Article

The Longitudinal Effects of Cancer Treatment on Sexuality in Individuals With Lung Cancer

Judith A. Shell

Marsha Carolan

Ying Zhang

Karen Meneses

long-term, sexual health, lung cancer
ONF 2008, 35(1), 73-79. DOI: 10.1188/08.ONF.73-79

Purpose/Objectives: To examine changes in sexual functioning during treatment for lung cancer and the extent to which age, gender, social support, and mood status affect sexual dysfunction.

Design: Prospective, exploratory.

Setting: Outpatient cancer clinic.

Sample: 59 of 84 eligible patients diagnosed with small cell or non-small cell lung cancer.

Methods: The Derogatis Interview for Sexual Function, Self-Report, to measure sexual functioning; the Social Provisions Scale to measure social support; and the Derogatis Affects Balance Scale to measure mood status were administered at diagnosis and at two and four months during treatment.

Main Research Variables: Level of sexual function, treatment, age, gender, social support, and mood status.

Findings: Results indicate a decrease in sexual function but no significant change in sexual function between the two treatment groups. Age was a significant factor affecting sexual function. Gender significantly affected sexual function at time 2 only. Between times 1 and 2, mood status had a significant relationship with sexual function. Social support did not affect sexual function directly; social support was found to significantly affect mood status.

Conclusions: Most patients reported below-normal sexual function at baseline. Sexual function worsened over time. Further research is warranted to examine time, place, and type of intervention needed.

Implications for Nursing: New data encourage assessment, intervention, and research related to the sexual function of patients with lung cancer.

