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Sexual Health of Colorectal Cancer Patients—a Systematic Review

  • Review Article
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Indian Journal of Surgery Aims and scope Submit manuscript

Abstract

A systematic review of the sexual dysfunction following surgery for colorectal cancer, hitherto less described, was conducted. This review looks at the pathophysiology, diagnosis, and treatment including palliative care of sexual dysfunction after colorectal cancer surgery. Peer-reviewed, English-language articles in PubMed, CINAHL, PsycINFO, and MEDLINE using keywords like “sexual health in cancer / colorectal cancer patients” and “sexual health in cancer patients in India” were used. A total of 55 articles were finally screened and 19 studies including 6778 patients were eventually included in this review, most of these being cross-sectional, longitudinal studies, or systematic reviews. Data pertaining to the Indian subset was limited (Shankar et al., APJCP 18(5): 1177, 2017). All studies showed that colorectal cancer patients’ sexual satisfaction and frequency of sexual intercourse decreased significantly. Indices of quality of life and sexual functioning need to be included as an important outcome in studies from India. Re-enforcing preoperative discussions between the physician and the patient, post-operative assessment, and treatment of sexual dysfunction after colorectal cancer surgery should be emphasized.

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Author information

Authors and Affiliations

  1. Terna Medical College, Terna Medical College and Hospital, Navi Mumbai, India

    Aishwarya Chokshi

  2. Department of General Surgery, Terna Medical College and Hospital, Nerul West, Navi Mumbai, 400706, Maharashtra, India

    Dnyanesh M. Belekar

  3. Terna Dental College, Terna Dental College and Hospital, Navi Mumbai, India

    Shikha Chokshi

Authors
  1. Aishwarya Chokshi
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  2. Dnyanesh M. Belekar
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  3. Shikha Chokshi
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Contributions

Aishwarya Chokshi: concepts, design, literature search, manuscript preparation, manuscript editing, manuscript review, guarantor.

Dnyanesh M. Belekar: manuscript review and manuscript editing.

Shikha Chokshi: design, literature search, manuscript preparation.

Corresponding author

Correspondence to Aishwarya Chokshi.

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The Terna Medical College Research Ethics Committee has confirmed that no ethical approval is required.

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The authors declare no competing interests.

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Supplementary file1 (DOCX 11 KB)

Appendix

Appendix

Measurements used:

 

a) Sociodemographic and medical information

Sociodemographic questionnaire referred to

A) Race

B) Gender

C) Age at diagnosis

D) Age at first consult

E) Past Medical history (physical–pre-existing urological problems and psychological-pre-existing depression, anxiety)

F) Family history–physical and psychological diseases

G) Sexual history–past or current STDs

H) Marital status and quality of the current marriage

I) Disease site–colon, rectum, anal

J) Histopathological type of the tumor

K) Kind of treatment received—surgery, chemotherapy, and/or radiation

L) Follow-up treatment received

b) European Organization for Research and Treatment of Cancer (EORTC) Core Quality of Life Questionnaire (QLQ-C30) and Colorectal Cancer-Specific Module (QLQ-CR38)

The QLQ-C30 is a 30-item self-report measure that assesses multiple QOL domains pertaining to last 1 week. The QLQ-CR38 is a supplement to the QLQ-C30 with 38 additional items specific to colorectal cancer. Higher scores represent better outcomes with respect to body image and global health status, but indicate greater symptomatology (worse outcomes) for the symptom subscales. The body image subscale asks participants to rate if they have been feeling physically less attractive, less feminine, and dissatisfied with their bodies as a result of cancer

c) Female Sexual Functioning Index (FSFI)

It is a 19-item scale with six subscales: desire, arousal, lubrication, orgasm, satisfaction, and pain/discomfort. Items refer to the past 4 weeks and responses are on 5- or 6-point Likert scales. Higher scores indicate better sexual function in all FSFI domains and the total score ranges from 2 to 36

Sr no

Questionnaire:

1

Importance of sexual health in Indian patients–

Sexuality is pretty much an untouched, unspoken-about topic in India; most patients are not aware of their sexual desires and the rest do not consider it important; Hence, to check for awareness

2

Impact of treatment on Sexual Function–

changes seen after treatment as compared to before (psychological and physical)—emotional connect, physical contact (e.g., holding hands, cuddling), frequency of sex, intimacy, quality, orgasm

3

Sexual distress–

whether present and the extent

4

Changes in males

5

Changes in females

6

Sexual dysfunction–

present and extent

7

Body image distress–

whether present and the extent

8

Effect on social integration–

how it has affected their relationship with their partners, family members, and the society

9

Depressive symptoms–

whether present and severity

10

Effect on overall quality of life

11

Willingness of the patients to discuss the issue –

with healthcare workers and family members

  1. VAS, Vaginal Assessment Scale; VuAS, Vulvar Assessment Scale.

Vaginal Assessment Scale (VAS) / Vaginal Assessment Scale (VAS)

None

Mild

Moderate

Severe

Dryness

    

Soreness

    

Irritation

    

Pain

    

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Chokshi, A., Belekar, D.M. & Chokshi, S. Sexual Health of Colorectal Cancer Patients—a Systematic Review. Indian J Surg 85, 5–15 (2023). https://doi.org/10.1007/s12262-022-03377-5

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  • DOI: https://doi.org/10.1007/s12262-022-03377-5

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