Sexual Function in Males After Radiotherapy for Rectal Cancer
Received 11 March 2009; received in revised form 11 March 2009; accepted 12 March 2009. published online 02 November 2009.
Purpose
Knowledge of sexual problems after pre- or postoperative radiotherapy (RT) with 50 Gy for rectal cancer is limited. In this study, we aimed to compare self-rated sexual functioning in irradiated (RT+) and nonirradiated (RT-) male patients at least 2 years after surgery for rectal cancer.
Methods and Materials
Patients diagnosed with rectal cancer from 1993 to 2003 were identified from the Norwegian Rectal Cancer Registry. Male patients without recurrence at the time of the study. The International Index of Erectile Function, a self-rated instrument, was used to assess sexual functioning, and serum levels of serum testosterone were measured.
Results
Questionnaires were returned from 241 patients a median of 4.5 years after surgery. The median age was 67 years at survey. RT+ patients (n = 108) had significantly poorer scores for erectile function, orgasmic function, intercourse satisfaction, and overall satisfaction with sex life compared with RT– patients (n = 133). In multiple age-adjusted analysis, the odds ratio for moderate–severe erectile dysfunction in RT+ patients was 7.3 compared with RT– patients (p <0.001). Furthermore, erectile dysfunction of this degree was associated with low serum testosterone (p = 0.01).
Conclusion
RT for rectal cancer is associated with significant long-term effects on sexual function in males.
∗Oslo University Hospital, Ullevål Cancer Centre, Oslo, Norway
†Oslo University Hospital, Department of Clinical Cancer Research, the Norwegian Radium Hospital, Oslo, Norway
‡Faculty of Medicine, University of Oslo, Oslo, Norway
§School of Pharmacy, University of Oslo, Oslo, Norway
¶The University Hospital of Northern Norway, Tromsø, Norway
‖Oslo University Hospital, Department of Gastrointestinal Surgery, Ullevål, Oslo, Norway
Reprint requests to: Kjersti Bruheim, MD, Oslo University Hospital, Ullevål Cancer Centre, 0407 Oslo, Norway. Tel: (+47) 23-02-66-00; Fax: (+47) 23-02-66-01
This work was supported by a research grant from the South Eastern Norway Health Authority and with support from the Norwegian Colorectal Registry and the Norwegian Cancer Registry.
ABSTRACT