Locally advanced cervical cancer (LACC) can be treated with chemoradiotherapy (CRT) or neoadjuvant chemotherapy (NACT) and radical hysterectomy (RH), and there is much debate about which treatment strategy is best for preserving individuals’ sexual functioning and quality of life. CRT has demonstrated drawbacks when it comes to cancer patients’ sexuality and quality of life, but less is known about the long-term effects of NACT-RH as a treatment for LACC.
A recent retrospective case-control study examined the quality of life and sexual functioning of 48 LACC survivors who were treated with NACT-RH and 48 control patients who underwent hysterectomy for uterine fibromatosis in the same time period (September 2009 – February 2015). The patients underwent treatment at the Department of Gynecologic Oncology of Umberto I Hospital in Rome.
After providing written and informed consent to participate in the study, the patients completed three validated questionnaires: the European Organization for Research and Treatment of Cancer (EORTC) Quality-of-Life questionnaire (QLQ) EORTC QLQ-C30, the EORTC QLQ-CX24, and the Female Sexual Function Index (FSFI). The quality-of-life questionnaires result in an overall “global health status score” and measure individuals’ fatigue, pain, nausea, appetite loss, sleep disturbance, constipation, diarrhea, and the financial impact of their condition. On the other hand, the FSFI assesses female sexual function through six domains: desire, arousal, lubrication, orgasm, satisfaction, and pain.
The average age of the LACC patients was 45.5 years. Across the board, the LACC patients had worse quality of life and sexual function than the control patients. With regard to symptoms, the LACC patients also experienced worse or more severe symptoms.
The results of this study are discouraging, but they point to the importance of supporting LACC patients with their sexual function and quality of life after treatment, as well as that of employing cervical cancer prevention strategies like human papillomavirus (HPV) vaccines and routine cancer screening globally.
LACC survivors may be able to take steps to improve their quality of life. For example, they can work with a sex therapist and/or sexual medicine specialist to navigate changes in their sexual function and establish new, healthy routines with intimacy. Connecting with other cancer survivors is a good way to get support from a community that is facing the same challenges. Finally, maintaining open communication with romantic partners, family members, and health care providers is important so that patients can have their needs met and not suffer unnecessarily.
Resources:
Palaia, I., Santangelo, G., Caruso, G., Perniola, G., Tibaldi, V., Muzii, L., Panici, P.B., & Di Donato, V. (2022). Long-term Quality of Life and Sexual Function After Neoadjuvant Chemotherapy and Radical Surgery for Locally Advanced Cervical Cancer. The Journal of Sexual Medicine, 19(4), 613-619. DOI: https://doi.org/10.1016/j.jsxm.2022.01.519
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