Treatment for Men With Germ-Cell Tumours Affects Long-Term Sexual Functioning:: Presented at ASCO-GU

By Matt Silver

SAN FRANCISCO -- February 13, 2018 -- Impairment in sexual functioning is a significant issue for men who are long-term survivors of germ-cell tumours, and treatment with chemotherapy and/or radiotherapy demonstrates the highest effect on the quality of patients’ sex life, according to results of a pilot study presented here on February 9 at the 2018 Genitourinary Cancers Symposium.

Michal Chovanec, MD, PhD, Comenius University, National Cancer Institute, Bratislava, Slovakia, and colleagues prospectively examined the link between treatment and long-term sexual functioning in 155 male survivors of germ-cell tumours. Patients completed a sexual-function questionnaire at a median 10 years of follow up post-treatment from a national cancer centre. Seventeen survivors (11%) had had orchiectomy alone (control subjects), while 138 (89%) survivors had received a cisplatin-based chemotherapy, radiotherapy to the retroperitoneal lymph nodes, or both.

The investigators found that survivors treated with chemotherapy and/or radiotherapy had difficulty maintaining erection during intercourse compared with control subjects (both P = .04). Patients who had received chemotherapy and/or radiotherapy also reported difficulty in achieving orgasm during intercourse (P = .04) and were more disappointed with their overall quality of sex life (P = .002).

The active and control groups reported no differences in sexual desire or in the number of attempts to initiate sexual intercourse in the last month. Survivors from all treatment groups reported no or only mild anxiety resulting from sexual relationships.

Dr. Chovanec noted that one surprising finding of the study was that that older men with the longest follow-up reported similar satisfaction with their sex life as the youngest men in the cohort, while men aged between these 2 groups had the highest number of complaints.

“We can only speculate about the real implications,” Dr. Chovanec said. “These are pilot data that need to be further investigated.”

The investigators particularly noted that treatment of patients for cancer does not end with a cancer cure. “We should not take the curative treatment of our patients as our final act as clinicians,” Dr. Chovanec stressed. “Surviving cancer is a complex medical problem that entails a series of possible diseases and psycho-social issues resulting from the curative cancer treatment. It should be the responsibility of the treating oncologist to help identify such chronic health issues, and to be the leading responsible clinician in the multidisciplinary management of these late toxicities.”

This study was chosen as a Merit Award winner for 2018.

The 2018 Genitourinary Cancers Symposium is cosponsored by the American Society of Clinical Oncology (ASCO), the American Society for Radiation Oncology (ASTRO), and the Society of Urologic Oncology (SUO).

[Presentation title: Long-term Sexual Functioning in Germ-cell Tumor Survivors. Abstract 549]

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