Sexual Dysfunction Poses Significant Issue for Women With Lung Cancer

Due to the high rate at which sexual dysfunction occurs in women with lung cancer, sexual health should be considered as part of an integrated thoracic oncology care strategy, according to Narjust Florez, MD, who presented findings from the SHAWL study at the 2022 World Conference on Lung Cancer.

Florez, a medical oncologist and associate director of the Cancer Equity Program at Dana-Farber Cancer Institute, indicated that 77% of female patients with lung cancer surveyed (n = 239) reported having moderate to severe sexual dysfunction. A total of 49% of patients hadn’t previously experienced sexual health issues prior to diagnosis. The most common symptoms of sexual dysfunction were vaginal dryness (34%), decreased sexual desire or interest (15%), and vaginal pain or discomfort with sexual activity (13%).

“What this means is that women’s sexual dysfunction is affecting their daily life,” Florez explained. “They often think about the lack of sexual activity on a daily basis. [I want to remind my colleagues] that sexual health and sexuality and intimacy are not only about penetrative intercourse. This [also includes] most forms of [physical] intimacy.”

Rationale for the study included that upwards of 95% of patients with lung cancer score below the 50th percentile in terms of sexual function. Moreover, sexual dysfunction appeared to persist rather than improve over time and has been associated with worse symptom distress and decreased functional status.

Most findings regarding sexual function for patients with lung cancer were generated prior to FDA approvals for targeted therapies and immunotherapeutics. As this aspect of care is often underreported, it is also understudied. The study’s goal was to examine the frequency of sexual dysfunction in women diagnosed with lung cancer through self-reported, validated online questionnaire.

SHAWL is an observational, cross-sectional international study that was conducted together with the GO2 Foundation for Lung Cancer in addition to the Lung Cancer Registry. The trial included a total of 249 patients with an average age of 59.6 years (range, 29-84). Most patients were non-Hispanic White (88%) and had been diagnosed with non–small cell lung cancer with adenocarcinoma histology (81%). Additionally, 45% of patients were receiving treatment with targeted therapeutics.

“We had the honor of working with a multidisciplinary team that included a certified sexuality counselor, OB/GYN, members of the GO2 Foundation, as well as 2 excellent patient advocates that review every patient case on the protocol including the level of support knowledge.”

Within the previous 30 days, in a population of 127 patients, 59% reported having vaginal dryness and 26% reported vaginal pain/discomfort during sexual activity. Differences were observed prior to and following lung cancer diagnosis for decreased sexual desire and interest (15% vs 31%; P <.001) and vaginal pain/discomfort (13% vs 43%; P <.001). Factors that frequently affected sex satisfaction included fatigue (40%), feeling sad or unhappy (28%), partner issues (22%), and shortness of breath (15%).

“The results are sobering,” she emphasized. “It's a question that should have been asked many years ago.”

Reference

Florez N, Acharya R, Wei Z, et al. Sexual Health Assessment in Women with Lung Cancer (SHAWL) study. Presented at the 2022 World Conference on Lung Cancer; August 6-9, 2022; Vienna, Austria; abstract MA14.04.