Quality of life and menopausal and sexual symptoms in gynecologic cancer survivors: a cohort study

Abstract

Objectives: The aims of this study were to investigate the frequency of menopausal and sexual symptoms and the proportion of sexually active women and to assess and identify quality of life (QOL) predictors in gynecologic cancer survivors.

Methods: A prospective case series following a cohort of women under radiation therapy was conducted, including 107 women (aged 21-75 y) with gynecologic cancer (cervical or endometrial cancer) who underwent pelvic radiotherapy in the Radiotherapy Division of the Women's Integral Healthcare Center at the Universidade Estadual de Campinas. Adverse effects of radiotherapy were evaluated using the Common Terminology Criteria Adverse Event Scale. QOL was measured using the abbreviated version of the World Health Organization's Quality of Life instrument before radiotherapy (T0) and at 4 months (T1), 1 year (T2), and 3 years (T3) after radiotherapy. QOL scores were assessed over time using the Wilcoxon signed-rank test. Multiple linear regression analysis was used to identify QOL predictors.

Results: A decrease in the frequency of vaginal dryness (26.7% in T0 vs 8.3% in T3; P < 0.01) and an increase in the proportion of sexually active women (21.5% in T0 vs 44.2% in T3; P < 0.01) were observed. A significant increase in QOL scores was observed in the psychological domain and general health and overall QOL. Dyspareunia negatively affected the physical (P < 0.01), psychological (P < 0.01), and social relationship domains (P < 0.01); overall QOL (P = 0.01); and general health (P = 0.04). Family income was positively related to environment domain (P < 0.01), overall QOL (P = 0.04), and general health (P < 0.01).

Conclusions: Data derived from this study indicated that gynecologic cancer survivors had a lower frequency of vaginal dryness and a higher proportion of these women were sexually active 3 years after completion of radiotherapy. Furthermore, QOL improved and dyspareunia negatively affected various QOL dimensions.