Sexuality in patients with advanced cancer: a prospective study in a population admitted to an acute pain relief and palliative care unit

Abstract

The aim of this study was to characterize sexuality attitudes and feelings in a larger sample of patients with advanced cancer in comparison with their previous status before diagnosis. Of the 100 patients randomized, 65 patients answered to all the questions included in the questionnaire. Of these 65, 25 patients were male and 40 were female, with a mean Karnofsky of 58 (range 40-70) and a mean well-being sensation of 5.67 (range 2-10). In all, 60% of patients did not feel to be less attractive after disease, 30% of patients a little, and only 10% very much. Most patients (86.4%) considered important to talk about sexuality and to face such an issue with skilled people. About half of the patients (47%) reported that sexuality was very important for psychological well-being. Only 7.6% of patients had a good sexual intercourse, 15.2% had a light activity, 39.4% had an insufficient activity, and 37.8% did not have any activity. A significant relationship was observed with age (0.002), Karfnosky status (P = .024), and well-being (P = .004). Only 12.1% of patients had a good sexual satisfaction, 12.1% experienced a mild satisfaction, 30.3% had insufficient satisfaction, and 45.5% had no sexual satisfaction. The difference was significant (P < .001). A significant relationship was observed with age (.047), Karfnosky status (P = .001), and well-being (P = .009). Only 3% of patients had a good frequency, 7.6% had a mild frequency, 37.9% had a limited frequency, and 51.5% had no sexual intercourses (P = .01). Emotional aspects maintained a relevant role in sexuality, as in 50% of patients these aspects were very important and for 12.1% important. Despite sexual activities decreased after the development of cancer, most patients considered important to talk about sexuality and to face such an issue with some experienced operators. Moreover, some patients were still able to maintain a sufficient sexual activity, in terms of quality and quantity. The emotional aspects had a relevant role in sexuality, possibly as a surrogate of impeded physical activity. The data gathered from this survey reveal how much sexuality continues to be present even though in different formality (satisfaction during the relationships) and different times (frequency of the relationships) in the life of the patients with advanced cancer.