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Sexual Wellbeing and Supportive Care Needs After Cancer in a Multiethnic Asian Setting: A Qualitative Study

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Abstract

The physical and emotional impact of cancer and its treatment may be detrimental to the sexual well-being of patients. We aimed to gain an in-depth insight on the impact of cancer on the sexual wellbeing of cancer patients living in a middle-income setting with limited supportive care services. Twenty focus group discussions, stratified by gender, were conducted among 102 patients with breast, cervical, colorectal, or prostate cancer. Participants were recruited from five hospitals in Klang Valley, Malaysia. Discussions were audio recorded and transcribed verbatim. Thematic analysis was performed using NVivo. Three major themes emerged: loss, adjustments, and unmet supportive care needs. Under the main theme of loss, changes in physical appearances and childbearing abilities negatively impacted participants’ self-confidence and body image, particularly in the females. Changes in quality of sexual activity were commonly raised, which often brought about conflicts and marital strains. Various methods to cope with the changes were described, including reprioritization of sex, using sexual aids, employing other forms of intimacy, and reframing sex as an obligation. Participants further voiced the unmet need for professional counselling services to enable honest communication between patients and their partners, and also sexual healthcare services, which were all deemed as paramount to address their sexual issues. In the low- and middle-income countries, provision of sexual healthcare services including counselling and clinical management of sexual dysfunction should not be overlooked as an important component of supportive cancer care.

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Availability of Data and Materials

The data that support the findings of this study are available from the corresponding author upon reasonable request.

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Funding

This study was supported through an unrestricted educational grant from PhAMA (Pharmaceutical Association of Malaysia). The funders had no role in the design of the study, data collection and analysis, preparation of the manuscript, or decision to publish.

Author information

Authors and Affiliations

  1. Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, 50603 , Lembah Pantai, Kuala Lumpur, Malaysia

    Wai-Chee Kuan, Yek-Ching Kong, Li-Ping Wong & Nirmala Bhoo-Pathy

  2. Department of Radiotherapy and Oncology, Kuala Lumpur Hospital, 50586, Kuala Lumpur, Malaysia

    Ros Suzanna Bustamam

  3. Department of Obstetrics and Gynecology, Faculty of Medicine, Universiti Malaya, 50603, Kuala Lumpur, Malaysia

    Yin-Ling Woo

  4. Department of Surgery, Faculty of Medicine, Universiti Malaya, 50603, Kuala Lumpur, Malaysia

    Nur Aishah Taib

  5. Department of Clinical Oncology, Faculty of Medicine, Universiti Malaya, 50603, Kuala Lumpur, Malaysia

    Gwo-Fuang Ho

  6. Department of Radiotherapy and Oncology, National Cancer Institute, 62250, Putrajaya, Malaysia

    Hafizah Zaharah

  7. Subang Jaya Medical Centre, 47500, Subang Jaya, Malaysia

    Cheng-Har Yip

Authors
  1. Wai-Chee Kuan
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  2. Yek-Ching Kong
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  3. Ros Suzanna Bustamam
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  4. Li-Ping Wong
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  7. Gwo-Fuang Ho
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  8. Hafizah Zaharah
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  10. Nirmala Bhoo-Pathy
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Contributions

W-CK: Formal analysis, data interpretation, and writing—review and editing. Y-CK: Conceptualization, data curation, formal analysis, data interpretation, and writing—review and editing. RSB: Data curation, and writing—review and editing. L-PW: Data interpretation, and writing—review and editing. Y-LW: Data curation, and writing—review and editing. NAT: Data curation, and writing—review and editing. G-FH: Data curation, and writing—review and editing. C-HY: Data curation, and writing—review and editing. NB-P: Conceptualization, funding acquisition, formal analysis, data interpretation, and writing—review and editing.

Corresponding author

Correspondence to Nirmala Bhoo-Pathy.

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Conflict of interest

The authors declare no competing conflicts.

Consent to Participate

Written informed consent was obtained from all participants prior to the focus group discussion.

Consent for Publication

Written informed consent was obtained from all participants prior to the focus group discussion.

Ethics Approval

Ethical approval for the study was obtained from the Medical Research Ethics Committee (NMRR-17-3361-39122), University Malaya Medical Research Ethics Committee (201831-6061) and Ramsay Sime Darby Health Care Independent Ethics Committee (201809.2).

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Kuan, WC., Kong, YC., Bustamam, R.S. et al. Sexual Wellbeing and Supportive Care Needs After Cancer in a Multiethnic Asian Setting: A Qualitative Study. Sex Disabil 41, 17–30 (2023). https://doi.org/10.1007/s11195-022-09772-w

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  • DOI: https://doi.org/10.1007/s11195-022-09772-w

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