Women treated with radiation therapy for stage I cervical cancer have worse long-term sexual function than women treated with surgery, according to a study published in the Journal of Clinical Oncology .
The American Cancer Society estimates that there will be 10,370 new cases of cervical cancer in the U.S. in 2005 and roughly 3,710 deaths from the disease. However, the number of deaths resulting from cervical cancer had declined; this is credited to widespread use of a screening test called the Pap smear. Currently, over half of patients with cervical cancer are diagnosed when the cancer is still confined to the cervix (stage I).
Stage I cervical cancer is often treated with surgery (hysterectomy with lymph node dissection) or radiation therapy.
In order to evaluate the long-term effects of each of these treatments on quality of life and sexual function, researchers conducted a study among 37 women treated with surgery, 37 women treated with radiation therapy, and 40 women without cancer. The women without cancer were matched to the women with cancer by age and race. At least five years after cancer treatment, women were interviewed regarding quality of life and sexual functioning. The sexual functioning score incorporated information about sexual desire, ability to become aroused, vaginal lubrication, ability to reach orgasm, sexual satisfaction, and pain with intercourse.
Treatment with radiation therapy was associated with worse long-term sexual function:
- There was no difference between the radiation therapy group and the surgery group in level of sexual desire, but other measures of sexual function and the overall sexual function score were worse in women who had been treated with radiation therapy.
- Other factors that influenced sexual function were marital status (married women reported better sexual functioning) and menopausal symptom score (menopausal symptoms were associated with worse sexual functioning).
- The difference in sexual function between the radiation therapy group and the surgery group persisted even after accounting for tumor size, histology, and grade.
- There was no significant different in sexual functioning between the women treated with surgery and the women without cancer.
The researchers conclude that stage I cervical cancer patients who are treated with radiation therapy have more problems with sexual function than women treated with hysterectomy and lymph node dissection. Women treated with hysterectomy can expect to have long-term levels of sexual function that are similar to women who have not had cancer.
Reference: Frumovitz M, Sun CC, Schover LR et al. Quality of Life and Sexual Functioning in Cervical Cancer Survivors. Journal of Clinical Oncology. 2005;23:7428-7436.