Sexual function outcomes in prostate and cervical cancer patients treated with radiotherapy in sub-Saharan Africa: A cross-sectional study

TL;DR

This study found high rates of sexual dysfunction in prostate and cervical cancer patients after radiotherapy in sub-Saharan Africa, affecting quality of life.

Contribution

The study provides the first detailed assessment of sexual function outcomes in pelvic cancer patients treated with radiotherapy in sub-Saharan Africa.

Findings

Most female participants experienced poor lubrication, orgasm, and sexual satisfaction after cervical cancer radiotherapy.

Prostate cancer patients showed severe erectile dysfunction and low sexual desire following radiotherapy.

Sexual dysfunction was common across both cancer types, leading to low relationship satisfaction and avoidance of sexual activity.

Abstract

Radiotherapy is indispensable for the successful treatment of many pelvic malignancies, but it is often associated with significant adverse effects on sexual function, including vaginal stenosis, decreased lubrication, erectile dysfunction, and loss of libido. Sexuality and sexual function are important aspects of quality of life for cancer survivors, yet sexual dysfunction remains an underreported complication among patients, particularly those treated for prostate and cervical cancers in limited-resource settings. This quantitative cross-sectional study aimed to evaluate sexual function outcomes among 144 prostate and 160 cervical cancer patients treated with pelvic radiotherapy at a major cancer treatment centre in sub-Saharan Africa. Data were collected using questionnaires based on the Female Sexual Function Index and the International Index of Erectile Function. Data were coded, cleaned, and analyzed using STATA statistical software package (version 17). The mean age of the patients with cervical cancer was 53.5 years (SD 9.6) ranging from 37 to 69 years whereas the mean age of patients with prostate cancer was 67.1 years (SD 7.7) ranging from 56 to 79 years. Among female participants, 79.9%, had moderate to severe sexual dissatisfaction, 94.4% had poor or no satisfactory orgasm whereas 97.2% had difficulty with lubrication. Only 5.6%, 5.6%, 2.8%, and 20.1% of the female participants achieved sexual desire, orgasm, lubrication, and overall satisfaction respectively. In all, 94.4% of the female participants had a total FSFI score less than 26 whereas 5.6% had a score greater than 26. Most patients did not indulge in sexual activity. There was a high prevalence of sexual dysfunction across multiple domains, with cervical cancer patients experiencing diminished desire, poor arousal, lubrication difficulties, and impaired orgasmic function, leading to low relationship satisfaction and avoidance of sexual activity. Similarly, prostate cancer patients demonstrated severe erectile dysfunction, low sexual desire, and dissatisfaction with intercourse and overall sexual experience.

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