If I am in the mood, I enjoy it: an exploration of cancer-related fatigue and sexual functioning in women with breast cancer

Abstract

Background: We recently reported that cancer-related fatigue (CRF) after adjuvant breast cancer therapy was prevalent and disabling, but largely self-limiting within 12 months. The current paper describes sexual functioning (SF) and its relationship to CRF, mood disorder, and quality of life (QOL) over the first year after completion of adjuvant therapy.

Methods: Women were recruited after surgery, but prior to commencing adjuvant treatment, for early-stage breast cancer. Self-reported validated questionnaires assessed SF, CRF, mood, menopausal symptoms, disability, and QOL at baseline, completion of therapy, and at 6 months and 12 months after treatment.

Results: Of the 218 participants, 92 (42%) completed the SF measure (mean age, 50 years). They were significantly younger, more likely to be partnered, and less likely to be postmenopausal than nonresponders. At baseline, 40% reported problems with sexual interest and 60% reported problems with physical sexual function. SF scores declined across all domains at the end of treatment, then improved but remained below baseline at 12 months, with a significant temporal effect in the physical SF subscale and a trend for overall satisfaction. There were significant correlations between the SF and QOL domains (physical and emotional health, social functioning, and general health) as well as overall QOL. The presence of mood disorder, but not fatigue, demographic, or treatment variables, independently predicted worse overall sexual satisfaction.

Conclusions: Sexual dysfunction is common after breast cancer therapy and impacts QOL. Interventions should include identification and treatment of concomitant mood disorder.

Figure 1.

CAncer Rehabilitation Evaluation System (CARES) sexual domain scores over time. Higher scores indicate greater dysfunction.

Figure 2.

Trends in fatigue (SOMA) and mood (PSYCH) scores over time. Higher scores indicate more severe problems

Figure 3.

Trends in SF-36 quality of life domains over time. Higher scores indicate better function. Abbreviations: BP, bodily pain; GH, general health; PF, physical function; RE, role limitation due to emotional problems; RP, role limitation due to physical health; SF, social functioning; SF-36, short-form 36.