Kofi Adesi Kyei

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

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.

The sexuality of women with cervical cancer undergoing definitive radiotherapy in Ghana

The purpose of this study was to assess the sexuality of cervical cancer patients undergoing radiotherapy at a major cancer treatment center in Ghana. This is an area of interest as globally; cervical cancer kills approximately 342,000 people per annum with an estimated number of 604,000 new cases in 2020. Acknowledging the World Health Organization's definition of sexual health as a state of physical, mental and social well-being in relation to sexuality, this paper sheds light on how these dimensions affect the quality of life of cervical cancer patients. This was a longitudinal study, which assessed the impact of radiotherapy on the sexuality of both premenopausal and postmenopausal cervical cancer patients presenting for primary treatment with chemoradiation from April to July, 2021 at a major cancer treatment centre in Ghana. The Female Sexual Function Index and Body Image Scale questionnaires were respectively used to evaluate the sexual functions scores among the cervical cancer patients, and to assess the impact of the treatment on their body image. MATLAB software was used for data analysis. Most of the cervical cancer patients sampled were postmenopausal (57 %). About 79 % premenopausal and 96 % postmenopausal cervical cancer patients were sexually inactive during radiotherapy (day 15). Also, 48 % premenopausal and 24 % postmenopausal patients were very dissatisfied with their bodies at the onset of treatment. The frequency of orgasm in cervical cancer patients declined after treatment causing a deterioration in their sexual function. The patients' sexuality was influenced by age and menopausal status. The decreased sexual desire of the patients resulted in emotional distancing from their partners, which invariably induced changes in their partners' level of sexual interest. This study established significant differences between premenopausal and postmenopausal cervical cancer patients who were generally very dissatisfied with their sexual relationships with their partners on day 1 (p = 0.02) and on day 15 (p = 0.00) of treatment. The majority of patients who presented for treatment for cervical cancer in this study were postmenopausal. Their interest in sexual activity was more influenced by their menopausal status than their antineoplastic treatment. This study indicates that cervical cancer patients are more likely to develop sexual health problems which could substantially worsen over the course of their treatment and beyond. The study will contribute within the oncology team by assisting personnel in putting in place measures that will guide the treatment of cervical cancer patients and improve quality of care.