Psychosexual development and satisfaction in long-term survivors of childhood cancer: Neurotoxic treatment intensity as a risk indicator.
Risk factors for impairment in psychosexual development and satisfaction among adult survivors of childhood cancer are poorly understood. The authors compared psychosexual outcomes between survivors and healthy controls, and tested whether at-risk survivors can be identified by 1) treatment neurotoxicity or 2) diagnosis.



A total of 144 young adult survivors of childhood cancer and 144 matched controls completed questionnaires regarding psychosexual development, sexual satisfaction, and satisfaction with relationship status. Survivors were aged 20 to 40 years and were 5 to 34 years after diagnosis. Using medical chart data, survivors were divided into non-neurotoxic (48 survivors), low-dose (36 survivors), and high-dose (58 survivors) neurotoxic treatment groups.



Apart from having fewer lifetime sex partners, survivors did not appear to differ from controls. However, survivors of brain tumors and any survivor who received high-dose neurotoxic treatment reported the lowest rates of achieving milestones of psychosexual development, whereas sexual and relationship status satisfaction were found to be related to relationship status. Neurotoxic treatment intensity further distinguished between survivors of brain tumors with and without psychosexual impairment.



The intensity of neurotoxic treatment may be a valuable indicator of risk for psychosexual impairment relative to diagnosis alone. Health care providers should assess romantic/sexual problems among survivors at risk and make referrals if needed. Cancer 2017;123:1869-1876. © 2017 American Cancer Society.
Center for Biobehavioral Health, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio.|Department of Pediatrics, The Ohio State University, Columbus, Ohio.
Vicky
V
Lehmann
Healthy Psychology Research Section, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
Marrit A
MA
Tuinman
Center for Biobehavioral Health, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio.
Madelaine C
MC
Keim
Center for Biobehavioral Health, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio.
Adrien M
AM
Winning
Hematology/Oncology & BMT, Nationwide Children's Hospital, Columbus, Ohio.
Randal S
RS
Olshefski
Hematology/Oncology & BMT, Nationwide Children's Hospital, Columbus, Ohio.
Rajinder P S
RPS
Bajwa
Healthy Psychology Research Section, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
Mariët
M
Hagedoorn
Center for Biobehavioral Health, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio.|Department of Pediatrics, The Ohio State University, Columbus, Ohio.
Cynthia A
CA
Gerhardt
D000328:Adult; D000970:Antineoplastic Agents / Q000009:adverse effects; D001932:Brain Neoplasms / Q000628:therapy; D016022:Case-Control Studies; D016371:Cranial Irradiation / Q000009:adverse effects; D003561:Cytarabine / Q000009:adverse effects; D005260:Female; D006801:Humans; D007278:Injections, Spinal; D007938:Leukemia / Q000628:therapy; D008223:Lymphoma / Q000628:therapy; D008297:Male; D008727:Methotrexate / Q000009:adverse effects; D009369:Neoplasms / Q000628:therapy*; D020258:Neurotoxicity Syndromes / Q000453:epidemiology* / Q000209:etiology; D009948:Orgasm; D010549:Personal Satisfaction; D011606:Psychosexual Development; D060728:Reproductive Health; D012307:Risk Factors; D012747:Sexual Partners; D011795:Surveys and Questionnaires; D017741:Survivors; D013852:Thiotepa / Q000009:adverse effects; D055815:Young Adult
D000970:Antineoplastic Agents; D003561:Cytarabine; D013852:Thiotepa; D008727:Methotrexate
childhood cancer; long-term survivors; neurotoxicity; psychosexual development; sexual satisfaction