title: Sexual dysfunction and infertility as late effects of cancer treatment.
abstract: Sexual dysfunction is a common consequence of cancer treatment, affecting at least half of men and women treated for pelvic malignancies and over a quarter of people with other types of cancer. Problems are usually linked to damage to nerves, blood vessels, and hormones that underlie normal sexual function. Sexual dysfunction also may be associated with depression, anxiety, relationship conflict, and loss of self-esteem. Innovations in cancer treatment such as robotic surgery or more targeted radiation therapy have not had the anticipated result of reducing sexual dysfunction. Some new and effective cancer treatments, including aromatase inhibitors for breast cancer or chemoradiation for anal cancer also have very severe sexual morbidity. Cancer-related infertility is an issue for younger patients, who comprise a much smaller percentage of total cancer survivors. However, the long-term emotional impact of being unable to have a child after cancer can be extremely distressing. Advances in knowledge about how cancer treatments may damage fertility, as well as newer techniques to preserve fertility, offer hope to patients who have not completed their childbearing at cancer diagnosis. Unfortunately, surveys in industrialised nations confirm that many cancer patients are still not informed about potential changes to their sexual function or fertility, and all modalities of fertility preservation remain underutilised. After cancer treatment, many patients continue to have unmet needs for information about restoring sexual function or becoming a parent. Although more research is needed on optimal clinical practice, current studies suggest a multidisciplinary approach, including both medical and psychosocial treatment options.
authors.affiliation: Department of Behavioral Science, Unit 1330, University of Texas MD Anderson Cancer Center, PO Box 301439, Houston, TX 77230-1439, USA.
authors.forename: Leslie R
authors.initials: LR
authors.lastname: Schover
authors.affiliation: Department of Internal Medicine, ZH 4A 35, VU University Medical Centre, PO Box 7057, 1007 MB Amsterdam, The Netherlands.
authors.forename: Marleen
authors.initials: M
authors.lastname: van der Kaaij
authors.affiliation: Department of Reproductive Medicine and Gynaecological Oncology, University Medical Center Utrecht, PO Box 85500, 3508 GA Utrecht, The Netherlands.
authors.forename: Eleonora
authors.initials: E
authors.lastname: van Dorst
authors.affiliation: Department of Clinical Oncology, Leiden University Medical Center, K1-P, Albinusdreef 2, 2333 ZA Leiden, The Netherlands.
authors.forename: Carien
authors.initials: C
authors.lastname: Creutzberg
authors.affiliation: Service d'Urologie et d'Andrologie, Hopital Rangueil, 1, avenue Jean Poulhes, TSA 50032, 31059 Toulouse Cedex 9, France.
authors.forename: Eric
authors.initials: E
authors.lastname: Huyghe
authors.affiliation: National Advisory Unit on Late Effects after Cancer Treatment, Department of Oncology, Oslo University Hospital, Oslo, Norway.
authors.forename: Cecilie E
authors.initials: CE
authors.lastname: Kiserud
keywords: Fertility preservation; Late effects; Oncofertility; Oncology; Sexual dysfunction; Sexuality