Jump to a section

    References

    Alfonso, C.A., Cohen, M.A., Levin, M., Simon, K., Abraham, N., & Metropolitan Hospital Center Psycho-Oncology Study Group. (1997). Sexual dysfunction in cancer patients: A collaborative psycho- oncology project. International Journal of Mental Health, 26(1), 90-98.
    American Cancer Society. (2007). Cancer facts and figures 2007. Atlanta, GA: Author.
    Andersen, B., & Elliot, M. (1994). Female cancer survivors: Appreciating their sexual concerns. Canadian Journal of Human Sexuality, 3, 107-122.
    Anderson, B. (1996). Predicting and treating the sexual difficulties of gynecologic cancer survivors. Cancer Control, 3(2), 113-119.
    Auchincloss, S. (1991). Sexual dysfunction after cancer treatment. Journal of Psychosocial Oncology, 9(1), 23-47.
    Baron, R.S., Cutrona, C.E., Hicklin, D., Russell, D.W., & Lubaroff, D.M. (1990). Social support and immune function among spouses of cancer patients. Journal of Personality and Social Psychology, 59(2), 344-352.
    Bernhard, J., & Ganz, P. (1991a). Psychosocial issues in lung cancer patients (Part 1). Chest, 99(1), 216-223.
    Bernhard, J., & Ganz, P. (1991b). Psychosocial issues in lung cancer patients (Part 2). Chest, 99(2), 480-485.
    Burbie, G.E., & Polinsky, M.L. (1992). Intimacy and sexuality after cancer treatment: Restoring a sense of wholeness. Journal of Psychosocial Oncology, 10(1), 19-33.
    Carpenter, J.S., Elam, J.L., Ridner, S.H., Carney, P.H., Cherry, G.J., & Cucullu, H.L. (2004). Sleep, fatigue, and depressive symptoms in breast cancer survivors and matched healthy women experiencing hot flashes. Oncology Nursing Forum, 31(3), 591-598.
    Catania, J.A., Gibson, D.R., Chitwood, D.D., & Coates, T.J. (1990). Methodological problems in AIDS behavioral research: Influences on measurement error and participation bias in studies of sexual behavior. Psychological Bulletin, 108(3), 339-362.
    Cella, D.F., Orofiamma, B., Holland, J.C., Silberfarb, P.M., Tross, S., Feldstein, M., et al. (1987). The relationship of psychological distress, extent of disease, and performance status in patients with lung cancer. Cancer, 60(7), 1661-1667.
    Cutrona, C.E. (1989). Ratings of social support by adolescents and adult informants: Degree of correspondence and prediction of depressive symptoms. Journal of Personality and Social Psychology, 57(4), 723-730.
    Cutrona, C.E., Cole, V., Colangelo, N., Assouline, S.G., & Russell, D.W. (1994). Perceived parental social support and academic achievement: An attachment theory perspective. Journal of Personality and Social Psychology, 66(2), 369-378.
    Cutrona, C.E., & Russell, D. (1987). The provisions of social relationships and adaptation to stress. In W.H. Jones & D. Periman (Eds.), Advances in personal relationships (vol. 1, pp. 37-67). Greenwich, CT: JAI Press.
    Derogatis, L.R. (1975). The Affects Balance Scale. Baltimore: Clinical Psychometric Research.
    Derogatis, L.R. (1987). Derogatis Interview for Sexual Functioning (DISF/DISF-SR). Riderwood, MD: Clinical Psychometric Research.
    Derogatis, L.R. (1996). Derogatis Affects Balance Scale: Administration, scoring, and procedures manual. Riverwood, MD: Clinical Psychometric Research.
    Derogatis, L.R. (1997). The Derogatis Interview for Sexual Functioning (DISF/DISF-SR): An introductory report. Journal of Sex and Marital Therapy, 23(4), 291-304.
    Fransson, P., & Widmark, A. (1996). Self-assessed sexual function after pelvic irradiation for prostate carcinoma: Comparison with an age-matched control group. Cancer, 78(5), 1066-1078.
    Ganz, P.A., Greendale, G.A., Petersen, L., Zibecchi, L., Kahn, B., & Belin, T.R. (2000). Managing menopausal symptoms in breast cancer survivors: Results of a randomized controlled trial. Journal of the National Cancer Institute, 92(13), 1054-1064.
    Ganz, P.A., Rowland, J.H., Desmond, K., Meyerowitz, B.E., & Wyatt, G.E. (1998). Life after breast cancer: Understanding women's health-related quality of life and sexual functioning. Journal of Clinical Oncology, 16(2), 501-514.
    Ginsburg, M.L., Quirt, C., Ginsburg, A.D., & MacKillop, W.J. (1995). Psychiatric illness and psychosocial concerns of patients with newly diagnosed lung cancer. Canadian Medical Association Journal, 152(5), 701-708.
    Iwamoto, R. (2001). Radiation therapy. In S. Otto (Ed.), Oncology nursing (4th ed., pp. 606-637). St. Louis, MO: Mosby.
