While research into immunotherapy and other targeted therapies attract a lot of attention during the World Conference on Lung Cancer each year, the final day of WCLC 2022 in Vienna, Austria, was a reminder that lung cancer is a complex disease that has a far-reaching impact on patients.
On Tuesday, August 9, investigators presented survey data (abstract 1324) from the Sexual Health Assessment in Women with Lung Cancer (SHAWL) Study. Reported by Narjust Florez, MD, sexual dysfunction is highly prevalent in women with lung cancer, with most survey participants reporting little to no interest in sexual activity.
“The results are sobering,” said Dr. Florez, associate director of the Cancer Care Equity Program and assistant professor of medicine at the Dana Farber Cancer Institute and Harvard Medicine, Boston. “These are questions that should have been asked many years ago.”
Of the 249 women who completed the survey, 183 (77%) reported little to no interest in sexual activity, and 159 (67%) said they rarely or never wanted to have sexual activity. The most common factors that negatively affected participants’ satisfaction with their sex lives included fatigue (95 women, or 40% of study participants), feeling sad/unhappy (66, 28%), issues with their partners (52, 22%), and shortness of breath (36, 15%).
Out of the 127 study participants who had sexual activity in the past 30 days, 75 (59%) reported significant issues with vaginal dryness and 63 (26%) reported vaginal pain or discomfort during sexual activity. When comparing sex before and after lung cancer diagnosis, marked differences were noted in sexual desire and interest and vaginal pain and discomfort.
“Sexual health should be integrated into thoracic oncology care, and further research is necessary to develop tailored interventions for patients with lung cancer,” said Dr. Florez, co-founder of LatinasInMed and founder of the Florez Labs, as well as a host of the IASLC podcast Lung Cancer Considered.
The SHAWL Study was a cross-sectional, IRB-approved, global survey study administered via the GO2 Foundation Lung Cancer Registry. The study utilized the Patient-Reported Outcomes Measurement Information System (PROMIS®) Sexual Function and Satisfaction Measures (a validated questionnaire) to evaluate sexual health. Study participants were recruited between June 2020 to June 2021.
Study participants were older than 18 years of age, self-identified as a woman, had fluency in English, and had a lung cancer diagnosis. Participants were asked about sexual activity pre-lung cancer diagnosis and over the “past 30 days” prior to completing the survey.
Of the 249 women who completed the survey, most (64%) had stage IV lung cancer and 107 (45%) were receiving targeted therapy, with 93 of those (87%) taking medication for more than six months. At the time of survey completion, 78 participants (33%) were taking antidepressants and 34 (14%) were taking beta blockers. Within the prior 30 days, 127 (53%) participants had sexual activity with themselves or someone else.
Dr. Florez said discussing or treating sexual health issues can be difficult for patients because there is stigma attached, particularly for older women. Providers need to be aware of the issue and broach it with their patients. As Dr. Florez said: “It needs to be addressed to improve our patients’ quality of life.”
