Sexual function and disease progression in women with advanced cancer

To prospectively evaluate sexual function, body image, quality of life, and disease progression rates in women with advanced cancer.

Sixty women staged III-IV breast, gynaecological, or colorectal cancer completed the Female Sexual Function Index (FSFI), the Body Image Scale, the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire (EORTQL), and the Beck Depression Inventory. Forty-three women (71.67%) completed the questionnaires again approximately 1 year later. The Wilcoxon test was used to compare the scores between the two evaluations. The participants were informed that they could attend additional consultations for symptom control or management of sexual difficulties if they wished.

Twenty-eight women showed disease progression (65.12%), and seven died. Twenty-one women remained sexually active (48.8%), all of whom were married/partnered. There was no difference in the FSFI score over time [28 (21.4-32.1) vs. 30.3 (24.2-33.3) P = 0.19]. The body image scores improved [6 (1-15) vs. 3 (0-10), P = 0.039], while the perceived global health status worsened [EORTQL: 75 (50-83.3) vs. 41.7 (25-50), P = 0.001].

Body image scores improved over time despite a concomitant decrease in the perceived global health status. A portion of women with recurrent or metastatic cancer remained interested in sexual intimacy. New studies are needed to understand the differences between the needs of women with advanced cancer who are vs. are not sexually active, for the development of more effective therapeutic approaches.