Experts Call for More Awareness of Sexual Dysfunction in Lung Cancer Patients


Key Points

  • Sexual dysfunction is a particular issue among patients with lung cancer, since lung cancer management often focuses on short-term quality-of-life improvement and palliative care.
  • Oncologists and patients should discuss sexual dysfunction at the beginning of the cancer treatment and seek help from health-care professionals specializing in sexual health when necessary.

Many lung cancer patients suffer difficulties with sexual expression and intimacy, yet for too long the topic has been ignored by doctors and researchers, experts said at the 4th European Lung Cancer Conference (ELCC) in Geneva, Switzerland. Researchers have estimated that sexual dysfunction affects between 40% and 100% of patients who undergo cancer treatment. Studies have shown that these problems can persist as time passes, rather than improving. However, much of the information gathered so far relates to breast, gynecologic, or prostate cancers. Much less is known about other cancers, including lung cancer.

“It’s time that doctors and scientists paid more attention to this important issue,” said Stéphane Droupy, MD, PhD, from the University Hospital of Nîmes, France. At the ELCC Multidisciplinary Interactive Session on sexuality and cancer, Dr. Droupy and Luca Incrocci, MD, PhD, discussed how to evaluate sexual function and how to treat sexual side effects after therapy of lung cancer.

“We still have to do a lot of work on the awareness of sexual problems after cancer—and lung cancer in particular—and we hope that our session at ELCC will help begin the discussion about how best to help this group of patients,” Dr. Droupy said.

Lung Cancer Patients Hit Especially Hard

The emotional and physical consequences of lung cancer, as well as the impact of treatments, can all affect sexuality, he said. For example, patients often experience a loss of libido when they learn they have cancer, he said. Feelings of grief and depression can also diminish desire. The physical changes that result from cancer and the impact of treatments such as surgery, chemotherapy, and radiotherapy can also have negative impacts on sexual expression, he said.

In the case of lung cancer, some of these problems can be particularly challenging, Dr. Droupy said. “Unlike other cancers, where survival is improving, lung cancer management often focuses on short-term quality of life improvement and palliative care. Sexuality is then even more difficult to protect or reconstruct in a short period of time when all efforts are made to stay alive.”

In this context, it is very important for patients and oncologists to seek help from health-care professionals specializing in sexual health, Dr. Droupy said.

Doctor-Patient Communication Is Key

Another important step is for doctors and patients to have open and honest discussions about what the patient is going through, said Dr. Incrocci, a radiation oncologist and sexologist from Erasmus Medical Center, Rotterdam, The Netherlands.

“We know that sexuality is important for quality of life and marital relationships, yet health-care professionals frequently avoid taking the sexual history of a cancer patient,” he said. “Of course this is a difficult subject to deal with, for patients and for health-care providers, but this should not stop us from doing what we can to improve the situation.”

Starting a discussion about this issue at the beginning of the cancer treatment is a vital first step, Dr. Incrocci said. This can help doctors to evaluate previous sexual dysfunction and motivation to keep an active sexual life, and to help patients understand what the consequences of the treatment might be.

As cancer treatment is underway, clinicians should be willing to provide solutions to the patients and couples when sexual difficulties appear, and to organize specialized help with sexual issues in parallel with management of the cancer.

Therapeutic care might include pharmacotherapy and sex therapy, Dr. Droupy said. It is also important that partners are involved in the process, as this optimizes the chances of healing and improvement.

“Whatever the clinical situation, reconstructing sexual function can significantly improve a cancer patient’s emotional state. It is an essential step to revive a sense of personal integrity and masculine or female identity,” he said.

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.