on 17 August 2016
Cancer survivorship rates are improving dramatically, with half of all people diagnosed with cancer in the UK now expected to survive for at least ten years. Although treatment of the cancer is the primary clinical goal, ensuring the best possible quality of life after treatment is important. Preservation of sexual function is a key component of quality of life, yet remains a commonly reported ‘unmet need’ by cancer survivors. However, sexual function declines with ageing and because the majority of cancers are diagnosed in the over-70s, it was previously unclear whether changes in sexual wellbeing reported by cancer survivors are a result of their disease or a natural by-product of ageing.
In a new study published today in Cancer we explored differences in sexual activity, function and concerns between cancer survivors and people who had never received a cancer diagnosis. The findings revealed that a diagnosis of cancer does not seem to affect whether or not people have sex, how often they have sex, what they do when they have sex, and (in the case of men) their sexual function. Compared with women of a similar age, women who had been diagnosed with cancer within the past five years were just as likely to be sexually active, although they were more likely to report problems with arousal. Following the five years post-diagnosis the only difference was greater dissatisfaction with their sex lives, with 18% of women with a history of cancer reporting dissatisfaction compared to 12% of cancer-free women. Male cancer survivors did not report any more sexual problems than their age-matched counterparts, but they were more dissatisfied with their sex lives (31% of men with cancer compared to 20% of men with no history of cancer).
The research involved 2982 men and 3708 women aged 50 years and older taking part in the English Longitudinal Study of Ageing (ELSA), a large population-based cohort of middle-aged and older adults living in England. Participants reported whether they had ever been diagnosed with cancer, and completed the Sexual Relationships and Activities Questionnaire, a comprehensive measure that includes questions on the frequency of sexual behaviours, problems with sexual activities and function, and concerns and worries about sexual activities, function and relationships. It is the first study to compare sexual behaviour and concerns between cancer survivors and controls from the same population-based study using a standardised measure.
The results of this study are generally encouraging in showing that older people with cancer do not experience greater problems with sexual activity or functioning than people of the same age without a history of cancer. However, with more than one in five men and one in nine women reporting that they were dissatisfied with their sex lives, it is clear that there is a need to identify interventions to enhance sexual health in ageing men and women. In the meantime, better advice on the normal changes in sexual activity and functioning that occur with ageing could help to address the mismatch between the normal sexual behaviour and lower sexual satisfaction seen in cancer survivors.
Jackson SE, Wardle J, Steptoe A, Fisher A. Sexuality after a cancer diagnosis: a population-based study. Cancer. First published ahead of print 17 August 2016. doi:10.1002/cncr.30263