麻豆传媒

VIENNA -- A total of 77% of women with lung cancer surveyed reported moderate to severe sexual dysfunction, according to results of the SHAWL study presented at the World Conference on Lung Cancer here.

Of the 127 participants who noted sexual activity in the previous 30 days, 75 (59%) reported significant issues with vaginal dryness, and 63 (26%) reported vaginal pain or discomfort during sexual activity, said Narjust Florez (Duma), MD, of Dana-Farber Cancer Institute and Harvard Medical School in Boston.

In addition, she said, marked differences were noted before and after participants' lung cancer diagnosis in decreased sexual desire/interest (15% vs 31%, P<0.001) and vaginal pain/discomfort (13% vs 43%, P<0.001).

The most common reasons given that negatively affected participants' satisfaction with their sex life ("very much" to "somewhat") included the following, Florez said:

• Fatigue: 95 patients (40%)

• Feeling sad/unhappy: 66 patients (28%)

• Issues with partner: 52 patients (22%)

• Shortness of breath: 36 patients (15%)

The take-home message is that sexual dysfunction is prevalent in women with lung cancer, that sexual health should be integrated into thoracic oncology care -- "now, not tomorrow" -- and that further research is necessary to develop tailored interventions for patients with lung cancer, Florez said.

She noted that previous research looking at sexual health had focused mainly on male patients and that most of the data about sexual dysfunction in patients with lung cancer preceded the approval of targeted therapy and immune checkpoint inhibitors.

For the SHAWL (Sexual Health Assessment in Women with Lung Cancer) study, Florez and colleagues surveyed 249 women with lung cancer to assess the prevalence of sexual dysfunction. The researchers administered the online questionnaire in collaboration with the GO2 Foundation for Lung Cancer and Lung Cancer Registry.

The average age of respondents was 59.6 (range of 29 to 84) and 88% were non-Hispanic white adults. Most participants (81%) had a diagnosis of non-small cell lung cancer-adenocarcinoma and 45% were currently receiving targeted therapy.

Prior to their lung cancer diagnosis, about half (49%) of respondents reported having no sexual health issues. After diagnosis, 77% reported moderate to severe sexual dysfunction.

Speaking at a press conference at the meeting, Florez called the results "sobering," showing that "sexual dysfunction is affecting patients' daily life ... They think about lack of sexual activity on a daily basis."

She noted that sexuality is not only about penetrative intercourse but also includes self-stimulation and masturbation, kissing, cuddling, and other forms of intimacy.

"We had many comments about post-coital bleeding that was often not discussed with their oncologist or primary team," Florez said. "If you look at other studies of sexual health, shortness of breath is on the bottom, but in lung cancer it really matters. Interventions are needed that can help our patients have intimacy while dealing with limited lung capacity."

Florez said her lab is developing multidisciplinary tailored interventions for patients with lung cancer that will attempt to address shortness of breath by teaching patients sexual positions to use when lung capacity is limited.

Discussing the results at the meeting, Karin Dieckmann, MD, of Medical University of Vienna, called the study interesting and important. "We have more women who get lung cancer and these patients have a longer survival," she said, adding that she was surprised so little had been previously known about the topic.

Limitations included the study's U.S.-based sample and cross-sectional design, Florez acknowledged. In addition, the study lacked follow-up, she said.

Dieckmann also noted that data were missing about stage of disease, local treatment, and when during the course of the disease the survey was completed. Despite that, "the study should be the basis of interdisciplinary collaboration between patients, psychologists, and oncologists to optimize quality of life and to give advice to the patient and her partner," she said.

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