Issues of intimacy and sexual dysfunction following major head and neck cancer treatment

Problems with sexuality and intimacy in head and neck cancer are under reported. This study set out to describe patients self-reporting of intimacy and sexual dysfunction following treatment and to explore associations with patient characteristics. Patients treated for primary head and neck squamous cell carcinoma, alive and disease free, were identified from the University Hospital Aintree Head and Neck Cancer database, January 2000 to December 2006. A postal survey with two questions from the European Organisation for Research and Treatment of Cancer Quality of Life questionnaire-Head and Neck 35 (EORTC H&N35) regarding sexuality, a self-designed question about intimacy and the University of Washington quality of life questionnaire Version 4 (UW-QOL v4) was sent to patients in March 2007. There was a 68% response (350/518). One-third of those answering the intimacy and sexuality questions reported substantial problems with sexual interest and enjoyment, and one-quarter reported problems with intimacy. Intimacy problems declined with age from 36% if aged under 55 years to 6% for those 75 years and older. Intimacy and sexuality issues were largely unrelated to site, stage of disease, treatment modality and time since surgery. Gender and having a spouse or partner were related to answering the questions but not to having problems. With one-quarter of responders reporting intimacy problems it is surprising how little information and support regarding intimacy and sexual dysfunction is offered to patients and their carers. There is a need to explore these issues more extensively with further research.