    Klemm, P.R. (1994). Variables influencing psychosocial adjustment in lung cancer: A preliminary study. Oncology Nursing Forum, 21(6), 1059-1062.
    Lamb, M.A. (1995). Effects of cancer on the sexuality and fertility of women. Seminars in Oncology Nursing, 11(2), 120-127.
    Meyerowitz, B.E., Desmond, K.A., Rowland, J.H., Wyatt, G.E., & Ganz, P.A. (1999). Sexuality following breast cancer. Journal of Sex and Marital Therapy, 25(3), 237-250.
    Northouse, L., Dorris, G., & Charron-Moore, C. (1995). Factors affecting couples adjustment to recurrent breast cancer. Social Science Medicine, 41(1), 69-76.
    Quinn, M., Fontanna, A.F., & Reznikoff, M. (1987). Psychological distress in reaction to lung cancer as a function of spousal support and coping strategy. Journal of Psychosocial Oncology, 4(4), 79-90.
    Rieker, P.P. (1996). How should a man with testicular cancer be counseled and what information is available to him? Seminars in Urologic Oncology, 14(1), 17-23.
    Russell, D.W., & Cutrona, C.E. (1984). The provisions of social relationships and adaptation to stress. Paper presented at the annual meeting of the American Psychological Association, Anaheim, CA.
    Russell, D.W., & Cutrona, C.E. (1991). Social support, stress, and depressive symptoms among the elderly: Test of a process model. Psychology and Aging, 6(2), 190-201.
    Ryan, L.S. (1996). Psychosocial issues and lung cancer: A behavioral approach. Seminars in Oncology Nursing, 12(4), 318-323.
    Sarna, L. (1993a). Correlates of symptom distress in women with lung cancer. Cancer Practice, 1(1), 21-28.
    Sarna, L. (1993b). Women with lung cancer: Impact on quality of life. Quality of Life Research, 2(1), 13-22.
    Schag, C.A., Ganz, P.A., Wing, D.S., Sim, M.S., & Lee, J.J. (1994). Quality of life in adult survivors of lung, colon, and prostate cancer. Quality of Life Research, 3(2), 127-141.
    Schover, L.R., & Jensen, S.B. (1988). Sexuality and chronic illness: A comprehensive approach. New York: Guilford Press.
    Schover, L.R., Montague, D.K., & Lakin, M.M. (1997). Sexual problems. In V.T. DeVita, S. Hellman, & S.A. Rosenberg (Eds.), Cancer: Principles and practices of oncology (5th ed., pp. 2857-2871). Philadelphia: Lippincott-Raven.
    Schover, L.R., Montague, D.K., & Schain, W.S. (1993). Psychologic aspects of patients with cancer: Sexual problems of patients with cancer. In V.T. DeVita, S. Hellman, & S.A. Rosenberg (Eds.), Cancer: Principles and practices of oncology (4th ed., pp. 2464-2480). Philadelphia: Lippincott Williams and Wilkins.
    Schover, L.R., Yetman, R.J., Tuason, L.J., Meisler, E., Esselstyn, C.B., Herman, R.E., et al. (1995). Partial mastectomy and breast reconstruction. A comparison of their effects on psychosocial adjustment, body image, and sexuality. Cancer, 75(1), 54-64.
    Schwartz, S., & Plawecki, H.M. (2002). Consequences of chemotherapy on the sexuality of patients with lung cancer. Clinical Journal of Oncology Nursing, 6(4), 212-216.
    Shell, J., & Campbell-Norris, C. (2006). Body image disturbance. In R.M. Carroll-Johnson, L.M. Gorman, & N.J. Bush (Eds.), Psychosocial nursing care along the cancer continuum (2nd ed., pp. 183-196). Pittsburgh, PA: Oncology Nursing Society.
    Siston, A.K., & List, M.A. (1997). Sexual functioning and head and neck cancer. Journal of Psychosocial Oncology, 15(3/4), 107-122.
    Smith, N., & Reilly, G. (1994). Sexuality and body image: The challenges facing male and female cancer patients. Canadian Journal of Human Sexuality, 3, 145-149.
    Stanford, J.L., Feng, Z., Hamilton, A.S., Gilliland, F.D., Stephenson, R.A., Eley, J.W., et al. (2000). Urinary and sexual function after radical prostatectomy for clinically localized prostate cancer: The Prostate Cancer Outcomes study. JAMA, 283(3), 354-360.
    Susman, E. (2001, September). Recognizing female sexual dysfunction as a complication of chemotherapy. Oncology Times, 23(9), 27-28.
    Thaler-DeMers, D. (2001). Intimacy issues: Sexuality, fertility, and relationships. Seminars in Oncology Nursing, 17(4), 255-262.
    Wilmoth, M.C. (2006). Life after cancer: What does sexuality have to do with it? Oncology Nursing Forum, 33(5), 905-910.
    Young-McCaughan, S. (1996). Sexual functioning in women with breast cancer after treatment with adjuvant therapy. Cancer Nursing, 19(4), 308-319.