Sexual health among cancer patients on active chemotherapy: A cross-sectional study from tertiary care cancer center in India.
Authors: Chaudhary Aman , Sharma Atul , Gogia Ajay , Malik Prabhat Singh , Batra Atul , kumar akash , Khurana Sachin , Pramanik Raja 
Published: June 2023

e24224 Background: Cancer and its treatment lead to the deterioration of the sexual health of patients which has been highlighted in many studies. Sexual dysfunction has a great impact on the overall quality of life of patients. In this study, we aimed to evaluate the overall sexual health of patients on active chemotherapy and their knowledge and attitude toward sexual health. Methods: A cross-sectional survey was carried out at a tertiary care center in India, patients were eligible if they had received at least two cycles of cytotoxic chemotherapy, were aged 18 to 65 years, had ECOG PS of < = 2, and were able to read either English or Hindi. The sexual health of patients was assessed using the EORTC SHQ C22 questionnaire. We used a self-designed questionnaire to assess the knowledge and attitude of patients. Results: A total of 211 patients were enrolled, the median age was 44 years (22-65), and male to female ratio was 1:1. Breast cancer patients represented around 35% of all the patients followed by carcinoma lung (15.6%) and gastrointestinal malignancies (14.2%). Around 52% patients had metastatic disease. Close to 46 % of patients received more than 4 cycles of planned chemotherapy. Overall the mean sexual satisfaction score was 40.2 ± 22.35 (on a scale of 0-100). The mean score for the importance given to sexual activity was 48.49 ± 32.55. Among the symptom scale fatigue was the most bothersome to patients undergoing chemotherapy with a mean score of 52.92 ± 38.56 and they were least concerned about pain during intercourse with a mean score of 23.22 ± 26.83. There was poor communication between patients and healthcare workers on this issue with the mean satisfaction score of communication with professionals being 9.79 ± 26.4. Male patients gave more importance to sexual activity compared to females (55.97 ± 33.66 versus 40.95 ± 29.69, p = 0.0004) and females experienced more pain during sexual intercourse (27.93 ± 28.41 versus 18.55 ± 24.42, p = 0.0059). Younger patients (age < = 40 years) were more satisfied with their sexual life (45.16 ± 23.95 versus 37.24 ± 20.85, p = 0.0274) and gave more importance to sexual activity (56.66 ± 32.43 versus s 43.51 ± 31.72, p = 0.0023) Patient with ECOG PS 2 felt more insecure regarding their ability to satisfy their partner sexually compared to ECOG PS1 patients (61.33 ± 40.6 versus 76.19 ± 32.15, p = 0.0040). Only 73 % of the patients thought that cancer patients can have sexual intercourse. 27 % of participants were of the belief that their partners can get cancer if they have intercourse with them. Overall 88% of patients had a positive attitude toward a discussion on sexual health. Conclusions: To the best of our knowledge this is the first Indian study that has evaluated the sexual health of patients who are on active chemotherapy. There is a great impact chemotherapy has on the sexual health of cancer patients despite this there is barely a discussion between patients and healthcare workers.