Sexual dysfunction is highly prevalent in women with lung cancer, with most participants in a survey reporting little to no interest in sexual activity, according to research led by Narjust Florez (Duma), MD, presented at the International Association for the Study of Lung Cancer (IASLC) World Conference on Lung Cancer 2022 (Abstract MA14.04).
Reporting results of the Sexual Health Assessment in Women with Lung Cancer (SHAWL) study, researchers showed marked differences in sexual desire/interest and vaginal pain/discomfort when comparing before and after lung cancer diagnosis.
Narjust Florez (Duma), MD
“The SHAWL study is about bringing women’s sexuality to the forefront of scientific discussions because it has been significantly understudied,” said Dr. Florez, Associate Director for the Cancer Care Equity Program at Dana-Farber Cancer Institute and an oncologist in the Lowe Center for Thoracic Oncology at Dana-Farber. “When comparing the information before lung cancer diagnosis and after lung cancer diagnosis, the difference is staggering. Lung cancer significantly affects the sexual health of these women.”
SHAWL Study
The SHAWL study is an observational, cross-sectional, international survey administered via the GO2 Foundation for Lung Cancer and the Lung Cancer Registry. The study utilized the Patient-Reported Outcomes Measurement Information System (PROMIS) Sexual Function and Satisfaction Measures, a validated questionnaire, to evaluate sexual health. The multidisciplinary SHAWL study team is comprised of mostly female health professionals and includes a certified sexuality counselor and two lung cancer patient advocates.
Study participants were recruited between June 2020 to June 2021. Participants were asked about sexual activity pre–lung cancer diagnosis and over the “past 30 days” prior to completing the survey.
Survey Results
Of the 249 patients who completed the survey, most (64%) had stage IV lung cancer and 107 (45%) were receiving targeted therapy, with 93 of those (87%) taking the medication for more than 6 months. At the time of survey completion, 78 participants (33%) were taking antidepressants and 34 (14%) were taking beta-blockers.
Within the prior 30 days, 127 (53%) participants had sexual activity with themselves or someone else. One hundred and eighty-three (77%) participants reported little to no interest in sexual activity, and 159 (67%) stated rarely or never wanting to have sexual activity. The most common reasons negatively affecting participants' satisfaction with their sex life included fatigue (n = 95, 40%), feeling sad/unhappy (n = 66, 28%), issues with their partners (n = 52, 22%), and shortness of breath (n = 36, 15%).
When comparing before and after lung cancer diagnosis, marked differences were noted in decreased sexual desire/interest (15% vs 31%, P < .001) and vaginal pain/discomfort (13% vs 43%, P < .001). Of the 127 participants who had sexual activity in the past 30 days, 75 (59%) reported significant issues with vaginal dryness, and 63 (26%) reported vaginal pain/discomfort during sexual activity.
“Sexual dysfunction is prevalent in women with lung cancer, and we need to remember that sexual health is related to quality of life,” said Dr. Florez. “Sexual health should be integrated into thoracic oncology and further research is necessary to develop tailored interventions for patients with lung cancer. Patients whose sexual health is addressed have better quality of life, better pain control, and better relationships with their partners and their health-care team.”
